Evaluation of antivaccination movement in Turkey: qualitative reports of family physicians

Background: In Turkey, childhood vaccination rates are decreasing in the context of increasingly visible antivaccination movements. Aims: To evaluate the antivaccination movement based on communication experiences between family physicians and antivaccine parents in Turkey. Methods: We conducted 39 face-to-face in-depth interviews with family physicians in Sakarya Province who had experiences of communicating with antivaccine parents during October–December 2019. With the permission of the participants, audio recording was obtained in all interviews except one; these were transcribed verbatim and checked. A thematic approach was used to analyse the data. Results: The most common concern about vaccination was the possible side-effects, followed by the origin of the vaccines, religious concerns and distrust of vaccines. The physicians said they assumed an inquisitive, informative and anxiety-relieving attitude towards antivaccine parents. They said they were able to persuade most parents to vaccinate their children and that highly educated parents or those whose attitudes and behaviours were strongly influenced by their religious leaders were the hardest to convince. Physicians emphasized the importance of trust in increasing vaccine acceptance and noted the need to educate religious leaders and families to introduce mandatory vaccination policies. Conclusion: Parents had various reasons for refusing childhood vaccinations, however, the family physicians used persuasive methods to convince them to accept the vaccinations. Strengthening the communication and persuasive skills of health care professionals regarding vaccination may help increase acceptance of childhood vaccinations.

Psychiatric impact on COVID-19 patients isolated in a tertiary care hospital in Pakistan

Background: Adverse psychological effects have been associated with COVID-19-related disease containment measures, but little is known about the psychiatric symptoms and distress. Aims: This study aimed to explore and understand the psychiatric symptoms and distress in suspected or confirmed COVID-19 patients isolated and quarantined in hospital. Methods: A mixed methods study was conducted in the COVID-19 units of Mayo Hospital, Lahore, Pakistan; 114 out of 160 adult patients were assessed by telephone using validated scales (Stress Reactions and Adjustment Disorder Checklist, 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale and Insomnia Severity Index) and a few open-ended questions about expectations and anticipated areas of need during hospitalization, including experiences with isolation. Results: The prevalence of adjustment disorder, acute stress disorder, anxiety, depressive symptoms and insomnia was 67.5%, 3.5%, 16.7%, 18.4%, and 29.8% respectively. One male patient tried to commit suicide during the study period. Fear, anger, low mood, anxiety and sleep disturbances were the most notable psychological consequences in qualitative the responses. Inadequate communication, poor ward facilities, concerns about the health of family members and financial problems were the most commonly identified factors leading to distress. Conclusion: Our results show alarmingly high levels of stress-related symptoms – insomnia, depression and anxiety – among COVID-19 confirmed or suspected hospitalized patients. There is a need to incorporate psychological services in the acute phase of illness for prompt recognition and management of psychiatric problems.

Sleep disturbances following recovery from COVID-19: a comparative cross-sectional study in Egypt

Background: Sequelae from COVID-19 are increasingly being reported, but sleep disturbances after recovery from the disease have had little attention. Aims: This study aimed to identify and compare sleep disturbances and associated correlates among adults who have recovered from COVID-19 with those who have never been infected with the disease. Methods: The sample included 85 adults who have recovered from COVID-19 and 85 adults who have never been infected (matched on age, sex, education and socioeconomic level). Individuals were recruited from Zagazig University Hospitals, Egypt from 1 September to 29 November 2020. Participants were interviewed using a sociodemographic and clinical checklist, the Pittsburgh Sleep Quality Index and the Hospital Anxiety Depression Scale. Results: Most (77%) of the recovered cases had experienced sleep disturbances, compared with 46% of controls. Individuals who had recovered from COVID-19 were more likely to have poor subjective sleep quality (odds ratio (OR) 1.5, 95% confidence interval (CI): 1.1–2.1), prolonged sleep latency (OR 1.8, 95% CI: 1.3–2.6), shorter sleep duration (OR 1.6, 95% CI: 1.1–2.2), reduced sleep efficiency (OR 3.8, 95% CI: 2.0–7.1), frequent daytime dysfunction (OR 1.9, 95% CI: 1.2–3.1) and poor global Pittsburgh Sleep Quality Index score (OR 3.0, 95% CI: 1.5–6.0). Depressive (P = 0.002) and anxiety (P = 0.003) symptoms were associated with a poor global Pittsburgh Sleep Quality Index score among recovered female participants (P = 0,034) who had low-to-medium education level (P = 0.004). Conclusions: Further studies (e.g. population-based longitudinal studies) are needed on sleep disturbances as a potential sequelae of COVID-19, because it can impair mental and physical well-being.

Relationship between obesity and depression, anxiety and psychological distress among Iranian health-care staff

Background: Psychological-related disorders such as obesity are a key contributor to morbidity and mortality. Aims: To assess the association between general and abdominal obesity with depression and anxiety among Iranian health-care staff. Methods: This cross-sectional study was conducted under the framework of the Study on the Epidemiology of Psycho- logical Alimentary Health and Nutrition. A total of 4361 Iranian health-care staff were analyzed for general obesity and 3213 for central obesity. Overweight and obesity was defined as body mass index 25.0–29.9 and ≥ 30.0 kg/m2, respectively. Abdominal obesity was defined as waist circumference (WC) ≥ 88 cm for females and ≥ 102 cm for males. The Iranian validated versions of the Hospital Anxiety and Depression Scale and the General Health Questionnaire were used to assess depression and anxiety. Results: Stratified analysis by sex revealed no significant relationship between general obesity, depression and anxiety among males. However, we found an inverse association between abdominal obesity (WC > 102 cm) and severe depression among males. In females, abdominal obesity was significantly associated with anxiety, before and after taking confounders into account. No significant association was seen between abdominal obesity and psychological distress in either sex after controlling for potential confounders. Conclusions: Abdominal obesity was associated with anxiety in Iranian adult females but not in males. Further studies, particularly prospective research, are required to confirm these findings.

Mobile phone use pattern and addiction in relation to depression and anxiety

Background: University students with heavy smartphone use are vulnerable to smartphone addiction that could be related to depression and trait anxiety. Aims: To assess gender differences in patterns of smartphone use and addiction in relation to depression and trait anxiety among Saudi university students. Methods: This was a cross-sectional study of 1513 students of Taif University, Saudi Arabia. A self-reported questionnaire was used to collect demographic data and data on pattern of smartphone use. The Problematic Use of Mobile Phones (PUMP) scale was used to determine smartphone addiction. The Arabic validated version of the Taylor Manifest Anxiety Scale and Beck Depression Inventory were used to assess trait anxiety and depression, respectively. Results: A female predominance was found for: prevalence of depression and trait anxiety, PUMP scores, duration of daily mobile use and number of daily calls. A significant positive correlation was found between PUMP score and depression and trait anxiety scores, duration of owning a smartphone, and average duration of each daily call. The PUMP scores were significantly higher in 6th year students, those from the theoretical college, single students, and students who used a smartphone for > 4 hours/day. Conclusions: Smartphone addiction is a major problem among Saudi university students, and it is associated with depression and trait anxiety. Future studies should aim to establish the best interventions to protect university students from the negative effects of smartphones.

Validation of the Arabic version of the childhood illness attitudes scales

Background: Excessive health anxiety can lead to significant disorders such as hypochondriasis. In children, assessment of the severity of health anxiety has been performed using the Childhood Illness Attitudes Scales (CIAS); however, no validated Arabic version of this tool exists. Aims: This study developed and validated an Arabic version of the CIAS questionnaire in Jordan in 2017 to provide a tool to measure the severity of health anxiety in the Arabic-speaking world. Methods: The CIAS was translated from English to Arabic then back-translated by a different translator and the 2 versions were compared before cognitive interviews were conducted. The final version of the questionnaire was circulated to 597 children. Of these, 200 were asked to retake the questionnaire after 10–15 days to evaluate test–retest reliability. Confirmatory factor analysis (CFA) on the 4-factor model suggested by the original questionnaire version was performed. Internal consistency and test–retest reliability were evaluated. Results: The CFA showed good fit (goodness of fit index = 0.92) with the 4-factor model of fears, help seeking, treatment experience, and symptom effects. Test–retest reliability was high and the model had good discriminant validity and internal consistency. Conclusions: The Arabic version of the CIAS provides a suitable tool to investigate the prevalence and severity of childhood anxiety in the Middle East.

Exposure to violence and its relationship to mental health among young people in Palestine

Background: Exposure to violence is a significant risk factor for the development of psychopathology in young people. Research on the mental health consequences of violence exposure in youth has focused mostly on post-traumatic stress disorder, however, the association with depression and anxiety has also been established. As a result of the longstanding Israeli–Palestinian conflict, young Palestinians are vulnerable to exposure to various types of violence. Aims: We examined psychiatric symptomatology and its relationship to direct and indirect forms of violence exposure. Methods: A representative household survey of 2481 Palestinian youth was conducted in 2014. Self-report measures included psychiatric symptomatology (global distress, depression, anxiety)and violence exposure (personal victimization, witnessed, vicariously heard about). Results: The proportion of elevated symptoms of global distress (46%), depression (55%), and (37%)anxiety was high; 47% had been a personal victim, 71% had witnessed violence, and 69% had heard about violence experienced by someone close to them. In logistic regression analysis, controlling for other bivariate correlates, exposure to any violence event, as well as any of the 3 types of violence exposure, were independently associated with each of the 3 measures of elevated psychiatric symptomatology. Females were 4 times more likely to report elevated psychopathology, despite being less likely to experience each type of violence.Conclusions: These findings suggest the need for services that cater to the mental health needs of youth in settings of high violence exposure, and that gender-specific strategies may be useful

Psychobehavioural responses to the 2014 Middle East respiratory syndrome-novel corona virus [MERS CoV] among adults in two shopping malls in Jeddah, western Saudi Arabia

Sporadic cases of Middle East respiratory syndrome caused by a novel corona virus [MERS-CoV] were first detected in Saudi Arabia in June 2012. The number of cases was highest during April and May 2014. To assess determinants of psychobehavioural responses among the general population in Jeddah, western Saudi Arabia, a cross-sectional survey was conducted at the end of June 2014. Data included sociodemographic characteristics, level of anxiety, protective measures and social avoidance responses. A total of 358 participants completed the questionnaire; 58.4% were female, and the age range was 18-72 years. None of the participants was diagnosed with MERS-CoV. More than half [57.7%] recorded a moderate anxiety score using a visual analogue scale. Anxiety level was significantly associated with increased perception of susceptibility to infection and social avoidance behaviours related to travel and being in public places

Des cas sporadiques d'infection par le coronavirus du syndrome respiratoire du Moyen-Orient [MERS-CoV] ont été détectés pour la première fois en Arabie saoudite en juin 2012. Le nombre de cas le plus élevé a été observé en avril et mai 2014. Afin de mesurer les déterminants des réactions psycho-comportementales de la population générale de Djeddah, dans la partie occidentale de l'Arabie saoudite, une étude transversale a été conduite fin juin 2014. Les données incluaient les caractéristiques socio-démographiques, le niveau d'anxiété, les mesures de protection et la mise en place de mesures d'éviction sociale. Un total de 358 participants ont rempli le questionnaire, dont 58,4% de femmes, les âges étant compris entre 18 et 72 ans. Le MERS-CoV n'a été diagnostiqué chez aucun patient. Plus de la moitié [57,7%] a rapporté un score d'anxiété modéré en se basant sur une échelle visuelle analogue. Le niveau d'anxiété était associé de façon significative à une perception augmentée de sensibilité à l'infection et au phénomène d'éviction sociale lié à la possibilité de voyager ou de se rendre dans les lieux publics

Anxiety, depression and health-related quality of life in those injured by landmines, Ham, Islamic Republic of Iran

We assessed depression, anxiety and health-related quality of life [HRQOL] in 137 cases of landmine I injury in Ham province, using the Hospital Anxiety and Depression Scale [HADS] and the Short Form Health Survey [SF36] questionnaires. We also compared their scores with an uninjured control group [n - 360]. Most of the injured were male [93.4%] and illiterate [54.7%] with some irreversible sequelae [86.9%]. Overall, 69.3% of the injured participants scored high for both anxiety and depression. The level of anxiety and depression was significantly higher in older cases, those not completely recovered compared with recovered cases and those with amputation compared with those without amputation. The injured also had significantly lower mean scores in all HRQOL components than the control group. Landmine injured should be monitored for early identification and treatment of depression and anxiety

Relationship between trait anxiety, dental anxiety and DMFT indexes of Turkish patients attending a dental school clinic

The aims of this study were to evaluate possible relationships between trait anxiety, dental anxiety and the total number of decayed, missing and filled teeth [DMFT] index of patients attending a dental school clinic. A sample of 558 patients was surveyed with the Turkish version of the Spielberger Trait Anxiety Inventory and Dental Anxiety Scale. DMFT index was calculated by clinical and radiographic examination. A significant linear correlation was observed between trait and dental anxiety, but there was no correlation between DMFT index, trait anxiety and dental anxiety. Trait anxiety has an impact on dental anxiety, but does not affect the DMFT index

Effect of music on anxiety, stress, and depression levels in patients undergoing coronary angiography

Control of stress and anxiety and the promotion of comfort are challenges facing health practitioners involved in catheterization. The aim of this case-control study was to examine the effect of music on the levels of anxiety, stress, and depression experienced by patients undergoing coronary angiography, as measured by the 21-item Depression Anxiety Stress Scales. Differences in pre- and post-intervention scores demonstrated that there were significant decreases in mean scores of state anxiety [P = 0.006], stress [P = 0.001] and depression P = 0.02] in the intervention group, who listened to 20 minutes of relaxing music, as compared with the control group who had 20 minutes of bed rest

Providing emotional stability through relaxation training

To determine the effects of integrative relaxation training [IRT] on emotional stability, we exposed 32 patients diagnosed with anxiety disorder to a pre-test [16PF] and to 12 sessions of group psychoeducation training. Patients were randomly assigned to 2 groups [study 17 and control 15 patients]. The study group received 12 weekly group sessions of IRT. Level of anxiety was evaluated in a post-test using a questionnaire and the State-Trait Anxiety Inventory [STAI]. Emotional stability and level of anxiety were significantly reduced in the study group: there was a marked increase in scores for emotionally s and venturesome and a decrease in scores for apprehensive and tense. The STAI score was statistically significantly lower in the study group

[Programme for improving emotional and cognitive changes in patients under renal dialysis in Egypt]

We investigated the effect of chronic renal failure on the emotional status, social and psychological adaptation and the cognitive status of patients and the effect of a programme to improve the psychosocial state of the patients; 40 renal dialysis patients and 40 healthy controls were included. We used the Emotional Status Scale, Psychosocial Adaptation Scale, the Primary Mental Abilities Test and the Memory Processes Scale for assessment of the participants. The controls had better emotional/ cognitive status and psychosocial adaptation than the dialysis patients, a statistically significant difference. There were also statistically significant differences between the patients before and after the application of the programme

Rates of depression and anxiety among female medical students in Pakistan

This study in 2002 determined the rate of anxiety and depression, and the associated social and environmental factors, among 87 randomly selected female medical students at a medical college in Lahore, Pakistan. Students completed the hospital anxiety and depression scale and a questionnaire about life events, social behaviour and past medical history. Overall, 43.7% of students reported anxiety and 19.5% depression. Students living in university dormitories were significantly more depressed and anxious than those living at home. Those having a history of negative life events in the recent past were more likely to be depressed. Students in their first 2 years of medical school were more stressed, and those who had more friends were less anxious and depressed

Psychological profile of Iranian patients with low-back pain

A hospital case - control study in Isfahan, Islamic Republic of Iran, compared the features of 200 patients with low - back pain with 350 matched controls. The control group psychological scored lower than patients in all dimensions of the Symptom Checklist - 90 checklist. Female patients were more psychologically affected by low - back pain than males. In both groups, grudge, general complaints, anxiety, depression, obsessive - compulsive behaviours, somatization and phobia varied with level of education. Patients' levels of depression and anxiety were related to occupational background. Longer duration of illness was accompanied by higher levels of anxiety, depression, obsessive - compulsive behaviours and somatization

Differential aspects of consultation-liaison psychiatry in a Saudi hospital. I: referral pattern and clinical indices

Consultation-liaison psychiatry has emerged as an important sub-specialty in the general hospital setting during recent years as a result of psychiatric acute wards moving into these hospitals. This has inspired the need for better structured research to establish its relevance and effectiveness. We, therefore, carried out a prospective cohort study at King Fahad General Hospital. We report the interaction of sociodemographic, clinical and diagnostic factors, time lag of referral and diagnostic ability of referring physicians. A total of 206 patients were referred over a period of 6 months. Sensitivity and specificity of the diagnostic skills of the referring doctors were found to be generally poor, particularly for anxiety

Психическое здоровье в чрезвычайных ситуациях: Психические и социальные аспекты здоровья людей в ситуациях, сопряженных с воздействием чрезвычайного стресса.

В данном документе обобщается нынешняя позиция Департамента психического здоровья и зависимости от психоактивных веществ по вопросу оказания помощи тем людям, которые находятся в чрезвычайных ситуациях, таким как беженцы, тем, кто вынужденно покинул места проживания, тем, кто пережил стихийное бедствие, а также тем, кто пострадал от терроризма, войны или геноцида. ВОЗ признает, что число лиц, подвергающихся чрезвычайному стрессу, является значительным, и что воздействие чрезвычайного стресса является фактором риска с точки зрения психического здоровья и социальных проблем. Изложенные здесь принципы и стратегии применимы, главным образом, в странах с ограниченными ресурсами, где проживает значительное число людей, подверженных стихийным бедствиям и войнам. Психическое здоровье и благополучие работников гуманитарной помощи также заслуживает внимания, однако их нужды в настоящем документе не рассматриваются.