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Comment
. 2022 Feb 5;399(10324):518.
doi: 10.1016/S0140-6736(22)00187-8.

Depression and anxiety during COVID-19

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Comment

Depression and anxiety during COVID-19

Michael Daly et al. Lancet. .
No abstract available

Conflict of interest statement

We declare no competing interests.

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Review
. 2021 Mar 3;18(5):2470.
doi: 10.3390/ijerph18052470.

Impact of COVID-19 on Mental Health in Adolescents: A Systematic Review

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Review

Impact of COVID-19 on Mental Health in Adolescents: A Systematic Review

Elizabeth A K Jones et al. Int J Environ Res Public Health. .

Abstract

Due to lack of sufficient data on the psychological toll of the COVID-19 pandemic on adolescent mental health, this systematic analysis aims to evaluate the impact of the pandemic on adolescent mental health. This study follows the PRISMA guidelines for systematic reviews of 16 quantitative studies conducted in 2019-2021 with 40,076 participants. Globally, adolescents of varying backgrounds experience higher rates of anxiety, depression, and stress due to the pandemic. Secondly, adolescents also have a higher frequency of using alcohol and cannabis during the COVID-19 pandemic. However, social support, positive coping skills, home quarantining, and parent-child discussions seem to positively impact adolescent mental health during this period of crisis. Whether in the United States or abroad, the COVID-19 pandemic has impacted adolescent mental health. Therefore, it is important to seek and to use all of the available resources and therapies to help adolescents mediate the adjustments caused by the pandemic.

Keywords: 2019-ncov; COVID 19; adolescent; anxiety; coronavirus; cov-19; depression; mental disorder; mental health; mental illness; psychiatric illness; sars-cov-2; teenagers.

Conflict of interest statement

The authors declare no conflict of interest.

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Editorial
. 2020 Apr;37(4):302.
doi: 10.1002/da.23014.

EDITORIAL: COVID-19 and Anxiety and Depression in 2020

Editorial

EDITORIAL: COVID-19 and Anxiety and Depression in 2020

Murray B Stein. Depress Anxiety. 2020 Apr.
No abstract available

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Review
. 2021 Oct 26:9:707358.
doi: 10.3389/fpubh.2021.707358. eCollection 2021.

Mental Health Disorders in Nurses During the COVID-19 Pandemic: Implications and Coping Strategies

Affiliations
Review

Mental Health Disorders in Nurses During the COVID-19 Pandemic: Implications and Coping Strategies

Brittney Riedel et al. Front Public Health. .

Abstract

Nurses caring for patients who contract coronavirus disease 2019 (COVID-19) have experienced significant traumas in the form of increased workloads, negative patient outcomes, and less social support system access. Nurses should be provided with information regarding early detection, coping skills and treatment for anxiety, depression, post-traumatic stress syndrome (PTSS)/post-traumatic stress disorder (PTSD), and other mental health disorders. Early intervention is important as mental health disorders can cause dysfunction, internal suffering, and in the most extreme situations, lead to death if not properly cared for. Healthcare corporations should consider providing coverage for mental health treatment for employees who experience COVID-19 traumas. With the implementation of healthy coping skills and therapeutic intervention, nurses will be able to let go of the negative impacts that the COVID-19 pandemic has caused and reintegrate into their roles as caring and entrusted health care providers. The current paper evaluates the mental health disorders encountered by nurses in the COVID-19 era based on the current medical literature and aims to provide practical coping strategies.

Keywords: COVID-19; coping skills; health care providers; health care workers; mental health disorders; pandemic.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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. 2022 Nov 1;79(11):1081-1091.
doi: 10.1001/jamapsychiatry.2022.2640.

Associations of Depression, Anxiety, Worry, Perceived Stress, and Loneliness Prior to Infection With Risk of Post-COVID-19 Conditions

Affiliations

Associations of Depression, Anxiety, Worry, Perceived Stress, and Loneliness Prior to Infection With Risk of Post-COVID-19 Conditions

Siwen Wang et al. JAMA Psychiatry. .

Erratum in

  • Change to Open Access Status.
    [No authors listed] [No authors listed] JAMA Psychiatry. 2022 Nov 1;79(11):1141. doi: 10.1001/jamapsychiatry.2022.3336. JAMA Psychiatry. 2022. PMID: 36169981 Free PMC article. No abstract available.

Abstract

Importance: Few risk factors for long-lasting (≥4 weeks) COVID-19 symptoms have been identified.

Objective: To determine whether high levels of psychological distress before SARS-CoV-2 infection, characterized by depression, anxiety, worry, perceived stress, and loneliness, are prospectively associated with increased risk of developing post-COVID-19 conditions (sometimes called long COVID).

Design, setting, and participants: This prospective cohort study used data from 3 large ongoing, predominantly female cohorts: Nurses' Health Study II, Nurses' Health Study 3, and the Growing Up Today Study. Between April 2020 and November 2021, participants were followed up with periodic surveys. Participants were included if they reported no current or prior SARS-CoV-2 infection at the April 2020 baseline survey when distress was assessed and returned 1 or more follow-up questionnaires.

Exposures: Depression, anxiety, worry about COVID-19, perceived stress, and loneliness were measured at study baseline early in the pandemic, before SARS-CoV-2 infection, using validated questionnaires.

Main outcomes and measures: SARS-CoV-2 infection was self-reported during each of 6 monthly and then quarterly follow-up questionnaires. COVID-19-related symptoms lasting 4 weeks or longer and daily life impairment due to these symptoms were self-reported on the final questionnaire, 1 year after baseline.

Results: Of 54 960 participants, 38.0% (n = 20 902) were active health care workers, and 96.6% (n = 53 107) were female; the mean (SD) age was 57.5 (13.8) years. Six percent (3193 participants) reported a positive SARS-CoV-2 test result during follow-up (1-47 weeks after baseline). Among these, probable depression (risk ratio [RR], 1.32; 95% CI = 1.12-1.55), probable anxiety (RR = 1.42; 95% CI, 1.23-1.65), worry about COVID-19 (RR, 1.37; 95% CI, 1.17-1.61), perceived stress (highest vs lowest quartile: RR, 1.46; 95% CI, 1.18-1.81), and loneliness (RR, 1.32; 95% CI, 1.08-1.61) were each associated with post-COVID-19 conditions (1403 cases) in generalized estimating equation models adjusted for sociodemographic factors, health behaviors, and comorbidities. Participants with 2 or more types of distress prior to infection were at nearly 50% increased risk for post-COVID-19 conditions (RR, 1.49; 95% CI, 1.23-1.80). All types of distress were associated with increased risk of daily life impairment (783 cases) among individuals with post-COVID-19 conditions (RR range, 1.15-1.51).

Conclusions and relevance: The findings of this study suggest that preinfection psychological distress may be a risk factor for post-COVID-19 conditions in individuals with SARS-CoV-2 infection. Future work should examine the biobehavioral mechanism linking psychological distress with persistent postinfection symptoms.

Conflict of interest statement

Conflict of Interest Disclosures: Dr Chavarro reported grants to his institution from the National Institutes of Health (NIH) during the conduct of the study and grants to his institution from the NIH, US Food and Drug Administration, and Centers for Disease Control and Prevention outside the submitted work. Dr Kubzansky reported grants from the NIH and support for data collection from the Lee Kum Sheung Center for Health and Happiness during the conduct of the study. Dr Koenen reported a Dean’s Acceleration Award internal grant from Harvard T.H. Chan School of Public Health during the conduct of the study. Dr Branch-Elliman reported being the site principal investigator for a COVID-19 therapeutics study funded by Gilead Sciences (funds provided to her institution) during the conduct of the study. No other disclosures were reported.

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Review
. 2022 Jul;36(7):681-702.
doi: 10.1007/s40263-022-00931-3. Epub 2022 Jun 21.

Post-COVID-19 Depressive Symptoms: Epidemiology, Pathophysiology, and Pharmacological Treatment

Affiliations
Review

Post-COVID-19 Depressive Symptoms: Epidemiology, Pathophysiology, and Pharmacological Treatment

Mario Gennaro Mazza et al. CNS Drugs. 2022 Jul.

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic is still spreading worldwide over 2 years since its outbreak. The psychopathological implications in COVID-19 survivors such as depression, anxiety, and cognitive impairments are now recognized as primary symptoms of the "post-acute COVID-19 syndrome." Depressive psychopathology was reported in around 35% of patients at short, medium, and long-term follow-up after the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. Post-COVID-19 depressive symptoms are known to increase fatigue and affect neurocognitive functioning, sleep, quality of life, and global functioning in COVID-19 survivors. The psychopathological mechanisms underlying post-COVID-19 depressive symptoms are mainly related to the inflammation triggered by the peripheral immune-inflammatory response to the viral infection and to the persistent psychological burden during and after infection. The large number of SARS-CoV-2-infected patients and the high prevalence of post-COVID-19 depressive symptoms may significantly increase the pool of people suffering from depressive disorders. Therefore, it is essential to screen, diagnose, treat, and monitor COVID-19 survivors' psychopathology to counteract the depression disease burden and related years of life lived with disability. This paper reviews the current literature in order to synthesize the available evidence regarding epidemiology, clinical features, neurobiological underpinning, and pharmacological treatment of post-COVID-19 depressive symptoms.

Conflict of interest statement

MGM, MP, SP, and FB declare that they have no conflicts of interest.

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Review
. 2020 Jun 23:9:636.
doi: 10.12688/f1000research.24457.1. eCollection 2020.

Epidemiology of mental health problems in COVID-19: a review

Affiliations
Review

Epidemiology of mental health problems in COVID-19: a review

Md Mahbub Hossain et al. F1000Res. .

Abstract

The novel coronavirus disease 2019 (COVID-19) has become a pandemic affecting health and wellbeing globally. In addition to the physical health, economic, and social implications, the psychological impacts of this pandemic are increasingly being reported in the scientific literature. This narrative review reflected on scholarly articles on the epidemiology of mental health problems in COVID-19. The current literature suggests that people affected by COVID-19 may have a high burden of mental health problems, including depression, anxiety disorders, stress, panic attack, irrational anger, impulsivity, somatization disorder, sleep disorders, emotional disturbance, posttraumatic stress symptoms, and suicidal behavior. Moreover, several factors associated with mental health problems in COVID-19 are found, which include age, gender, marital status, education, occupation, income, place of living, close contact with people with COVID-19, comorbid physical and mental health problems, exposure to COVID-19 related news and social media, coping styles, stigma, psychosocial support, health communication, confidence in health services, personal protective measures, risk of contracting COVID-19, and perceived likelihood of survival. Furthermore, the epidemiological distribution of mental health problems and associated factors were heterogeneous among the general public, COVID-19 patients, and healthcare providers. The current evidence suggests that a psychiatric epidemic is cooccurring with the COVID-19 pandemic, which necessitates the attention of the global health community. Future epidemiological studies should emphasize on psychopathological variations and temporality of mental health problems in different populations. Nonetheless, multipronged interventions should be developed and adopted to address the existing psychosocial challenges and promote mental health amid the COVID-19 pandemic.

Keywords: COVID-19; Coronavirus; Epidemiology; Mental Disorders; Mental Health; Review.

Conflict of interest statement

No competing interests were disclosed.

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Comment
. 2022 Feb 5;399(10324):518-519.
doi: 10.1016/S0140-6736(21)02800-2.

Depression and anxiety during COVID-19 - Authors' reply

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Comment

Depression and anxiety during COVID-19 - Authors' reply

Damian F Santomauro et al. Lancet. .
No abstract available

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. 2023 May 22;13(1):8257.
doi: 10.1038/s41598-023-33642-w.

Depression and anxiety during and after episodes of COVID-19 in the community

Affiliations

Depression and anxiety during and after episodes of COVID-19 in the community

Caterina Alacevich et al. Sci Rep. .

Abstract

Understanding the connection between physical and mental health with evidence-based research is important to inform and support targeted screening and early treatment. The objective of this study was to document the co-occurrence of physical and mental health conditions during and after the experience of symptomatic SARS-CoV-2 illness episodes. Drawing from a national symptoms' surveillance survey conducted in the UK in 2020, this study shows that individuals with symptomatic forms of SARS-CoV-2 (identified by anosmia with either fever, breathlessness or cough) presented significantly higher odds of experiencing moderate and severe anxiety (2.41, CI 2.01-2.90) and depression (3.64, CI 3.06-4.32). Respondents who recovered from physical SARS-CoV-2 symptoms also experienced higher odds of anxiety and depression in comparison to respondents who never experienced symptoms. The findings are robust to alternative estimation models that compare individuals with the same socioeconomic and demographic characteristics and who experienced the same local and contextual factors such as mobility and social restrictions. The findings have important implications for the screening and detection of mental health disorders in primary care settings. They also suggest the need to design and test interventions to address mental health during and after physical illness episodes.

Conflict of interest statement

The authors declare no competing interests. SdeL has received funding through his University for vaccine related research from AstraZeneca, GSK, Sanofi, Seqirus, MSD and Takeda. He has been a member of advisory boards for AstraZeneca, Sanofi and Seqirus.

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Review
. 2022 Dec:156:349-360.
doi: 10.1016/j.jpsychires.2022.10.045. Epub 2022 Oct 20.

Psychiatric and neurological complications of long COVID

Affiliations
Review

Psychiatric and neurological complications of long COVID

Jolanta B Zawilska et al. J Psychiatr Res. 2022 Dec.

Abstract

COVID-19 was primarily considered a pulmonary disease with extrapulmonary manifestations. As the pandemic spread, there has been growing evidence that the disease affects various organs/systems, including the central and peripheral nervous systems. Accumulation of clinical data demonstrates that in a large population of survivors impairments in the function of one or more organs may persist for a long time, a phenomenon commonly known as post COVID or long COVID. Fatigue and cognitive dysfunction, such as concentration problems, short-term memory deficits, general memory loss, a specific decline in attention, language and praxis abilities, encoding and verbal fluency, impairment of executive functions, and psychomotor coordination, are amongst the most common and debilitating features of neuropsychatric symptoms of post COVID syndrome. Several patients also suffer from compromised sleep, depression, anxiety and post-traumatic stress disorder. Patients with long COVID may demonstrate brain hypometabolism, hypoperfusion of the cerebral cortex and changes in the brain structure and functional connectivity. Children and adolescents represent a minority of COVID-19 cases, so not surprisingly data on the long-term sequelae after SARS-CoV-2 infections in these age groups are scarce. Although the pathogenesis, clinical characteristics, epidemiology, and risk factors of the acute phase of COVID-19 have been largely explained, these areas are yet to be explored in long COVID. This review aims to provide an update on what is currently known about long COVID effects on mental health.

Keywords: Anxiety; Cognitive deficits; Depression; Long COVID; Mental health; Post-traumatic stress disorder.

Conflict of interest statement

Declaration of competing interest The Authors declare no conflict of interest.

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. 2022 Jan 6;19(1):3.
doi: 10.1186/s12985-021-01729-3.

Mental health status of COVID-19 survivors: a cross sectional study

Affiliations

Mental health status of COVID-19 survivors: a cross sectional study

Munam Raza Jafri et al. Virol J. .

Abstract

Background: Coronavirus disease-19 (COVID-19) is a communicable disease caused by a virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Pandemics are associated with the high level of mental stress. In many countries, general people reported the high level of depression, anxiety, psychological distress, post-traumatic stress disorder during recent a pandemic. This study aims to investigate the mental health status of people who survived through this alarming situation of COVID-19.

Methods: In this study, seventy individuals (either gender) between the age of 18-60 years, who contracted COVID-19 previously and then recovered as indicated by negative PCR results, were included. Data was collected by using three tools: impact of event scale (IES-R), patient health questionnaire-9(PHQ-9) and corona anxiety scale (CAS). People with other systemic/mental disorders, ongoing malignancies, upper/lower motor disorders and inability to give consent were excluded from the study.

Results: Mean age of participants was 26.29 + 11.79. All the 70 responders suffered from COVID-19. Among these 23 (32.9%) were asymptomatic and 47(67.1%) had common symptoms related to COVID-19 53 (75.7%) responders also had symptoms post-recovery. Most of the people who suffered COVID-19 had mild depression. Twenty-nine participants (41.4%) reported the highest impact of this traumatic event on their mental health. After suffering from COVID-19, 74.3% reported no anxiety as measured through corona anxiety scale (CAS).

Conclusion: High level of post-traumatic stress was seen among participants who recovered from COVID-19, especially those patients who were symptomatic. Mild depression and anxiety were also noted among them.

Keywords: Anxiety; COVID-19; Depression; Pandemic; Stress.

Conflict of interest statement

The authors declare that they have no competing interests.

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. 2021 Jan 16;397(10270):220-232.
doi: 10.1016/S0140-6736(20)32656-8. Epub 2021 Jan 8.

6-month consequences of COVID-19 in patients discharged from hospital: a cohort study

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6-month consequences of COVID-19 in patients discharged from hospital: a cohort study

Chaolin Huang et al. Lancet. .

Retracted and republished in

Expression of concern in

Abstract

Background: The long-term health consequences of COVID-19 remain largely unclear. The aim of this study was to describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity.

Methods: We did an ambidirectional cohort study of patients with confirmed COVID-19 who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7, 2020, and May 29, 2020. Patients who died before follow-up, patients for whom follow-up would be difficult because of psychotic disorders, dementia, or re-admission to hospital, those who were unable to move freely due to concomitant osteoarthropathy or immobile before or after discharge due to diseases such as stroke or pulmonary embolism, those who declined to participate, those who could not be contacted, and those living outside of Wuhan or in nursing or welfare homes were all excluded. All patients were interviewed with a series of questionnaires for evaluation of symptoms and health-related quality of life, underwent physical examinations and a 6-min walking test, and received blood tests. A stratified sampling procedure was used to sample patients according to their highest seven-category scale during their hospital stay as 3, 4, and 5-6, to receive pulmonary function test, high resolution CT of the chest, and ultrasonography. Enrolled patients who had participated in the Lopinavir Trial for Suppression of SARS-CoV-2 in China received severe acute respiratory syndrome coronavirus 2 antibody tests. Multivariable adjusted linear or logistic regression models were used to evaluate the association between disease severity and long-term health consequences.

Findings: In total, 1733 of 2469 discharged patients with COVID-19 were enrolled after 736 were excluded. Patients had a median age of 57·0 (IQR 47·0-65·0) years and 897 (52%) were men. The follow-up study was done from June 16, to Sept 3, 2020, and the median follow-up time after symptom onset was 186·0 (175·0-199·0) days. Fatigue or muscle weakness (63%, 1038 of 1655) and sleep difficulties (26%, 437 of 1655) were the most common symptoms. Anxiety or depression was reported among 23% (367 of 1617) of patients. The proportions of median 6-min walking distance less than the lower limit of the normal range were 24% for those at severity scale 3, 22% for severity scale 4, and 29% for severity scale 5-6. The corresponding proportions of patients with diffusion impairment were 22% for severity scale 3, 29% for scale 4, and 56% for scale 5-6, and median CT scores were 3·0 (IQR 2·0-5·0) for severity scale 3, 4·0 (3·0-5·0) for scale 4, and 5·0 (4·0-6·0) for scale 5-6. After multivariable adjustment, patients showed an odds ratio (OR) 1·61 (95% CI 0·80-3·25) for scale 4 versus scale 3 and 4·60 (1·85-11·48) for scale 5-6 versus scale 3 for diffusion impairment; OR 0·88 (0·66-1·17) for scale 4 versus scale 3 and OR 1·77 (1·05-2·97) for scale 5-6 versus scale 3 for anxiety or depression, and OR 0·74 (0·58-0·96) for scale 4 versus scale 3 and 2·69 (1·46-4·96) for scale 5-6 versus scale 3 for fatigue or muscle weakness. Of 94 patients with blood antibodies tested at follow-up, the seropositivity (96·2% vs 58·5%) and median titres (19·0 vs 10·0) of the neutralising antibodies were significantly lower compared with at the acute phase. 107 of 822 participants without acute kidney injury and with estimated glomerular filtration rate (eGFR) 90 mL/min per 1·73 m2 or more at acute phase had eGFR less than 90 mL/min per 1·73 m2 at follow-up.

Interpretation: At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery.

Funding: National Natural Science Foundation of China, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, and Peking Union Medical College Foundation.

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. 2021 Dec;43(4):321-327.

Anxiety and Depression symptoms in Italian nurses during the Covid-19 pandemic

Affiliations
  • PMID: 35049155

Anxiety and Depression symptoms in Italian nurses during the Covid-19 pandemic

Elsa Vitale et al. G Ital Med Lav Ergon. 2021 Dec.

Abstract

Background and Aim. Starting from March 9, 2020, the Italian government has proclaimed a state of health emergency due to the epidemic, which later became a SARSCoV- 2 infection pandemic. The present study aimed to perform differences and any potential risk factors in anxious and depressive symptoms in Italian nurses during the Covid-19 pandemic according to selected sociodemographic variables. Methods. In November 2020 an "ad hoc" questionnaire was administered online to all Italian nurses. In the first part, a whole series of socio-demographic variables relating to the reference sample were collected, as: gender, the department to which participants belonged, if the respondent suffered from pulmonary or cardiovascular diseases, if the nurse lived alone or with other cohabitants and whether during the pandemic the participant contracted the SARS-CoV-2 infection or not. In the second part of the questionnaire, the Hospital Anxiety and Depression Scale was administered to quickly and easily assess the anxiety and depression levels among the Italian nurses during the Covid-19 pandemic. Results. 732 nurses agreed to participate to this survey. Among participants, 479 (65.3%) recorded an anxious symptomatology and 267 (6.4%) a depressive one. According to anxious symptoms, a significant difference was recorded between females and males (p min 0.001), as females recorded higher mild (24.04%), moderate (23.09%) and severe (13.39%) anxious symptom levels than males (Mild:1.50%; Moderate: 2.46%; Severe: 0.96%). By considering depressive symptoms according to socio demographic variables, only nurses without cardiovascular diseases recorded higher frequencies in mild (21.58%), moderate (8.47%) and severe (2.46%) depressive symptoms than nurses who suffered from a cardiovascular disease (Mild:2.05%; Moderate: 1.64%; Severe: 0.27%). Potential risk factors identified for anxious symptoms were: gender, both for mild (p min 0.001), moderate (p=.008) and severe (p=.003) anxious symptoms, and pulmonary diseases for severe anxious disorders (p=.014). Potential risk factors identified for the onset of depressive symptoms were: gender (p=.026), pulmonary diseases (p=.021), domestic partnership (p=.035), for mild symptoms; the presence of cardiac diseases (p=.006) for moderate symptoms. Conclusions. It urged to begin to further implement all forms of psychological support for nurses and further implementation of university nursing training programs that aim at both the technical and psychological management of the future professional to cope with maxi emergencies.

Contesto e obiettivo. A partire dal 9 marzo 2020, il governo italiano ha proclamato lo stato di emergenza sanitaria a causa dell’epidemia, che in seguito è diventata una pandemia di infezione da SARS-CoV-2. Il presente studio mirava a eseguire differenze ed eventuali fattori di rischio potenziali nei sintomi ansiosi e depressivi negli infermieri italiani durante la pandemia Covid-19 in base a variabili sociodemografiche selezionate. Metodi. Durante il mese di novembre 2020 è stato somministrato online un questionario “ad hoc” a tutti gli infermieri italiani. Nella prima parte sono state raccolte le variabili socio-demografiche relative al campione di riferimento, quali: sesso, reparto di appartenenza dei partecipanti, se l’intervistato soffriva di malattie polmonari o cardiovascolari, se viveva da solo o con altri conviventi e se durante la pandemia il partecipante ha contratto o meno l’infezione da SARS-CoV-2. Nella seconda parte del questionario, è stata somministrata la scala Hospital Anxiety and Depression Scale per valutare i livelli di ansia e di depressione tra gli infermieri italiani durante la pandemia Covid-19. Risultati. 732 infermieri hanno accettato di partecipare allo studio. Tra i partecipanti, 479 (65.3%) riportano una sintomatologia ansiosa e 267 (6.4%) una depressiva. In base ai sintomi ansiosi, è stata registrata una differenza significativa tra donne e uomini (p min 0.001), poiché le infermiere registrano livelli più elevati di sintomi ansiosi lievi (24.04%), moderati (23.09%) e gravi (13.39%) rispetto agli infermieri uomini (Lieve: 1.50%; Moderato: 2.46%; Grave: 0.96%). Considerando i sintomi depressivi in base alle variabili sociodemografiche, solo gli infermieri che non presentano malattie cardiovascolari registrano frequenze più elevate nei sintomi depressivi lievi (21.58%), moderati (8.47%) e gravi (2.46%) rispetto agli infermieri che affetti da una malattia cardiovascolare (Lieve: 2.05 %; Moderato: 1.64%; Grave: 0.27%). I potenziali fattori di rischio identificati per i sintomi ansiosi erano: sesso, sia per sintomi ansiosi lievi (p min 0.001), moderati (p=.008) e gravi (p=.003) e malattie polmonari per disturbi ansiosi gravi (p =. 014). I potenziali fattori di rischio identificati per l’insorgenza di sintomi depressivi sono stati: sesso (p=.026), malattie polmonari (p=.021), partnership domestica (p=.035), per sintomi lievi; la presenza di malattie cardiache (p=.006) per sintomi moderati. Conclusioni. Urge implementare ulteriormente tutte le forme di supporto psicologico per gli infermieri nonché l’ulteriore implementazione di programmi di formazione infermieristica universitaria che mirano alla gestione sia tecnica che psicologica del futuro professionista nel fronteggiare le maxi emergenze.

Keywords: Anxiety; Covid-19; Depression; Nurse.

Conflict of interest statement

The authors of this article have no conflict of interests to disclose.

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. 2021 Mar 12;16(3):e0247679.
doi: 10.1371/journal.pone.0247679. eCollection 2021.

Anxiety, depression, stress, fear and social support during COVID-19 pandemic among Jordanian healthcare workers

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Anxiety, depression, stress, fear and social support during COVID-19 pandemic among Jordanian healthcare workers

Eman Alnazly et al. PLoS One. .

Abstract

The emergence of Coronavirus disease 2019 (COVID-19) has affected health-care workers' psychological and mental health. Few studies have been conducted examining the psychological effect of COVID-19 on health-care worker psychological health in Jordan. Therefore, the present study aims to assess the respective levels of fear, anxiety, depression, stress, social support, and the associated factors, experienced by Jordanian health-care workers during the COVID-19 Pandemic. This study adopted a cross-sectional, correlational design to collect data from 365 health-care workers in Amman, Jordan, from August 16th to 23rd, 2020. Along with collecting sociodemographic characteristics, the Fear of COVID-19 Scale, the Depression, Anxiety, Stress Scale, and the Multidimensional Scale of Perceived Social Support electronically administered to participants. The majority of the participants (69.3%) were registered nurses. The mean overall score for the Fear of COVID-19 scale was 23.64 (SD + 6.85) which again exceeded the mid-point for the total score range (21), indicating elevated level fear of the COVID-19 pandemic. Participants had displayed extremely severe depression 40%, extremely severe anxiety 60%, and 35% severely distressed. Scores for depression (21.30 ± 10.86), anxiety (20.37 ± 10.80), stress (23.33 ± 10.87) were also high. Factors determined to be associated with psychological distress were being male, married, aged 40 years and older, and having more clinical experience. Assessment of social support indicated moderate-to-high levels of perceived support for all dimensions (significant other: 5.17 ± 1.28, family: 5.03 ± 1.30, friends: 5.05 ± 1.30). Weak significant correlations were found between social support and the other study variables (r < 0.22), indicating a weak association with fear, depression, anxiety, and stress, respectively. Overall, Jordanian health-care workers sample reported fear, depression, anxiety, and stress. The associated factors were being male, married, aged 40 years and older, and having more clinical experience. Regarding social support, participants primarily relied on support from their families, followed by support from friends.

Conflict of interest statement

The authors have declared that no competing interests exist.

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Review
. 2023 Feb;77(2):72-83.
doi: 10.1111/pcn.13481. Epub 2022 Oct 17.

Neurological post-acute sequelae of SARS-CoV-2 infection

Affiliations
Review

Neurological post-acute sequelae of SARS-CoV-2 infection

Masaki Takao et al. Psychiatry Clin Neurosci. 2023 Feb.

Abstract

The novel coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can have two phases: acute (generally 4 weeks after onset) and chronic (>4 weeks after onset). Both phases include a wide variety of signs and symptoms including neurological and psychiatric symptoms. The signs and symptoms that are considered sequelae of COVID-19 are termed post-COVID condition, long COVID-19, and post-acute sequelae of SARS-CoV-2 infection (PASC). PASC symptoms include fatigue, dyspnea, palpitation, dysosmia, subfever, hypertension, alopecia, sleep problems, loss of concentration, amnesia, numbness, pain, gastrointestinal symptoms, depression, and anxiety. Because the specific pathophysiology of PASC has not yet been clarified, there are no definite criteria of the condition, hence the World Health Organization's definition is quite broad. Consequently, it is difficult to correctly diagnose PASC. Approximately 50% of patients may show at least one PASC symptom up to 12 months after COVID-19 infection; however, the exact prevalence of PASC has not been determined. Despite extensive research in progress worldwide, there are currently no clear diagnostic methodologies or treatments for PASC. In this review, we discuss the currently available information on PASC and highlight the neurological sequelae of COVID-19 infection. Furthermore, we provide clinical suggestions for diagnosing and caring for patients with PASC based on our outpatient clinic experience.

Keywords: COVID-19; SARS-CoV-2; long COVID; neurological disorders; post-acute COVID-19 syndrome.

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. 2022 Aug 1;210(8):629-632.
doi: 10.1097/NMD.0000000000001513. Epub 2022 Mar 7.

Evaluation of Depression, Anxiety, and Sleep Quality in Children Diagnosed With COVID-19

Affiliations

Evaluation of Depression, Anxiety, and Sleep Quality in Children Diagnosed With COVID-19

Gülnihan Üstündağ et al. J Nerv Ment Dis. .

Abstract

COVID-19 has affected individuals of all age groups, both physically and mentally. We aimed to determine anxiety and depression in children diagnosed with COVID-19. Fifty children aged 8 to 18 years diagnosed with COVID-19 were included in the study. The children were evaluated the revised Child Anxiety and Depression Scale, STAI form TX-I (state anxiety inventory), and STAI form TX-II (trait anxiety inventory). Child Sleep Habits Questionnaire was applied for one of the parents according to three different periods. The periods were established as before the pandemic, during the illness-quarantine process, and after the quarantine. We observed the highest scores for depression-anxiety and the poorest sleep quality during the quarantine period. The scores for depression-anxiety were lower, and sleep quality scores were higher in the prepandemic period compared with after the quarantine period. Measures should be taken to protect mental health for children with COVID-19.

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Comment
. 2021 Nov 6;398(10312):1665-1666.
doi: 10.1016/S0140-6736(21)02221-2. Epub 2021 Oct 8.

Depression and anxiety disorders during the COVID-19 pandemic: knowns and unknowns

Affiliations
Comment

Depression and anxiety disorders during the COVID-19 pandemic: knowns and unknowns

Maxime Taquet et al. Lancet. .
No abstract available

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. 2021 Sep 1:292:270-275.
doi: 10.1016/j.jad.2021.05.121. Epub 2021 Jun 7.

COVID-19 dimensions are related to depression and anxiety among US college students: Findings from the Healthy Minds Survey 2020

Affiliations

COVID-19 dimensions are related to depression and anxiety among US college students: Findings from the Healthy Minds Survey 2020

Hans Oh et al. J Affect Disord. .

Abstract

Background: The COVID-19 pandemic has brought about tremendous social and economic turmoil, which has been associated with increased levels of depression and anxiety.

Methods: We analyzed data from the Healthy Minds Study (Fall Semester Cohort 2020), a non-probability sample of students across multiple colleges who completed an online survey between September - December 2020. Using multivariable logistic regression, we examined the associations between COVID-19 dimensions (concern, racial/ethnic discrimination, financial distress, infection, illness of loved one, death of loved one, caregiving) and mental health outcomes (depression, anxiety), adjusting for age, gender, race/ethnicity, and international student status.

Results: Nearly a fifth of the sample reported moderately severe or severe depression, and nearly a third reported moderately severe or severe anxiety over the past two weeks. When accounting for all COVID-19 dimensions in the same model, COVID-19 concern, racial/ethnic discrimination, financial distress, and infection were significantly associated with moderately severe or severe depression; COVID-19 concern, financial distress, and infection were significantly associated with moderately severe or severe anxiety.

Conclusions: This study showed that the COVID-19 pandemic may have shaped mental health through a range of potential social and environmental dimensions. Interventions are required that consider multiple dimensions of COVID-19 to improve mental health during and after the pandemic.

Keywords: Anxiety; Coronavirus; Covid-19; Depression; Pandemic.

Conflict of interest statement

None

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Review
. 2023 Feb;77(2):84-93.
doi: 10.1111/pcn.13508. Epub 2022 Dec 12.

Neuropsychiatric aspects of long COVID: A comprehensive review

Affiliations
Review

Neuropsychiatric aspects of long COVID: A comprehensive review

Takafumi Kubota et al. Psychiatry Clin Neurosci. 2023 Feb.

Abstract

Although some patients have persistent symptoms or develop new symptoms following coronavirus disease 2019 (COVID-19) infection, neuropsychiatric aspects of long COVID are not well known. This review summarizes and provides an update on the neuropsychiatric dimensions of long COVID. Its neuropsychiatric manifestations commonly include fatigue, cognitive impairment, sleep disorders, depression, anxiety, and post-traumatic stress disorder. There are no specific tests for long COVID, but some characteristic findings such as hypometabolism on positron emission tomography have been reported. The possible mechanisms of long COVID include inflammation, ischemic effects, direct viral invasion, and social and environmental changes. Some patient characteristics and the severity and complications of acute COVID-19 infection may be associated with an increased risk of neuropsychiatric symptoms. Long COVID may resolve spontaneously or persist, depending on the type of neuropsychiatric symptoms. Although established treatments are lacking, various psychological and pharmacological treatments have been attempted. Vaccination against COVID-19 infection plays a key role in the prevention of long coronavirus disease. With differences among the SARS-CoV-2 variants, including the omicron variant, the aspects of long COVID are likely to change in the future. Further studies clarifying the aspects of long COVID to develop effective treatments are warranted.

Keywords: COVID-19; long COVID; neurology; post COVID-19 condition; psychiatry.

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Comment
. 2020 Jul;99(7):953-954.
doi: 10.1111/aogs.13928. Epub 2020 Jun 13.

Anxiety and depression levels among pregnant women with COVID-19

Affiliations
Comment

Anxiety and depression levels among pregnant women with COVID-19

Phalguni Kotabagi et al. Acta Obstet Gynecol Scand. 2020 Jul.
No abstract available

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. 2023 Sep 19:11:1231326.
doi: 10.3389/fpubh.2023.1231326. eCollection 2023.

Depression, anxiety and stress among healthcare workers in the context of the COVID-19 pandemic: a cross-sectional study in a tertiary hospital in Northern Vietnam

Affiliations

Depression, anxiety and stress among healthcare workers in the context of the COVID-19 pandemic: a cross-sectional study in a tertiary hospital in Northern Vietnam

Hien Thu Pham et al. Front Public Health. .

Abstract

Introduction: The outbreak of coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) had significant effects on the mental well-being in general, particularly for healthcare professionals. This study examined the prevalence of depression, anxiety, and stress, and identified the associated risk factors amongst healthcare workers during the COVID-19 outbreak in a tertiary hospital located in Vietnam.

Methods: We conducted a cross-sectional study at a tertiary-level hospital, where the Depression Anxiety and Stress Scale 21 (DASS-21) web-based questionnaire was employed. We analyzed the determinant factors by employing multivariate logistic models.

Results: The prevalence of depression, anxiety, and stress symptoms were 19.2%, 24.7%, and 13.9%, respectively. Factors such as engaging in shift work during the pandemic, taking care of patients with COVID-19, and staff's health status were associated with mental health issues among health professionals. In addition, having alternate rest periods was likely to reduce the risk of stress.

Conclusion: The prevalence of mental health problems in healthcare workers during the COVID-19 pandemic was relatively high. Having resting periods could potentially mitigate the development of stress among health professionals. Our findings could be taken into account for improving mental health of the health professional population.

Keywords: COVID-19; DASS 21; Vietnam; anxiety; depression; healthcare workers; stress.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Review
. 2021 Mar 16;23(5):25.
doi: 10.1007/s11920-021-01237-9.

Neuropsychiatric Complications of COVID-19

Affiliations
Review

Neuropsychiatric Complications of COVID-19

Zev M Nakamura et al. Curr Psychiatry Rep. .

Abstract

Purpose of review: To describe the presentation, etiologies, and suggested management of post-acute COVID-19 neuropsychiatric symptoms.

Recent findings: Over 30% of patients hospitalized with COVID-19 may exhibit cognitive impairment, depression, and anxiety that persist for months after discharge. These symptoms are even more common in patients who required intensive care for severe effects of the virus. In addition to the pandemic-related psychological stress, multiple biological mechanisms have been proposed to understand the neuropsychiatric symptoms observed with COVID-19. Given limited research regarding effective interventions, we recommend pharmacologic and behavioral strategies with established evidence in other medically-ill populations. Long-term, neuropsychiatric complications of COVID-19 are common and consequential. Because these are likely to co-occur with other medical problems, patients recovering from COVID-19 are best managed in clinics with highly coordinated care across disciplines and medical specialties. Future research is needed to inform appropriate interventions.

Keywords: COVID-19; Mental health; Neurocognitive; Neuropsychiatric; Post-COVID-19; SARS-CoV-2.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

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Comment
. 2021 Sep:148:110567.
doi: 10.1016/j.jpsychores.2021.110567. Epub 2021 Jul 7.

Depression, anxiety, and insomnia symptoms among patients with COVID-19: It might be too soon for conclusions

Affiliations
Comment

Depression, anxiety, and insomnia symptoms among patients with COVID-19: It might be too soon for conclusions

Lucas Gonzaga et al. J Psychosom Res. 2021 Sep.
No abstract available

Keywords: Anxiety; COVID-19; Depression; Insomnia; Prevalence.

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. 2024 Dec 3:33:e74.
doi: 10.1017/S2045796024000763.

Persistence of anxiety and depression symptoms and their impact on the COVID-19 vaccine uptake

Affiliations

Persistence of anxiety and depression symptoms and their impact on the COVID-19 vaccine uptake

Yanhan Shen et al. Epidemiol Psychiatr Sci. .

Abstract

Aims: The enduring impact of the COVID-19 pandemic on mental health and its implications for COVID-19 vaccine uptake necessitate comprehensive investigation. We aimed to characterize the persistence of moderate to severe anxiety and depression symptoms from July 2020 to July 2023, explore demographic associations with symptom persistence, and assess how these symptoms affected COVID-19 vaccination uptake between May 2021 and July 2023.

Methods: Participants from the national community-based CHASING COVID Cohort were enrolled between March and June 2020 and completed quarterly follow-ups until December 2023. Scores ≥10 on the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaire 8-item at 14 follow-up assessments indicated moderate to severe anxiety and depression symptoms, respectively. Missing scores were imputed. Persistent anxiety and depression were defined as experiencing moderate to severe anxiety and depression symptoms ≥7 out of 14 follow-up assessments, respectively.

Results: Among 4,851 participants, 15.9% experienced persistent anxiety symptoms and 19.3% persistent depression symptoms from July 2020 to July 2023. Demographic factors associated with symptom persistence included younger age, female or non-binary gender, Hispanic ethnicity, lower education level, household income <$100k, presence of children <18 in the household, greater healthcare barriers and comorbidities. Participants with ongoing moderate to severe anxiety and depression symptoms had 0.95 (95% CI: 0.94, 0.97) and 0.95 (95% CI: 0.93, 0.96) times rates of receiving additional COVID-19 vaccine doses between May 2021 and July 2023, respectively.

Conclusions: Customized support for individuals with mental disorders may mitigate barriers to vaccine uptake. Further investigation is warranted to validate these findings and inform targeted interventions.

Keywords: COVID-19 vaccine; anxiety; depression; persistence; trajectories.

Conflict of interest statement

Author DN receives consulting fees from Gilead Sciences and AbbVie. All other authors have no conflicts of interest, financial or otherwise.

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Multicenter Study
. 2022 Jul 29;19(15):9273.
doi: 10.3390/ijerph19159273.

Psychometric Properties of the Hospital Anxiety and Depression Scale (HADS) in Previously Hospitalized COVID-19 Patients

Affiliations
Multicenter Study

Psychometric Properties of the Hospital Anxiety and Depression Scale (HADS) in Previously Hospitalized COVID-19 Patients

César Fernández-de-Las-Peñas et al. Int J Environ Res Public Health. .

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is associated with psychological/emotional disturbances. This study aimed to assess internal consistency, reliability, and construct validity of the Hospital Anxiety and Depressive Scale (HADS), as a patient-reported outcome measure (PROM) for evaluating emotional consequences of SARS-CoV-2 in hospitalized COVID-19 survivors with long COVID. The LONG-COVID-EXP-CM is a multicenter cohort study including patients hospitalized by COVID-19 during the first wave of the pandemic in five hospitals in Madrid. A total of 1969 (age: 61 ± 16 years, 46.5% women) COVID-19 survivors experiencing post-COVID symptoms a mean of 8.4 ± 1.5 months after hospital discharge completed HADS. Internal consistency (Cronbach α), reliability (item-internal consistency, item-discriminant validity), construct validity (confirmatory factor analysis), and floor effect and ceiling effect were calculated. The mean time for fulfilling HADS was 65 ± 12 s. A ceiling effect ranging from 1.99% to 13.74% and a floor effect ranging from 43.05% to 77.77% was observed. Based on the item-scale correlation coefficients, the Cronbach's alpha values reflecting the internal consistency reliability were 0.890 for the anxiety scale (HADS-A) and 0.856 for the depressive scale (HADS-D) The correlation coefficient between HADS-A and HADS-D scores was excellent (r: 0.878). The confirmatory factor analysis revealed that five out of the seven fitness indexes were excellent: CFI = 0.969, NNFI = 0.963; TLI = 0.963; AGFI = 0.951; GFI = 0.972), supporting good construct validity. In conclusion, this study indicates that both anxiety and depressive symptoms scales of HADS had overall good psychometric properties to be used for assessing psychological and emotional stress in COVID-19 survivors with long COVID.

Keywords: COVID-19; Hospital Anxiety and Depression Scale; long COVID; validity.

Conflict of interest statement

The authors declare no conflict of interest.

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. 2022 Jan 18;22(1):126.
doi: 10.1186/s12889-021-12479-w.

Association between COVID-19 vaccine hesitancy and generalized trust, depression, generalized anxiety, and fear of COVID-19

Affiliations

Association between COVID-19 vaccine hesitancy and generalized trust, depression, generalized anxiety, and fear of COVID-19

Yoichi Sekizawa et al. BMC Public Health. .

Abstract

Background: Although numerous studies have been published on the predictors of COVID-19 vaccine hesitancy, some possible predictors remain underexplored. In this study, we explored the associations of unwillingness and indecisiveness regarding COVID-19 vaccination with generalized trust, mental health conditions such as depression and generalized anxiety, and fear of COVID-19.

Methods: Data of wave 1 (from October 27 till November 6, 2020) and wave 3 (from April 23 till May 6, 2021) of a longitudinal online study conducted in Japan were used for the analyses. Unvaccinated participants were asked at wave 3 about their willingness to be vaccinated, with possible responses of willing, unwilling, or undecided. These three responses were used as the outcome variable, and multinomial logistic regression analyses were conducted with willingness to be vaccinated as the reference group. Explanatory variables included generalized trust, depression, generalized anxiety, and fear of COVID-19 both at wave 1 and 3, and sociodemographic and health-related variables.

Results: Of the 11,846 valid respondents, 209 (1.8%) answered that they had already been vaccinated against COVID-19, 7089 (59.8%) responded that they were willing to be vaccinated, 3498 (29.5%) responded that they were undecided, and 1053 (8.9%) responded that they were unwilling to be vaccinated. After adjusting for covariates, we found that: (1) participants with lower levels of generalized trust at wave 1 and 3 were more likely to be undecided or unwilling at wave 3; (2) respondents with moderately severe or severe depression at wave 1 and 3 were more likely to be undecided at wave 3; (3) participants with moderate or severe levels of generalized anxiety at wave 3 but not at wave 1 were more likely to be unwilling at wave 3; and (4) respondents with high levels of fear of COVID-19 at wave 1 and 3 were less likely to be undecided and unwilling at wave 3.

Conclusions: Generalized trust, mental health conditions such as depression and generalized anxiety, and low level of fear of COVID-19 are associated with unwillingness or indecision regarding being vaccinated against COVID-19.

Keywords: COVID-19; Depression; Fear of COVID-19; Generalized anxiety; Generalized trust; Vaccine hesitancy.

Conflict of interest statement

The authors declare that they have no competing interests.

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Editorial
. 2021 May;24(2):47-48.
doi: 10.1136/ebmental-2021-300266. Epub 2021 Apr 13.

COVID-19 vaccines, hesitancy and mental health

Affiliations
Editorial

COVID-19 vaccines, hesitancy and mental health

Katharine Smith et al. Evid Based Ment Health. 2021 May.
No abstract available

Keywords: adult psychiatry; anxiety disorders; depression & mood disorders.

Conflict of interest statement

Competing interests: AC has received research and consultancy fees from INCiPiT (Italian Network for Paediatric Trials), CARIPLO Foundation and Angelini Pharma, outside the submitted work. KS, SL and DF have nothing to declare.

Comment in

  • Carpe diem.
    Cipriani A. Cipriani A. Evid Based Ment Health. 2022 Nov;25(4):143-144. doi: 10.1136/ebmental-2022-300608. Evid Based Ment Health. 2022. PMID: 36396338 Free PMC article. No abstract available.

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. 2023 Mar 1:324:645-651.
doi: 10.1016/j.jad.2022.12.100. Epub 2023 Jan 5.

Previously independent patients with mild-symptomatic COVID-19 are at high risk of developing cognitive impairment but not depression or anxiety

Affiliations

Previously independent patients with mild-symptomatic COVID-19 are at high risk of developing cognitive impairment but not depression or anxiety

Giulia Gamberini et al. J Affect Disord. .

Abstract

Objectives: The aim of the study was to explore the cognitive functions of a large sample of hospitalised subjects with mild symptomatic Coronavirus Disease (COVID-19) who were previously independent at home and without neurological diseases.

Methods: Patients admitted in a COVID-19 Unit for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection between November 2020 and March 2021 were recruited. Inclusion criteria were: being independent at home before the infection, radiologically confirmed COVID-19 pneumonia, positive reverse transcriptase-polymerase chain reaction nasopharyngeal swab and no oxygen supplementation at the time of evaluation.

Exclusion criteria: cognitive impairment or neurological diseases previous to the infection, delirium episodes, and history of any mechanical ventilation use. They were evaluated with Montreal Cognitive Assessment (MoCA), Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A).

Results: Out of 522 subjects admitted in the COVID-19 Unit, 90 were enrolled [mean age = 68.32(11.99); 46M/44F]. An impaired MoCA (cut-off < 23) was found in 60 subjects (66.66 %). Pathological scores were obtained by 36.7 % of the subjects with <65 years and 78.3 % of those older than 65 years. A high prevalence of executive function and memory impairment was detected.

Conclusions: The results underline a high rate of cognitive impairment in previously independent mild COVID-19 patients. This might represent a potential threat for the everyday independence of these patients due to the consequences on everyday life activities and work following discharge from hospital. These subjects should, therefore, be monitored in order to allow a better understanding of the progression and consequences of the so-called "Long COVID".

Keywords: COVID-19; Cognitive function; MoCA; SARS-CoV-2.

Conflict of interest statement

Conflict of interest The authors declare no conflict of interest relevant to this paper.

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Randomized Controlled Trial
. 2021 Sep-Oct;15(5):355-356.
doi: 10.1097/ADM.0000000000000771.

COVID-19 and Cannabidiol (CBD)

Affiliations
Randomized Controlled Trial

COVID-19 and Cannabidiol (CBD)

Jag H Khalsa et al. J Addict Med. 2021 Sep-Oct.

Abstract

COVID-19 pandemic has resulted in devastating mortality and morbidity consisting of socioeconomic and health effects that have included respiratory/pulmonary, cardiovascular, mental health and neurological consequences such as anxiety, depression, and substance use. Extensive efforts are underway to develop preventive vaccines and therapeutics such as remdesivir, dexamethasone, convalescent plasma, and others to treat COVID-19 but many report residual mental health problems after recovery. Cannabis products such as cannabidiol (CBD) are being advertised for the treatment of COVID-19 associated mental health problems and substance use disorders. This commentary will briefly clear the myth that CBD can ameliorate a wide range of COVID-19 associated health effects including anxiety, depression, or any substance use disorder, and show that there is a clear lack of sufficient unbiased clinical evidence from well-designed double-blind, placebo-controlled clinical trials to prove the antianxiety or antidepression therapeutic properties of CBD and support its wide use as medicine to treat COVID-19- associated mental health conditions or substance use disorders. Finally, we suggest that addiction physicians must play an important role in dealing with their patients requesting CBD prescription for treating any of these conditions.

Conflict of interest statement

Research grants to the institution from Merck, Inc., Gillead Sciences, and Airbutus pharmaceuticals. Other authors report no conflicts of interest.

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Review
. 2023 Jan 29;20(3):2362.
doi: 10.3390/ijerph20032362.

The Influence of the COVID-19 Pandemic on Social Anxiety: A Systematic Review

Affiliations
Review

The Influence of the COVID-19 Pandemic on Social Anxiety: A Systematic Review

Reuben Kindred et al. Int J Environ Res Public Health. .

Abstract

The COVID-19 pandemic has resulted in negative mental health outcomes throughout the world, and its impact on social interactions and relationships is likely to be evident in problematic social anxiety. This systematic review qualitatively synthesized data from studies that have reported on the effects of the pandemic on social anxiety. A systematic search of Web of Science Core Collection, Embase, PsychINFO, Scopus, EBSCOhost, Cochrane Central Register of Controlled Trials, and Proquest Central-Dissertations and Theses was conducted, with thirty-three studies meeting the inclusion criteria. The results suggest that social anxiety has been heightened in the general population due to the pandemic, with women and low-income earners being especially vulnerable. Other contributing factors include impaired coping strategies, lower socio-emotional well-being, limited support networks, and contraction of the SARS-CoV-2 virus. Individuals with a Social Anxiety Disorder diagnosis may be at risk of a deterioration of mental health in general. Limitations of the literature reviewed include the predominance of cross-sectional study designs, which limit causal inferences are limited. Additionally, associations may be inflated as many studies have not accounted for mediating variables. Taken together, the research suggests that social anxiety, either pre-pandemic or arising due to the pandemic environment, has contributed to a variety of negative mental health outcomes related to social anxiety.

Keywords: COVID-19; anxiety; coronavirus; general population; lockdown; pandemic; prevalence; social anxiety; social phobia; systematic review.

Conflict of interest statement

The authors declare no conflict of interest.

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. 2022 Mar:147:79-84.
doi: 10.1016/j.jpsychires.2022.01.013. Epub 2022 Jan 7.

No significant association between COVID-19 diagnosis and the incidence of depression and anxiety disorder? A retrospective cohort study conducted in Germany

Affiliations

No significant association between COVID-19 diagnosis and the incidence of depression and anxiety disorder? A retrospective cohort study conducted in Germany

Louis Jacob et al. J Psychiatr Res. 2022 Mar.

Abstract

Little is known about the effects of coronavirus disease 2019 (COVID-19) on mental health compared with other respiratory infections. Thus, the aim of this retrospective cohort study was to investigate whether COVID-19 diagnosis is associated with a significant increase in the incidence of depression and anxiety disorder in patients followed in general practices in Germany compared with acute upper respiratory infection diagnosis. This study included all patients diagnosed with symptomatic or asymptomatic COVID-19 for the first time in 1198 general practices in Germany between March 2020 and May 2021. Patients diagnosed with acute upper respiratory infection were matched to those with COVID-19 using propensity scores based on sex, age, index month, and Charlson Comorbidity Index. The index date corresponded to the date on which either COVID-19 or acute upper respiratory infection was diagnosed. Differences in the incidence of depression and anxiety disorder between the COVID-19 and the acute upper respiratory infection group were studied using conditional Poisson regression models. This study included 56,350 patients diagnosed with COVID-19 and 56,350 patients diagnosed with acute upper respiratory infection (52.3% women; mean [SD] age 43.6 [19.2] years). The incidence of depression (IRR = 1.02, 95% CI = 0.95-1.10) and anxiety disorder (IRR = 0.94, 95% CI = 0.83-1.07) was not significantly higher in the COVID-19 group than in the upper respiratory infection group. Compared with acute upper respiratory infection diagnosis, COVID-19 diagnosis was not associated with a significant increase in the incidence of depression and anxiety disorder in patients treated in general practices in Germany.

Keywords: Anxiety disorder; COVID-19 diagnosis; Depression; General practices; Germany.

Conflict of interest statement

The authors declare no competing financial interests.

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Review
. 2022 Sep;12(9):e2602.
doi: 10.1002/brb3.2602. Epub 2022 Jul 28.

Neuropsychological effects of COVID-19: A review

Affiliations
Review

Neuropsychological effects of COVID-19: A review

Giuseppa Maresca et al. Brain Behav. 2022 Sep.

Abstract

Objective: The purpose of this review is to examine review literature on the psychological effects of the COVID-19 pandemic.

Methods: Studies were identified by an online search of the PubMed database. We selected studies published from January to May 2020 (during the COVID-19 emergency).

Results: We found that psychological effects of COVID-19 remain serious among the most of the population, in particular for people with mental disorders, adolescents, healthcare workers, and the general population that experienced high levels of stress, anxiety, and depression symptoms, with possible long-term psychological implications.

Conclusion: Findings revealed that living in urban areas, having economic stability, and living with parents were protective factors against anxiety for youth groups, whereas a risk factor was represented by the presence of COVID-19 infection that involved family members.

Keywords: COVID-19; emergency psychology; emotional epidemiology; mental health; psychological intervention.

Conflict of interest statement

The authors declare no conflict of interest.

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. 2022 Apr 1;77(4):e5-e10.
doi: 10.1093/geronb/gbab082.

The Toll of Feeling Older: Subjective Age Moderates the Associations Between Anxiety Sensitivity and Symptoms of Anxiety and Depression During the COVID-19 Epidemic

Affiliations

The Toll of Feeling Older: Subjective Age Moderates the Associations Between Anxiety Sensitivity and Symptoms of Anxiety and Depression During the COVID-19 Epidemic

Sharon Avidor et al. J Gerontol B Psychol Sci Soc Sci. .

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic is an ongoing stressor that may have detrimental effects on mental health. Theoretical and empirical literature implies that individuals who are characterized by catastrophic appraisals of somatic cues, a tendency known as anxiety sensitivity, as well as by older subjective age, might be particularly vulnerable to depression and anxiety during the pandemic. Furthermore, subjective age might moderate the relations between anxiety sensitivity with depression and anxiety symptoms. Yet, research to date has not explored the contribution of both anxiety sensitivity and subjective age in explaining distress following stress in general, nor in light of the current COVID-19 pandemic.

Method: Filling this gap, a convenience sample of 828 participants (Mage = 43.98, SD = 14.06) filled questionnaires measuring background variables, COVID-19-related stressors, anxiety sensitivity, subjective age, and anxiety and depression symptoms during the pandemic.

Results: Positive associations were found between anxiety sensitivity and subjective age, on the one hand, and anxiety and depression symptoms, on the other. Furthermore, subjective age moderated the relations between anxiety sensitivity with depression and anxiety symptoms. Although higher levels of anxiety sensitivity were related to depression and anxiety during the pandemic, these relations were significantly stronger among participants with an older subjective age.

Discussion: The findings are consistent with theories that view subjective age as an intraindividual construct involved in modulating important mental health outcomes in the context of coping with stress.

Keywords: Anxiety; Anxiety sensitivity; Depression; Subjective age.

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. 2020 Dec;37(12):1280-1288.
doi: 10.1002/da.23109. Epub 2020 Nov 10.

Exposure to COVID-19 pandemic stress: Associations with depression and anxiety in emerging adults in the United States

Affiliations

Exposure to COVID-19 pandemic stress: Associations with depression and anxiety in emerging adults in the United States

Autumn Kujawa et al. Depress Anxiety. 2020 Dec.

Abstract

Background: Stressful events due to the coronavirus disease-2019 (COVID-19) pandemic are likely to have profound effects on mental health, and validated methods for assessing these experiences and associations with psychopathology are needed. We developed the Pandemic Stress Questionnaire (PSQ) and tested its psychometric properties, characterized experiences in emerging adults, and examined associations with internalizing symptoms.

Methods: Emerging adults (N = 450) completed the PSQ and measures of internalizing symptoms and perceived stress through an online platform in May 2020. One month later, 288 participants completed a follow-up questionnaire to assess reliability of the PSQ and longitudinal associations between stress and internalizing symptoms.

Results: Results supported the validity/reliability of PSQ total scores and indicated that stressful events were highly prevalent in May, particularly among younger, female, and Black emerging adults. Symptoms of depression and anxiety were high overall, but decreased at the follow-up assessment. Pandemic-related stress was moderately associated with both depression and anxiety at each assessment, but baseline stress did not predict change in symptoms when controlling for baseline symptoms.

Conclusions: Results provide empirical evidence that emerging adults are at high risk for depression and anxiety related to the psychosocial effects of the COVID-19 pandemic, and highlight specific types of experiences associated with greatest risk. Further, this study provides support for a questionnaire measure of experiences related to the COVID-19 pandemic that can be applied in future work to advance understanding of risk and resilience in response to stressful events.

Keywords: anxiety; coronavirus; depression; pandemics; young adult.

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Review
. 2022 Nov 1;38(6):555-561.
doi: 10.1097/MOG.0000000000000876. Epub 2022 Sep 9.

Gastrointestinal symptoms in COVID-19: the long and the short of it

Affiliations
Review

Gastrointestinal symptoms in COVID-19: the long and the short of it

Daniel E Freedberg et al. Curr Opin Gastroenterol. .

Abstract

Purpose of review: A large and growing number of patients have persistent gastrointestinal symptoms that they attribute to COVID-19. SARS-CoV-2, the virus that causes COVID-19, replicates within the gut and acute COVID-19 is associated with alteration of the gut microbiome. This article reviews recent observational data related to gastrointestinal symptoms in 'long COVID' and discusses pathophysiologic mechanisms that might explain persistent post-COVID gastrointestinal symptoms.

Recent findings: Gastrointestinal symptoms are present in half of the patients with acute COVID-19, persist 6 months after COVID-19 in 10-25% of patients, and are rated as the most bothersome symptom in 11% of all patients. These symptoms include heartburn, constipation, diarrhoea and abdominal pain and decline in prevalence with the passage of time. Long COVID gastrointestinal symptoms are associated with mental health symptoms (anxiety and depression) that predate COVID-19 and also with mental health symptoms that are concurrent, after recovery from COVID-19. The cause of long COVID gastrointestinal symptoms is unknown and hypotheses include the SARS-CoV-2 virus itself, which infects the gastrointestinal tract; COVID-19, which can be accompanied by gut microbiome changes, a profound systemic inflammatory response and critical illness; and/or effects of pandemic stress on gastrointestinal function and symptom perception, which may be unrelated to either SARS-CoV-2 or to COVID-19.

Summary: New, persistent gastrointestinal symptoms are commonly reported after recovery from COVID-19. The pathophysiology of these symptoms is unknown but likely to be multifactorial.

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Review
. 2024:1458:51-57.
doi: 10.1007/978-3-031-61943-4_4.

Long COVID-19 and Suicide

Affiliations
Review

Long COVID-19 and Suicide

Leo Sher. Adv Exp Med Biol. 2024.

Abstract

Suicide is a significant public health problem around the world. More than 90% of individuals who die by suicide have a diagnosable psychiatric disorder, and most persons who attempt suicide also have a psychiatric illness. Depression, anxiety, posttraumatic symptoms, sleep disturbances, decreased energy, and cognitive abnormalities are the most frequently reported psychiatric symptoms of long COVID. All these conditions are associated with suicidal ideation and behavior. Therefore, individuals with long COVID may be at increased risk of suicide. Recent studies of patients with long COVID confirm that individuals with long COVID are at increased suicide risk. It is vital to educate clinicians taking care of long COVID individuals that patients with long COVID may be suicidal, that it is essential to screen patients with long COVID for suicidality, and if needed, suicide prevention interventions should be employed.

Keywords: Depression; Long COVID; Mental health; Public health; Suicide.

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Observational Study
. 2023 Feb;27(3):1176-1184.
doi: 10.26355/eurrev_202302_31224.

The impact of COVID-19 anxiety on eating disorders in medical and Master's students

Affiliations
Free article
Observational Study

The impact of COVID-19 anxiety on eating disorders in medical and Master's students

O Aygun et al. Eur Rev Med Pharmacol Sci. 2023 Feb.
Free article

Abstract

Objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) first appeared in China with rapidly progressing pneumonia of unknown cause. Our goal was to investigate the relationship between COVID-19 anxiety and eating disorders among front-line physicians during the COVID-19 pandemic.

Subjects and methods: This study is observational, prospective and analytical. The study population age range is from 18 to 65 years and includes healthcare professionals with a Master's degree or higher or subjects who have completed their education. We administered the Demographic Data Form, the Eating Disorder Rating Scale (EDRS), and the Coronavirus Anxiety Scale (CAS) to "Health professionals with a Master's degree or higher education, or who are receiving or have received Medical Specialization Training" across Turkey.

Results: The study initially included 312 people in total, but 19 were excluded (9 due to a pre-existing eating disorder, 2 for pregnancy, 2 for colitis, 4 for Diabetes Mellitus, 1 for depression, 1 with generalized anxiety disorder - GAD), leaving 293 subjects (82 men and 211 women). Assistant doctor was the highest status in the study group (56%), while specialization Training was the highest level of training (60.1%).

Conclusions: We presented a detailed account of effects of scales and parameters related to the COVID-19 process on eating disorders and weight change in a specific population. These effects show both anxiety scores related to COVID-19 and eating disorders on various aspects and identify various variables influencing these scales in the main groups and subgroups.

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. 2022 Jan 15:297:233-245.
doi: 10.1016/j.jad.2021.10.039. Epub 2021 Oct 24.

Intersections between pneumonia, lowered oxygen saturation percentage and immune activation mediate depression, anxiety, and chronic fatigue syndrome-like symptoms due to COVID-19: A nomothetic network approach

Affiliations

Intersections between pneumonia, lowered oxygen saturation percentage and immune activation mediate depression, anxiety, and chronic fatigue syndrome-like symptoms due to COVID-19: A nomothetic network approach

Hawraa Kadhem Al-Jassas et al. J Affect Disord. .

Abstract

Background: COVID-19 is associated with neuropsychiatric symptoms including increased depressive, anxiety and chronic fatigue-syndrome (CFS)-like and physiosomatic symptoms.

Aims: To delineate the associations between affective and CFS-like symptoms in COVID-19 and chest computed tomography scan anomalies (CCTAs), oxygen saturation (SpO2), interleukin (IL)-6, IL-10, C-Reactive Protein (CRP), albumin, calcium, magnesium, soluble angiotensin converting enzyme (ACE2) and soluble advanced glycation products (sRAGEs).

Method: The above biomarkers were assessed in 60 COVID-19 patients and 30 healthy controls who had measurements of the Hamilton Depression (HDRS) and Anxiety (HAM-A) and the Fibromyalgia and Chronic Fatigue (FF) Rating Scales.

Results: Partial Least Squares-SEM analysis showed that reliable latent vectors could be extracted from a) key depressive and anxiety and physiosomatic symptoms (the physio-affective or PA-core), b) IL-6, IL-10, CRP, albumin, calcium, and sRAGEs (the immune response core); and c) different CCTAs (including ground glass opacities, consolidation, and crazy paving) and lowered SpO2% (lung lesions). PLS showed that 70.0% of the variance in the PA-core was explained by the regression on the immune response and lung lesions latent vectors. One common "infection-immune-inflammatory (III) core" underpins pneumonia-associated CCTAs, lowered SpO2 and immune activation, and this III core explains 70% of the variance in the PA core, and a relevant part of the variance in melancholia, insomnia, and neurocognitive symptoms.

Discussion: Acute SARS-CoV-2 infection is accompanied by lung lesions and lowered SpO2 which may cause activated immune-inflammatory pathways, which mediate the effects of the former on the PA-core and other neuropsychiatric symptoms due to SARS-CoV-2 infection.

Keywords: COVID-19; Chronic fatigue syndrome; Inflammation; Major depression; Neuro-immune; Psychiatry.

Conflict of interest statement

The authors have no financial conflict of interests.

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. 2024 May 7:2024:9682710.
doi: 10.1155/2024/9682710. eCollection 2024.

The Impact of COVID-19 Vaccination on Symptoms of Anxiety and Depression before and after COVID-19 Vaccines Were Universally Available for Adults in the United States

Affiliations

The Impact of COVID-19 Vaccination on Symptoms of Anxiety and Depression before and after COVID-19 Vaccines Were Universally Available for Adults in the United States

Angela M Parcesepe et al. Depress Anxiety. .

Abstract

Our objective was to examine the influence of COVID-19 vaccination on recent (i.e., past month) moderate or severe symptoms of anxiety (GAD-7 ≥ 10) or depression (PHQ-8 ≥ 10) before and after the COVID-19 vaccine became universally available for adults in the U.S. Participants belonged to the Communities, Households, and SARS-CoV-2 Epidemiology Cohort (CHASING COVID), a national longitudinal study. Our analytic population included 4,832 participants who reported vaccination status from December 2020 to December 2021 with follow-up outcomes assessed through March 2022. We emulated a hypothetical randomized experiment, a target trial, to estimate the effect of COVID-19 vaccination on symptoms of anxiety or depression. Before vaccines were universally available, participants who were vaccinated versus not had significantly lower adjusted odds of symptoms of moderate or severe anxiety (aOR: 0.79; 95% CI: 0.70-0.89). In the universal vaccine era, vaccination was associated with marginally higher adjusted odds of symptoms of moderate or severe anxiety (aOR: 1.23; 95% CI: 1.00-1.50). Vaccination did not influence subsequent moderate or severe depressive symptoms in the preuniversal vaccine era (aOR: 0.92; 95% CI: 0.82-1.03) or universal vaccine era (aOR: 1.11; 95% CI: 0.91-1.36). Research into the longitudinal relationship between COVID-19 vaccination and symptoms of depression and anxiety is warranted, with a focus on advancing understanding of potential mediators on the pathway between vaccination and mental health as well as modifiable factors, such as vaccine hesitancy or vaccine beliefs, that may help identify populations for whom vaccination may be particularly beneficial to their mental health.

Conflict of interest statement

This study received funding from Pfizer, a producer of the COVID-19 vaccine. DN reports consulting fees from Abbvie and Gilead, producers of COVID-19-related vaccines and pharmaceuticals.

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. 2022 Sep 9:12:966361.
doi: 10.3389/fcimb.2022.966361. eCollection 2022.

Gut and oral microbiota associations with viral mitigation behaviors during the COVID-19 pandemic

Affiliations

Gut and oral microbiota associations with viral mitigation behaviors during the COVID-19 pandemic

Kelvin Li et al. Front Cell Infect Microbiol. .

Abstract

Imposition of social and health behavior mitigations are important control measures in response to the coronavirus disease 2019 (COVID-19) pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Although postulated that these measures may impact the human microbiota including losses in diversity from heightened hygiene and social distancing measures, this hypothesis remains to be tested. Other impacts on the microbiota and host mental and physical health status associations from these measures are also not well-studied. Here we examine changes in stool and oral microbiota by analyzing 16S rRNA gene sequence taxonomic profiles from the same individuals during pre-pandemic (before March 2020) and early pandemic (May-November 2020) phases. During the early pandemic phase, individuals were also surveyed using questionnaires to report health histories, anxiety, depression, sleep and other lifestyle behaviors in a cohort of predominantly Caucasian adults (mean age = 61.5 years) with the majority reporting at least one underlying co-morbidity. We identified changes in microbiota (stool n = 288; oral n = 89) between pre-pandemic and early pandemic time points from the same subject and associated these differences with questionnaire responses using linear statistical models and hierarchical clustering of microbiota composition coupled to logistic regression. While a trend in loss of diversity was identified between pre-pandemic and early pandemic time points it was not statistically significant. Paired difference analyses between individuals identified fewer significant changes between pre-pandemic and early pandemic microbiota in those who reported fewer comorbidities. Cluster transition analyses of stool and saliva microbiota determined most individuals remained in the same cluster assignments from the pre-pandemic to early pandemic period. Individuals with microbiota that shifted in composition, causing them to depart a pre-pandemic cluster, reported more health issues and pandemic-associated worries. Collectively, our study identified that stool and saliva microbiota from the pre-pandemic to early pandemic periods largely exhibited ecological stability (especially stool microbiota) with most associations in loss of diversity or changes in composition related to more reported health issues and pandemic-associated worries. Longitudinal observational cohorts are necessary to monitor the microbiome in response to pandemics and changes in public health measures.

Keywords: 16S rRNA gene amplicon sequencing; COVID-19; ecological stability; gut microbiota; microbiome; saliva microbiota.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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. 2021 Dec:151:110656.
doi: 10.1016/j.jpsychores.2021.110656. Epub 2021 Oct 30.

Symptoms of depression, anxiety, and perceived mastery in older adults before and during the COVID-19 pandemic: Results from the Longitudinal Aging Study Amsterdam

Affiliations

Symptoms of depression, anxiety, and perceived mastery in older adults before and during the COVID-19 pandemic: Results from the Longitudinal Aging Study Amsterdam

Judith H van den Besselaar et al. J Psychosom Res. 2021 Dec.

Abstract

Objective: Governmental measures to protect older adults from COVID-19 are hypothesized to cause anxiety and depression. Previous studies are heterogeneous and showed small effects. This study aims to assess depressive and anxiety symptoms and perceived mastery just after the first wave of the COVID-19 pandemic compared to previous years in community-dwelling older adults and to identify potential risk groups according to the comprehensive geriatric assessment framework.

Methods: Data were used from 1068 Dutch older adults (aged 55-93 at baseline in 2011-2013) participating in the Longitudinal Aging Study Amsterdam, including 4 follow-ups spanning 9 years. Depressive symptoms, anxiety symptoms and feelings of mastery were assessed with the short Center for Epidemiologic Studies Depression scale (CES-D-10), the Hospital Anxiety Depression Scale - Anxiety subscale (HADS-A) and the Pearlin Mastery Scale. Linear mixed regression was used to compare outcomes in June-August 2020 to previous years and to examine predictors to identify risk groups.

Results: Slight increases in CES-D-10 (1.37, 95% Confidence interval [CI] 1.12;1.62), HADS-A (0.74, 95% CI 0.56;0.94) and mastery (1.10, 95% CI 0.88;1.31) occurred during the COVID year compared to previous years. Older adults with functional limitations or with frailty showed a smaller increase in feelings of mastery in the COVID-year.

Conclusion: Our results suggest limited mental health effects on older adults from the first COVID-19 wave. Older adults have perhaps better coping strategies than younger adults, or preventive measures did not have extensive consequences for the daily life of older adults. Further monitoring of depression, anxiety and perceived mastery is recommended.

Keywords: COVID-19; Cohort study; Mental health; Older adults; SARS-CoV-2.

Conflict of interest statement

The authors have no competing interests to report.

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. 2024 Nov;67(11):1239-1247.
doi: 10.1007/s00103-024-03953-y. Epub 2024 Sep 27.

[Fatigue after COVID-19 disease associated with depression and anxiety in insured persons from healthcare and social professions]

[Article in German]
Affiliations

[Fatigue after COVID-19 disease associated with depression and anxiety in insured persons from healthcare and social professions]

[Article in German]
Svenja Mertens et al. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Nov.

Abstract

Background: Fatigue is one of the most frequent symptoms in post-COVID syndrome (PCS) patients and describes a long-term feeling of tiredness and exhaustion. Frequently, it follows an infection or is a component of depressive symptoms. But fatigue itself is also a risk to mental health like other chronic conditions. The objective of this paper was to analyse the relationship between fatigue and depression/anxiety and the differences between PCS patients and fully recovered COVID-19 cases.

Methods: In a longitudinal study with three measurement points, insured members of the Statutory Accident Insurance and Prevention in the Health and Welfare Service with a SARS-CoV‑2 infection in 2020 were asked about fatigue, depression/anxiety and persisting COVID-19 symptoms. To analyse the longitudinal effects of the two variables, a cross-lagged panel model was applied.

Results: In the present sample (n = 860), a proportion of 68.7% to 75.1% of people was suffering from PCS. The results showed a model fit of R2 = 61.49% and all effects were significant, but the cross-lagged effects were not significantly different from each other. If stratified according to whether PCS symptoms were present, the cross-lagged effects weakened in both groups, while the effects of fatigue on depression and anxiety only remained in the group of those affected by PCS.

Discussion: The results show a relationship in both directions between fatigue and depression/anxiety. PCS patients can benefit from psychotherapeutic treatment to tackle fatigue and prevent depression and anxiety.

Zusammenfassung: HINTERGRUND: Fatigue bezeichnet einen andauernden Erschöpfungszustand, der auf eine Infektionskrankheit folgen kann. Sie zählt zu den häufigsten Symptomen beim Post-Covid-Syndrom (PCS). Auch bei psychischen Erkrankungen kann Fatigue auftreten, allerdings ist Fatigue, wie andere chronische Erkrankungen, auch selbst ein Risikofaktor für Depressivität und Ängstlichkeit. Ziel der Analyse ist es, zu untersuchen, inwieweit sich Fatigue und Depressivität/Ängstlichkeit gegenseitig bedingen und ob es Unterschiede zwischen PCS-Betroffenen und vollständig Genesenen gibt.

Methodik: In einer Längsschnittuntersuchung mit 3 Messzeitpunkten wurden Versicherte der Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege, die im Jahr 2020 mit SARS-CoV‑2 infiziert waren, zu Fatigue, Depressivität/Ängstlichkeit und lang anhaltenden COVID-19-Symptomen befragt. Zur Analyse der längsschnittlichen Effekte der beiden Variablen wurde ein kreuzlagiges Paneldatenmodell angewandt.

Ergebnisse: Die Stichprobe (n = 860) weist zu den 3 Messzeitpunkten einen Anteil von 68,7–75,1 % an PCS-Betroffenen auf. Das Modell zeigt eine Güte von R2 = 61,49 % und durchgehend signifikante Effekte, jedoch unterscheiden sich die kreuzlagigen Pfade nicht signifikant voneinander. Wird danach stratifiziert, ob eine PCS-Symptomatik vorliegt, schwächen sich in beiden Gruppen die kreuzlagigen Effekte ab, während nur in der Gruppe der PCS-Betroffenen die Effekte von Fatigue auf Depressivität und Ängstlichkeit bestehen bleiben.

Diskussion: Die vorliegenden Ergebnisse zeigen einen wechselseitigen Zusammenhang von Fatigue- und Depressivitäts‑/Ängstlichkeitssymptomatik. PCS-Betroffene könnten von psychotherapeutischen Behandlungen aufgrund ihrer Fatigue profitieren, da dem Entstehen von Depressionen oder Angststörungen vorgebeugt werden kann.

Keywords: COVID-19; Depression; Healthcare workers; Post-COVID syndrome; Post-viral fatigue.

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. 2021 May 28;100(21):e25945.
doi: 10.1097/MD.0000000000025945.

Prevalence and influencing factors of anxiety and depression symptoms among the first-line medical staff in Wuhan mobile cabin hospital during the COVID-19 epidemic: A cross-sectional survey

Affiliations

Prevalence and influencing factors of anxiety and depression symptoms among the first-line medical staff in Wuhan mobile cabin hospital during the COVID-19 epidemic: A cross-sectional survey

Xiao-Bo Zhang et al. Medicine (Baltimore). .

Abstract

To investigate the prevalence of anxiety and depressive symptoms and the associated risk factors among first-line medical staff in Wuhan during the coronavirus disease 2019 (COVID-19) epidemic.From March 5 to 15, 2020, the Hamilton Anxiety Scale and Hamilton Depression scale were used to investigate the anxiety and depression status of medical staff in Wuhan Cabin Hospital (a Hospital). Two hundred seventy-six questionnaires were received from 96 doctors and 180 nurses, including 79 males and 197 females.During the COVID-19 epidemic, the prevalence rate of anxiety and depression was 27.9% and 18.1%, respectively, among 276 front-line medical staff in Wuhan. The prevalence rate of anxiety and depression among doctors was 19.8% and 11.5%, respectively, and the prevalence rate of anxiety and depression among nurses was 32.2% and 21.7%, respectively. Females recorded higher total scores for anxiety and depression than males, and nurses recorded higher scores for anxiety and depression than doctors.During the COVID-19 epidemic, some first-line medical staff experienced mental health problems such as depression and anxiety. Nurses were more prone to anxiety and depression than doctors. Effective strategies toward to improving the mental health should be provided to first-line medical staff, especially female medical staff and nurses.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

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Editorial
. 2021 Nov;28(6):1315-1316.
doi: 10.1002/cpp.2701.

Psychological consequences of COVID-19

Affiliations
Editorial

Psychological consequences of COVID-19

Paul M G Emmelkamp. Clin Psychol Psychother. 2021 Nov.
No abstract available

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. 2021 Feb 1;63(2):89-97.
doi: 10.1097/JOM.0000000000002086.

Association Between Proportion of Workday Treating COVID-19 and Depression, Anxiety, and PTSD Outcomes in US Physicians

Affiliations

Association Between Proportion of Workday Treating COVID-19 and Depression, Anxiety, and PTSD Outcomes in US Physicians

Danielle M Gainer et al. J Occup Environ Med. .

Abstract

Objective: The primary objective of this cross-sectional study was to examine the association between time spent treating patients with Coronavirus disease 2019 (COVID-19) and levels of depression, anxiety, and posttraumatic stress disorder (PTSD) in US physicians.

Methods: The authors conducted an anonymous online survey of US physicians. Linear regression was used to test the association between proportion of day treating COVID-19 and symptoms of depression, anxiety, and PTSD.

Results: In a sample of 1724 US physicians, proportion of day treating COVID-19 was positively and significantly associated with depression, anxiety, and PTSD scores (P < 0.001 for each).

Conclusions: Mental health resources should be provided to physicians who treat COVID-19 because the proportion of day treating COVID-19 is associated with depression, anxiety, and PTSD outcomes.

Conflict of interest statement

Gainer, Nahhas, Bhatt, Merrill, and McCormack have no relationships/conditions/circumstances that present potential conflict of interest.

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. 2024 Nov 1;81(11):1071-1080.
doi: 10.1001/jamapsychiatry.2024.2339.

COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People

Collaborators, Affiliations

COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People

Venexia M Walker et al. JAMA Psychiatry. .

Abstract

Importance: Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited.

Objective: To determine which mental illnesses are associated with diagnosed COVID-19 by vaccination status in both hospitalized patients and the general population.

Design, setting, and participants: This study was conducted in 3 cohorts, 1 before vaccine availability followed during the wild-type/Alpha variant eras (January 2020-June 2021) and 2 (vaccinated and unvaccinated) during the Delta variant era (June-December 2021). With National Health Service England approval, OpenSAFELY-TPP was used to access linked data from 24 million people registered with general practices in England using TPP SystmOne. People registered with a GP in England for at least 6 months and alive with known age between 18 and 110 years, sex, deprivation index information, and region at baseline were included. People were excluded if they had COVID-19 before baseline. Data were analyzed from July 2022 to June 2024.

Exposure: Confirmed COVID-19 diagnosis recorded in primary care secondary care, testing data, or the death registry.

Main outcomes and measures: Adjusted hazard ratios (aHRs) comparing the incidence of mental illnesses after diagnosis of COVID-19 with the incidence before or without COVID-19 for depression, serious mental illness, general anxiety, posttraumatic stress disorder, eating disorders, addiction, self-harm, and suicide.

Results: The largest cohort, the pre-vaccine availability cohort, included 18 648 606 people (9 363 710 [50.2%] female and 9 284 896 [49.8%] male) with a median (IQR) age of 49 (34-64) years. The vaccinated cohort included 14 035 286 individuals (7 308 556 [52.1%] female and 6 726 730 [47.9%] male) with a median (IQR) age of 53 (38-67) years. The unvaccinated cohort included 3 242 215 individuals (1 363 401 [42.1%] female and 1 878 814 [57.9%] male) with a median (IQR) age of 35 (27-46) years. Incidence of most outcomes was elevated during weeks 1 through 4 after COVID-19 diagnosis, compared with before or without COVID-19, in each cohort. Incidence of mental illnesses was lower in the vaccinated cohort compared with the pre-vaccine availability and unvaccinated cohorts: aHRs for depression and serious mental illness during weeks 1 through 4 after COVID-19 were 1.93 (95% CI, 1.88-1.98) and 1.49 (95% CI, 1.41-1.57) in the pre-vaccine availability cohort and 1.79 (95% CI, 1.68-1.90) and 1.45 (95% CI, 1.27-1.65) in the unvaccinated cohort compared with 1.16 (95% CI, 1.12-1.20) and 0.91 (95% CI, 0.85-0.98) in the vaccinated cohort. Elevation in incidence was higher and persisted longer after hospitalization for COVID-19.

Conclusions and relevance: In this study, incidence of mental illnesses was elevated for up to a year following severe COVID-19 in unvaccinated people. These findings suggest that vaccination may mitigate the adverse effects of COVID-19 on mental health.

Conflict of interest statement

Conflict of Interest Disclosures: Dr A. Walker reported grants from the National Institute for Health and Care Research (NIHR) during the conduct of the study. Dr Mehrkar reported grants obtained from the Bennett Foundation, Wellcome Trust, NIHR Oxford Biomedical Research Centre, NIHR Applied Research Collaboration Oxford and Thames Valley, Mohn-Westlake Foundation, and National Health Service (NHS) England during the conduct of the study and consultancy fees from Induction Healthcare and is a senior clinical researcher at the University of Oxford in the Bennett Institute and from the Royal College of General Practitioners (RCGP)/British Medical Association (member of the RCGP health informatics group) and the NHS Digital General Practice Extraction Service (advisory group that advises on access to general practice data for pandemic planning and research outside the submitted work. Dr Chaturvedi reported grants from UK Research and Innovation (UKRI) during the conduct of the study and personal fees from AstraZeneca (data monitoring and safety committee member) outside the submitted work. Dr Sterne reported grants from the UK National Institute for Health and Care Research, UKRI Medical Research Council, and Health Data Research UK during the conduct of the study. No other disclosures were reported.

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. 2021 Jan-Dec:12:21501327211059348.
doi: 10.1177/21501327211059348.

Risk Factors for Postpartum Depression During COVID-19 Pandemic: A Systematic Literature Review

Affiliations

Risk Factors for Postpartum Depression During COVID-19 Pandemic: A Systematic Literature Review

Sadia Usmani et al. J Prim Care Community Health. 2021 Jan-Dec.

Abstract

Introduction: The COVID-19 pandemic has had a devastating worldwide effect on mental health. Recent studies correlate the spreading of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with symptoms of depression, most prominent in postpartum women. Our systematic literature review scope is to identify the risk factors and predictors for postpartum depression (PPD) and describe the steps that should be taken to help postpartum women. This study will help clinicians, researchers, and policymakers to elucidate the predictors of PPD during this pandemic and prevent these adverse outcomes in future crises.

Methods: We conducted a systematic search by employing databases PubMed, Google Scholar, Scopus, and Embase to identify articles published before March 2021. About 463 publications were generated during our search process and from those, 36 were reviewed, summarized, and synthesized. Studies qualified the criteria if they (1) utilized qualitative or quantitative design, (2) explored the risk factors for PPD, and (3) were written in English. Quality evaluation of each study was achieved by using criteria set by Lincoln and Guba.

Results: Prevalence of depression symptoms ranged from 7% to 80.8% in postpartum women during the SARS-COV 2 pandemic. The risk factors for PPD were classified into 6 major categories: socio-demographic, psychological, pre-existing pathology, metabolic factors, previous events of miscarriage, and media misinformation.

Conclusion: It is extremely vital to care for women's mental health during pregnancy and after childbirth during these unprecedented times. This review urges the need to design adequate interventions for this vulnerable population to prevent negative consequences of PPD.

Keywords: COVID-19; anxiety; mental health; postnatal depression; postpartum depression; sars-cov-2; women.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Meta-Analysis
. 2024 Feb;88(3):823-856.
doi: 10.1177/00302228211050503. Epub 2021 Oct 8.

Death Anxiety Associated With Coronavirus (COVID-19) Disease: A Systematic Review and Meta-Analysis

Affiliations
Meta-Analysis

Death Anxiety Associated With Coronavirus (COVID-19) Disease: A Systematic Review and Meta-Analysis

Safiye Özgüç et al. Omega (Westport). 2024 Feb.

Abstract

Death anxiety is a feeling that exists since birth, continues throughout life, lies at the root of all fears, and develops after the awareness that people will no longer exist and that they can lose themselves and the world. It is associated with death-induced anxiety with many features of the COVID-19 pandemic, which can be seen as a threat to human existence. In this study, it is aimed to compile studies on death anxiety associated with coronavirus disease, list the general characteristics of these studies through descriptive summaries, and combine findings on the level of death anxiety associated with coronavirus disease through meta-analysis. The findings of this study suggest that COVID-19 pandemic process and is affected by socio-demographic factors such as fear of COVID-19, gender, and occupation. As a result of this study, it was determined that death anxiety was relatively high during the COVID-19 pandemic process.

Keywords: COVID-19; death anxiety; mental health; meta-analysis; prevention; systematic review.

Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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. 2024 Jun 12;19(6):e0305229.
doi: 10.1371/journal.pone.0305229. eCollection 2024.

The prevalence of mental health and addiction concerns and factors associated with depression and anxiety during the COVID-19 pandemic in Ontario, Canada: A cross-sectional study

Affiliations

The prevalence of mental health and addiction concerns and factors associated with depression and anxiety during the COVID-19 pandemic in Ontario, Canada: A cross-sectional study

Oswin Chang et al. PLoS One. .

Abstract

Objective: Higher than expected rates of mental health and/or addiction (MHA) concerns have been documented since the onset of the COVID-19 pandemic. A more up-to-date prevalence of MHA outcomes and the factors associated with the occurrence of MHA concerns remains unclear. This study examined the prevalence of MHA outcomes and factors associated with screening positive for symptoms of depression only, anxiety only, and both depression and anxiety two years into the COVID-19 pandemic in Ontario, Canada.

Method: Ontario adults ≥18 years of age (n = 5000) reported on the presence of symptoms associated with depression, anxiety, and substance use between January and March 2022. Data were also collected on pandemic-related health variables, including COVID-19 infection fear, changes in socioeconomic status and mental health since pandemic onset, satisfaction with social supports, and MHA service needs.

Results: The prevalence of positive screening for depressive or anxiety symptoms only was 8% and 11%, respectively, while 36% screened positive for both. Moderate/high risk levels of substance use were found in 20% of participants for tobacco and 17% for both alcohol and cannabis. Moderate/high risk levels of alcohol use and certain pandemic-related factors (negative change in mental health, unmet MHA service needs) were associated with positive screening for symptoms of depression only, anxiety only, and both depression and anxiety. Satisfaction with social supports was associated with lower likelihoods of being in the depression only and both depression and anxiety groups, and non-White ethnicity was associated with depression only.

Conclusions: There was a continued burden of MHA issues two years into the pandemic. These results underscore the ongoing need for timely and accessible MHA services.

Conflict of interest statement

The authors have declared that no competing interests exist.

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. 2024 Jun 27:2024:2598864.
doi: 10.1155/2024/2598864. eCollection 2024.

Depression, Anxiety, and Cognitive Distortion among College Students: A Cross-Lagged Prospective Network Study during and after the COVID-19 Pandemic

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Depression, Anxiety, and Cognitive Distortion among College Students: A Cross-Lagged Prospective Network Study during and after the COVID-19 Pandemic

Hongyu Zou et al. Depress Anxiety. .

Abstract

Background: The high prevalence of depressive and anxiety symptoms among college students during the COVID-19 pandemic raised serious global public health concerns. Grounded in Beck's cognitive theory, we tested whether cognitive distortion (included form of rumination) influenced the development of depression and anxiety during and after the pandemic.

Materials and methods: A total of 2,709 college students in southern China completed self-report measures of depression and anxiety as part of a psychological screening questionnaire during the COVID-19 lockdown. Six months later, after lockdown, 689 of these students completed the same questionnaires.

Results: A cross-sectional network analysis showed that relative to their self-reports during the pandemic, college students reported fewer depressive symptoms and higher anxiety symptoms after the pandemic. A cross-lagged network among depression, anxiety, and cognitive distortion exhibited a consistent pattern, with symptom rumination serving as central node. Surprisingly, depression predicted later anxiety, but anxiety did not predict later depression.

Conclusion: Symptoms of depression and anxiety were uniquely related to different cognitive distortions, suggesting different mechanisms of development during the pandemic. Symptom rumination should be considered a key target in cognitive behavioral therapy.

Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest, and the manuscript is approved by all authors for submission and publication.

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