Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study.

BACKGROUND: Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies. METHOD: In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category). RESULTS: In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04). CONCLUSIONS: This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.

Effects of the Global Ecological Crisis on the Mental Health of Children and Adolescents: An International Perspective.

Climate change has become a global emergency, which mental health effects are increasingly being described and understood. Children and adolescents, especially those in low income countries and minority communities, are particularly vulnerable to experience the worst impacts of climate change now and in the coming decades. Our group of early career mental health clinicians and researchers in nine culturally and socioeconomic different countries across three continents initiated a global, online discussion about the effects of climate change on the mental health of children and adolescents, based on literature and our professional experience. We identified a paucity of research and psychiatric education on the topic, and a need to advance global and local efforts in this direction. We also identified three main domains of mental health impact of climate change: direct, indirect, and through physical conditions. Our work offers a preliminary, up-to-date overview of the consequences of climate change on the mental health of children and adolescents, and provides recommendations to advance policies, public health efforts, research, education, and clinical care in the emerging area of 'Climate Psychiatry'.

[Psychometric properties of the Hungarian Adult Attachment Scale]. / A Collins­Read Felnott Kötodési Skála pszichometriai jellemzoinek vizsgálata.

BACKGROUND AND PURPOSE: The revised Adult Attachment Scale (AAS) developed by N. L. Collins is a widely used questionnaire to measure adult attachment. However, its psychometric properties have not been investigated in Hungary. We aimed to confirm the key psychometric properties of the Hungarian version of the AAS focusing on reliability indices on a population that consis-ted of depressed and non-depressed young adults. METHODS: The AAS is a self-report questionnaire, in which two different dimensional evaluating systems are possible: the original (close, depend, and anxiety) and the alternative scoring system (anxiety, avoidance). Our study population consisted of young adults with a history of major depression (n = 264, median age = 25.7 years) and their never-depressed biological siblings (n = 244, median age = 24.0). RESULTS: The internal consistency of close, anxiety, and avoidance scales were satisfactory (Cronbach-α >0.7). The consistency of the depend scale was slightly lower than expected (Cronbach-α = 0.62). Test-retest reliability was good for all of the scales, it ranged from 0.73 to 0.78 after 14 months of follow-up period. The scale showed good discrimination as tested by the differences of close and anxiety attachment dimensions between the groups (p<0.01). More-over, we were able to differentiate the currently dep-res-sed subjects based on these attachment dimensions. Explo-ra-tory and confirmatory factor analyses were conducted, and a bifactor solution proved optimal model fit. CONCLUSION: The three dimensions of the AAS has not been confirmed. However, the close and anxiety scales of AAS were found to be adequate. Our results also indicate that attachment features correlate with major depressive episodes in adulthood.

Factor structure of The Opening Minds Stigma Scale for Health Care Providers and psychometric properties of its Hungarian version.

BACKGROUND: The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a widely used questionnaire to measure the stigmatising attitudes of healthcare providers towards patients with mental health problems. The psychometric properties of the scale; however, have never been investigated in Hungary. We aimed to thoroughly explore the factor structure of the OMS-HC and examine the key psychometric properties of the Hungarian version. METHODS: The OMS-HC is a self-report questionnaire that measures the overall stigmatising attitude by a total score, and three subscales can be calculated: Attitude, Disclosure and Help-seeking, and Social Distance. Our study population included specialists and trainees in adult and child psychiatry (n = 211). Exploratory and confirmatory factor analyses were performed, and higher-order factors were tested. We calculated the test-retest reliability on a subgroup of our sample (n = 31) with a follow-up period of 1 month. The concurrent validity of the scale was measured with the Mental Illness: Clinician's Attitudes-4 scale (MICA-4). RESULTS: Three factors were extracted based on a parallel-analysis. A bifactor solution (a general factor and three specific factors) showed an excellent model-fit (root mean square error of approximation = 0.025, comparative fit index = 0.961, and Tucker-Lewis index = 0.944). The model-based reliability was low; however, the general factor showed acceptable reliability (coefficient omega hierarchical = 0.56). The scale demonstrated a good concurrent validity with the MICA-4 [intraclass correlation coefficient (ICC) = 0.77]. The test-retest reliability was excellent for the general factor (ICC = 0.95) and good for the specific factors (ICC = 0.90, 0.88, and 0.84, respectively). CONCLUSIONS: The three dimensions of the OMS-HC was confirmed, and the scale was found to be an adequate measure of the stigmatising attitude in Hungary. The bifactor model is more favourable as compared to the three correlated factor model; however, despite the excellent internal structure, its model-based reliability was low.

Parity of esteem: A global COVID-19 vaccination approach for people with mental illnesses, based on facts from 34 countries; recommendations and solutions.

Background: The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has detrimental effects on physical and mental health. Patients with severe mental illness are at higher risk of contracting the virus due to social determinants of health. Vulnerable populations include the elderly, people with pre-existing conditions, and those exposed to SARS-CoV-2. Unfortunately, only a few countries have updated vaccination strategies to prioritize patients with mental illnesses. Therefore, we aimed to explore whether individuals with mental disorders are prioritized in vaccine allocation strategies in different world regions. They are often neglected in policymaking but are highly vulnerable to the threatening complications of COVID-19. Methods: A questionnaire was developed to record details regarding COVID-19 vaccination and prioritizations for groups of persons with non-communicable diseases (NCDs), mental disorders, and substance use disorders (SUDs). NCDs were defined according to the WHO as chronic diseases that are the result of a combination of genetic, physiological, environmental, and behavioral factors such as cardiovascular diseases, cancer, respiratory diseases, and diabetes. Results: Most countries surveyed (80%) reported healthcare delivery via a nationalized health service. It was found that 82% of the countries had set up advisory groups, but only 26% included a mental health professional. Most frequently, malignancy (68%) was prioritized followed by diabetes type 2 (62%) and type 1 (59%). Only nine countries (26%) prioritized mental health conditions. Conclusion: The spread of the coronavirus has exposed both the strengths and flaws of our healthcare systems. The most vulnerable groups suffered the most and were hit first and faced most challenges. These findings raise awareness that patients with mental illnesses have been overlooked in immunization campaigns. The range of their mortality, morbidity, and quality of life could have widened due to this delay.

[Effect of the COVID-19 pandemic on the outcome of testicular torsion in children]. / A COVID­19-járvány hatása a gyermekkori herecsavarodások kimenetelére.

INTRODUCTION: The COVID-19 pandemic influenced not only the elective, but the acute surgeries also, all around the world. Some authors found more delayed cases and more orchiectomies performed in childhood because of testicular torsions during the pandemic. OBJECTIVE: To examine the impact of the COVID-19 pandemic on the treatment of childhood testicular torsion and the frequency of semicastration due to torsion at the first author's institute. METHODS: A retrospective observational cohort study was performed in a representative Hungarian centre. Boys under 18 years of age operated with testicular torsion were divided into two groups: before COVID-19 (BC; 01/07/2017-31/12/2019) and during COVID-19 (DC; 01/01/2020-30/06/2022) pandemic. PARAMETERS: elapsed time between the first symptom and arrival at the hospital (<24 h or >24 h), elapsed time to start the surgical procedure since the arrival to the hospital and the rate of semicastration were analysed. For statistical analysis, Mann-Whitney U and chi2 tests were used. RESULTS: During the study period, altogether, 100 patients (45 BC and 55 DC) were operated on testicular torsion. Statistically significant difference was found between the two timeframes: in the elapsed time from the first symptom and arrival at the hospital (p = 0.048). During the pandemic surgeries started earlier (1.5; 2.5 h) than before the pandemic (1.5; 3.25 h, p = 0.01). No difference was found in the frequency of semicastration between the groups (p = 0.594). DISCUSSION: Contrary to the literature, during the COVID-19 pandemic, patients with testicular torsion arrived earlier at the hospital, and surgeries were started earlier, than before the pandemic at the investigated institute. CONCLUSION: The reason behind this accelerated care pathway might be the absence of less severe cases during the COVID-19 period. When people are more prone to stay home, if it does not seem necessary to seek help for any kind of non-urgent medical problem. Orv Hetil. 2023; 164(35): 1367-1372.

Prevention of suicides associated with global warming: perspectives from early career psychiatrists.

Climate change poses significant challenges to global mental health, with potential consequences including increased rates of suicide and mental health disorders. Early Career Psychiatrists (ECPs) play a crucial role in addressing these challenges. The Climate Psychiatry Alliance, a group of psychiatrists dedicated to improving mental health amidst climate change, recognizes the importance of cultivating climate-aware ECPs. Training ECPs to become confident climate-aware clinicians enables them to effectively treat patients experiencing anxiety, depression, and PTSD in the context of climate-related distress. Together with other mental health professionals, ECPs can contribute to efforts by implementing strategies for monitoring and treating mental health problems arising from climate events. Additionally, they can raise awareness about the psychological consequences and risks of suicide associated with climate change. Collaboration among ECPs from various regions is essential in developing community-based approaches and reducing vulnerabilities. ECPs must prioritize supporting vulnerable populations by advocating for increased funding for mental health support and research in affected areas. Long-term solutions to address the mental health impacts of climate change and global warming should be pursued to mitigate future suicidality. Integrating climate considerations into local mental health programs and expanding psychological support services is crucial. By promoting emotional resilience and self-awareness, ECPs can contribute to building a more climate-resilient and mentally healthy society.

Corrigendum: Illness perceptions of COVID-19 in Europe: predictors, impacts and temporal evolution.

[This corrects the article DOI: 10.3389/fpsyg.2021.640955.].

Psychometric properties of the Opening Minds Stigma Scale for Health Care Providers in 32 European countries - A bifactor ESEM representation.

Aims: To measure the stigma of healthcare providers toward people suffering from mental illness, the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a commonly applied instrument. However, this scale has not been thoroughly validated in many European countries, its psychometric properties are still unknown and data on practicing psychiatrists is lacking. Therefore, this multicenter study aimed to assess the psychometric characteristics of the 15-item OMS-HC in trainees and specialists in adult and child psychiatry in 32 countries across Europe. Materials and methods: The OMS-HC was conducted as an anonymous online survey and sent via Email to European adult and child psychiatrists. Parallel analysis was used to estimate the number of OMS-HC dimensions. Separate for each country, the bifactor ESEM, a bifactor exploratory structural equation modeling approach, was applied to investigate the factor structure of the scale. Cross-cultural validation was done based on multigroup confirmatory factor analyses and reliability measures. Results: A total of 4,245 practitioners were included, 2,826 (67%) female, 1,389 (33%) male. The majority (66%) of participants were specialists, with 78% working in adult psychiatry. When country data were analyzed separately, the bifactor model (higher-order factor solution with a general factor and three specific factors) showed the best model fit (for the total sample χ2/df = 9.760, RMSEA = 0.045 (0.042-0.049), CFI = 0.981; TLI = 0.960, WRMR = 1.200). The average proportion of variance explained by the general factor was high (ECV = 0.682). This suggests that the aspects of 'attitude,' 'disclosure and help-seeking,' and 'social distance' could be treated as a single dimension of stigma. Among the specific factors, the 'disclosure and help-seeking' factor explained a considerable unique proportion of variance in the observed scores. Conclusion: This international study has led to cross-cultural analysis of the OMS-HC on a large sample of practicing psychiatrists. The bifactor structure displayed the best overall model fit in each country. Rather than using the subscales, we recommend the total score to quantify the overall stigmatizing attitudes. Further studies are required to strengthen our findings in countries where the proposed model was found to be weak.

Attitudes of psychiatrists towards people with mental illness: a cross-sectional, multicentre study of stigma in 32 European countries.

Background: Mental health-related stigma occurs among the public and professionals alike. The lived experience of mental illness has been linked to less stigmatising attitudes. However, data on psychiatrists and the relationship between stigmatising attitudes and psychotherapeutic activity or case discussion groups remains scarce. Methods: A cross-sectional multicentre study was performed in 32 European countries to investigate the lived experiences and attitudes of psychiatrists toward patients with mental illness as well as the relationship between stigma, psychosocial and professional factors. The self-reported, anonymous, internet-based Opening Minds Stigma Scale for Health Care Providers was used to measure the stigmatising attitudes. The survey was translated into the local language of each participating country. All participants were practising specialists and trainees in general adult or child and adolescent psychiatry. The study took place between 2nd October, 2019 and 9th July, 2021 and was preregistered at ClinicalTrial.gov (NCT04644978). Findings: A total of 4245 psychiatrists completed the survey. The majority, 2797 (66%), had completed training in psychiatry, and 3320 (78%) worked in adult psychiatry. The final regression model showed that across European countries more favourable attitudes toward people with mental illness were statistically significantly associated with the lived experience of participants (including seeking help for their own mental health conditions (d = -0.92, 95% confidence interval (CI) = -1.68 to -0.15, p = 0.019), receiving medical treatment for a mental illness (d = -0.88, 95% CI = -1.71 to -0.04, p = 0.040), as well as having a friend or a family member similarly affected (d = -0.68, 95% CI = -1.14 to -0.22, p = 0.004)), being surrounded by colleagues who are less stigmatising (d = -0.98, 95% CI = -1.26 to -0.70, p < 0.001), providing psychotherapy to patients (d = -1.14, 95% CI = -1.63 to -0.65 p < 0.001), and being open to (d = -1.69, 95% CI = -2.53 to -0.85, p < 0.001) and actively participating in (d = -0.94, 95% CI = -1.45 to -0.42, p < 0.001) case discussion, supervision, or Balint groups. Interpretation: Our study highlights the importance of psychotherapy training, supervision, case discussions and Balint groups in reducing the stigmatising attitudes of psychiatrists toward patients. As the findings represent cross-national predictors, Europe-wide policy interventions, national psychiatric education systems and the management of psychiatric institutions should take these findings into consideration. Funding: National Youth Talent Award (Ministry of Human Resources, Hungary, (NTP-NFTÖ-20-B-0134). All authors received no funding for their contribution.

Laparoscopic appendectomy in children Evaluation of the learning curve / Laparoszkópos appendectomia gyermekkorban

Introduction: The advantages of laparoscopic against open appendectomy were observed both in adults and children. Objective: The aim of the authors was to study the learning period when they switched from open to laparoscopic appendectomy. Methods: Retrospective, observational study was performed. Children (0­18 years) between 2016 and 2017 were included, who underwent acute appendectomy. Exclusion criteria were other surgical procedure performed at the same time (Meckel's diverticulum, ovarian pathology), converted laparoscopic procedure and malignancies. Patients were divided to open appendectomy (OA) and laparoscopic appendectomy (LA) groups. Duration of the procedures, length of hospital stay, postoperative complications were reviewed. For statistical analysis Mann­Whitney, Fisher's exact and chi2 tests were used. Results: During the study period, 297 appendectomies were performed (open: 149, laparoscopic: 148). In 2017, reaching the end of the learning curve, laparoscopy was the faster procedure (p = 0.0003). The length of stay was shorter in laparoscopic than in open appendectomy (p<0.0001). There was no difference in the number of postoperative complications between the OA and the LA groups (p = 0.2409). Discussion: Our study supports the international studies in English literature which showed that the results of a laparoscopic operation in childhood after the "learning phase" do not differ, and may be better, than those of an open one. Conclusion: LA is a safe and fast procedure in childhood. Even paediatric surgeons who did previously only open procedures, can switch to the laparoscopic technique following a short learning curve.

Stigma towards mental illness and help-seeking behaviors among adult and child psychiatrists in Hungary: A cross-sectional study.

OBJECTIVE: Stigma towards people with mental health problems is a growing issue across the world, to which healthcare providers might contribute. The aim of the present study was to explore psychiatrists' attitudes towards their patients and link them to psychosocial and professional factors. METHODS: An online questionnaire was used to approach the in- and outpatient psychiatric services across Hungary. A total of 211 trainees and specialists in adult and child psychiatry participated in our study. Their overall stigmatizing attitudes were measured, with focus on attitude, disclosure and help-seeking, and social distance dimensions by using the self-report Opening Minds Stigma Scale for Health Care Providers (OMS-HC). Multiple linear regression analyses were performed to elucidate the dimensions of stigma and its association with sociodemographic, professional and personal traits. RESULTS: Stigmatizing attitudes of close colleagues towards patients were statistically significant predictors of higher scores on the attitude [B = 0.235 (0.168-0.858), p = 0.004], the disclosure and help-seeking subscales [B = 0.169 (0.038-0.908), p = 0.033], and the total score of the OMS-HC [B = 0.191 (0.188-1.843), p = 0.016]. Psychiatrists who had already sought help for their own problems had lower scores on the disclosure and help-seeking subscale [B = 0.202 (0.248-1.925), p = 0.011]. The overall stigmatizing attitude was predicted by the openness to participate in case discussion, supervision or Balint groups [B = 0.166 (0.178-5.886), p = 0.037] besides the more favorable attitudes of their psychiatrist colleagues [B = 0.191 (0.188-1.843), p = 0.016]. CONCLUSIONS: The favorable attitudes of psychiatrists are associated with their own experiences with any kind of psychiatric condition, previous help-seeking behavior and the opportunity to work together with fellow psychiatrists, whose attitudes are less stigmatizing. The perception of fellow colleagues' attitudes towards patients and the openness to case discussion, supervision and Balint groups were the main two factors that affected the overall attitudes towards patients; therefore, these should be considered when tailoring anti-stigma interventions for psychiatrists.

Suicide, Stigma and COVID-19: A Call for Action From Low and Middle Income Countries.

Suicide is a global health issue that needs to be addressed. The COVID-19 pandemic has resulted in an increased mental health burden. Stigma has obstructed efforts to prevent suicide as individuals who need urgent support do not seek appropriate help. The influence of stigma is likely to grow in tandem with the COVID-19 pandemic. The stigmatization of persons with mental illnesses is widespread worldwide, and it has substantial effects on both the individual and society. Our viewpoints aim to address the probable link between stigma and suicide in the wake of the current pandemic and propose ideas for reducing suicide-related stigma.

Associations of lockdown stringency and duration with Google searches for mental health terms during the COVID-19 pandemic: A nine-country study.

OBJECTIVES: We examined the associations of lockdown stringency and duration with Google searches for four mental health concepts (i.e., "Anxiety," "Depression," "Suicide," "Mental Health") in nine countries (i.e., Hungary, India, Iran, Italy, Paraguay, Serbia, South Africa, Spain, Turkey) during the COVID-19 pandemic. METHODS: We retrieved national-level data for each country from Google Trends and the Global Panel Database of Pandemic Policies. In our primary analysis, we used data from all countries to estimate a set of multilevel regression models examining associations of overall lockdown stringency and lockdown duration with relative search volumes for each mental health term. We repeated the models after replacing overall lockdown stringency with each of the lockdown stringency components. RESULTS: A negative association was found between overall lockdown stringency and "Depression." Lockdown duration and the most stringent stay-at-home requirements were negatively associated with "Anxiety." Policies that recommended or required the cancelation of public events evidenced negative associations with "Depression," whereas associations between policies that required some or all levels of schooling to close and "Depression" were positive. Policies that recommended or required workplaces to close and those that enforced quarantines on non-citizens arriving from high-risk regions or closed borders entirely were negatively associated with "Suicide." CONCLUSIONS: Lockdown duration and some lockdown policies during the COVID-19 pandemic were generally associated with significantly lower, rather than higher, Google searches for selected mental health terms. These findings could be used alongside other evidence to develop future lockdown strategies that are sensitive to mental health issues during public health crises.

Is everyone invited to the discussion table? A bibliometric analysis COVID-19-related mental health literature.

Background: The COVID-19 pandemic has captured the mental health discussion worldwide. Examining countries' representation in this discussion could prove instrumental in identifying potential gaps in terms of ensuring a truly global conversation in times of global crisis. Methods: We collected mental health and COVID-19-related journal articles published in PubMed in 2020. We focused on the corresponding authors' countries of affiliation to explore countries' representation. We also examined these articles' academic impact and correlations with their corresponding authors' countries of affiliation. Additional journals and countries' indicators were collected from the Web of Science and World Bank websites, respectively. Data were analyzed using the IBM SPSS Statistics and the VOSviewer software. Results: In total, 3492 publications were analyzed. Based on the corresponding author, high-income countries produced 61.9% of these publications. Corresponding authors from Africa, Latin America and the Caribbean, and the Middle East combined accounted for 11.8% of the publications. Europe hosted corresponding authors with the most publications and citations, and corresponding authors from North America had the largest mean journal impact factor. Conclusions: The global scientific discussion during the COVID-19 pandemic saw an increased contribution of academics from developing countries. However, authors from high-income countries have continued to shape this discussion. It is imperative to ensure the active participation of low- and middle-income countries in setting up the global mental health research agenda, particularly in situations of global crisis, such as the ongoing pandemic.

Scaling Up Global Mental Health Services During the COVID-19 Pandemic and Beyond.

Every health care system requires an adequate health care workforce, service delivery, financial support, and information technology. During the COVID-19 pandemic, global health systems were ill prepared to address the rising prevalence of mental health problems, especially in low- and middle-income countries (LMICs), thereby increasing treatment gaps. To close these gaps globally, task shifting and telepsychiatry should be made available and maximized, particularly in LMICs. Task shifting to nonspecialist health workers to improve essential mental health coverage and encourage efficient use of the available resources and technology has become the most viable strategy.

How to overcome barriers to publication in low- and middle-income countries: Recommendations from early career psychiatrists and researchers from around the world.

There is an increasing movement toward international collaboration and global discussion in mental health. If provided with the right opportunities, early career psychiatrists (ECPs) and researchers in mental health can contribute meaningfully to this discussion. However, they often experience multiple barriers when attempting to add their voices via academic publications. We represent a diverse group of ECPs and researchers from all six World Health Organization regions. In this piece, we discuss these barriers, grounded in our first-hand experiences, and put forth a series of recommendations. The most potentially beneficial and immediate way forward is ensuring a much-needed mentorship and support, particularly for low- and middle-income countries. In this regard, international organizations, especially those with a particular focus on education, such as the Section on Education in Psychiatry of the World Psychiatric Association, can play a pivotal role.

Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution.

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors. Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context. Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.

To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic.

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans' social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multiple regression analyses showed that prosocial behavior was associated with better well-being consistently across regions. With regard to predictors of prosocial behavior, high levels of perceived social support were most strongly associated with prosocial behavior, followed by high levels of perceived stress, positive affect and psychological flexibility. Sociodemographic and psychosocial predictors of prosocial behavior were similar across regions.

Mental Health and Adherence to COVID-19 Protective Behaviors among Cancer Patients during the COVID-19 Pandemic: An International, Multinational Cross-Sectional Study.

A population-based cross-sectional study was conducted during the first COVID-19 wave, to examine the impact of COVID-19 on mental health using an anonymous online survey, enrolling 9565 individuals in 78 countries. The current sub-study examined the impact of the pandemic and the associated lockdown measures on the mental health, and protective behaviors of cancer patients in comparison to non-cancer participants. Furthermore, 264 participants from 30 different countries reported being cancer patients. The median age was 51.5 years, 79.9% were female, and 28% had breast cancer. Cancer participants reported higher self-efficacy to follow recommended national guidelines regarding COVID-19 protective behaviors compared to non-cancer participants (p < 0.01). They were less stressed (p < 0.01), more psychologically flexible (p < 0.01), and had higher levels of positive affect compared to non-cancer participants. Amongst cancer participants, the majority (80.3%) reported COVID-19, not their cancer, as their priority during the first wave of the pandemic and females reported higher levels of stress compared to males. In conclusion, cancer participants appeared to have handled the unpredictable nature of the first wave of the pandemic efficiently, with a positive attitude towards an unknown and otherwise frightening situation. Larger, cancer population specific and longitudinal studies are warranted to ensure adequate medical and psychological care for cancer patients.