Mental Health and well-being During the COVID-19 Pandemic and After the Russian Invasion of Ukraine.

The study compared the mental health of university students during the COVID-19 pandemic and the Russian invasion of Ukraine. A repeated online cross-sectional study was performed twice among university students in Ukraine: in November 2020 (Pre-war sample, n = 752) and September-October 2022 (During-war sample, n = 862). The survey measured life satisfaction (SWLS), perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). Stress, anxiety, and life satisfaction levels were similar during the war and pandemic, while symptoms of depression decreased during the war, compared to the pandemic. Network analysis showed that anxiety has a crucial effect on depression and stress, and stress is most closely related to life satisfaction. The association of life satisfaction with anxiety and depression disappeared in wartime, in contrast to the pandemic. The priority of prevention and intervention programs in wartime Ukraine should focus on anxiety as the most influential factor in other mental health and well-being problems. The results showed high resistance and adaptation to war conditions among university students in Ukraine.

Where does mating drive come from?

Comment on "Asexuality in Drosophila juvenile males is organizational and independent of juvenile hormone" by Ji et al.

Competition between stochastic neuropeptide signals calibrates the rate of satiation.

We investigated how transmission of hunger- and satiety-promoting neuropeptides, NPY and αMSH, is integrated at the level of intracellular signaling to control feeding. Receptors for these peptides use the second messenger cAMP. How cAMP integrates opposing peptide signals to regulate energy balance, and the in vivo spatiotemporal dynamics of endogenous peptidergic signaling, remain largely unknown. We show that AgRP axon stimulation in the paraventricular hypothalamus evokes probabilistic NPY release that triggers stochastic cAMP decrements in downstream MC4R-expressing neurons (PVHMC4R). Meanwhile, POMC axon stimulation triggers stochastic, αMSH-dependent cAMP increments. Release of either peptide impacts a ~100 µm diameter region, and when these peptide signals overlap, they compete to control cAMP. The competition is reflected by hunger-state-dependent differences in the amplitude and persistence of cAMP transients: hunger peptides are more efficacious in the fasted state, satiety peptides in the fed state. Feeding resolves the competition by simultaneously elevating αMSH release and suppressing NPY release, thereby sustaining elevated cAMP in PVHMC4R neurons. In turn, cAMP potentiates feeding-related excitatory inputs and promotes satiation across minutes. Our findings highlight how biochemical integration of opposing, quantal peptide signals during energy intake orchestrates a gradual transition between stable states of hunger and satiety.

Competition between stochastic neuropeptide signals calibrates the rate of satiation.

We investigated how transmission of hunger- and satiety-promoting neuropeptides, NPY and αMSH, is integrated at the level of intracellular signaling to control feeding. Receptors for these peptides use the second messenger cAMP, but the messenger's spatiotemporal dynamics and role in energy balance are controversial. We show that AgRP axon stimulation in the paraventricular hypothalamus evokes probabilistic and spatially restricted NPY release that triggers stochastic cAMP decrements in downstream MC4R-expressing neurons (PVH MC4R ). Meanwhile, POMC axon stimulation triggers stochastic, αMSH-dependent cAMP increments. NPY and αMSH competitively control cAMP, as reflected by hunger-state-dependent differences in the amplitude and persistence of cAMP transients evoked by each peptide. During feeding bouts, elevated αMSH release and suppressed NPY release cooperatively sustain elevated cAMP in PVH MC4R neurons, thereby potentiating feeding-related excitatory inputs and promoting satiation across minutes. Our findings highlight how state-dependent integration of opposing, quantal peptidergic events by a common biochemical target calibrates energy intake.

Mental health symptoms and coping strategies among Ukrainians during the Russia-Ukraine war in March 2022.

CONTEXT: The Russian attack on Ukraine has been ongoing since February 24, 2022. Nevertheless, no research has documented the mental health of Ukrainians during the biggest land war in Europe after the Second World War, or how Ukrainians cope with the impact of the war. OBJECTIVES: To provide the prevalence rates of symptoms of psychological distress, anxiety, depression, and insomnia; and to link them with Ukrainians' productive coping strategies during the war. DESIGN, SETTING, AND PARTICIPANTS: Online survey conducted in Ukraine during the initial period of the Russian invasion (March 19-31, 2022), using a quota sampling method, of 1,400 Ukrainians aged 18 years or older, with a total of 801 valid responses for a response rate of 57.2%. MAIN OUTCOME MEASURES: Psychological distress assessed by the Kessler Psychological Distress scale (K6); anxiety assessed by Generalized Anxiety Disorder-2 (GAD-2) scale; depression assessed by Patient Health Questionnaire-2 (PHQ-2); insomnia assessed by Insomnia Severity Index-4 (ISI-4); modes of coping assessed by Brief COPE. RESULTS: Of 801 Ukrainian adults, 52.7% had symptoms of psychological distress (mean = 13.3 [SD = 4.9]); 54.1% of them reported symptoms of anxiety (mean = 2.9 [SD = 1.7]); 46.8% reported symptoms of depression (mean = 2.6 [SD = 1.6]). Symptom criteria for insomnia were met by 97 respondents (12.1%) (mean = 10.4 [SD = 4.2]). Demographic variables (including gender, living in an urban area, having children or elderly persons in the household, living in an area occupied by Russian forces) were associated with symptoms of distress, anxiety, depression, and insomnia. The productive coping strategies of using instrumental support, behavioral disengagement, self-distraction, and planning were significantly associated with mental health symptoms. CONCLUSIONS: Prevalence rates of symptoms of psychological distress, anxiety, depression, and insomnia were high. These findings underscore the need for healthcare and productive coping strategies for Ukrainians during the war.

Early evidence on the mental health of Ukrainian civilian and professional combatants during the Russian invasion.

BACKGROUND: The ongoing Russian invasion of Ukraine has led many Ukrainians to fight for their country, either in the regular army or as civilian members of voluntary territorial defense forces. There is, however, a dearth of knowledge on the mental health of combatants in this conflict. Prior research on the mental health of combatants is unlikely to translate to the situation at hand because such research is focused on combatants fighting abroad and neglects civilian combatants. METHODS: This study provides the first attempt to investigate the mental health of Ukrainian combatants in the regular army and voluntary territorial defense forces by analyzing the prevalence rates of common mental health issues, as well as their demographic and socioeconomic predictors. RESULTS: Between March 19 and 31, 2022, the initial period of Russia's invasion of Ukraine, a sample of 178 Ukrainian combatants (104 in the regular army and 74 civilian combatants) participated in a survey on symptoms of anxiety (GAD-2), depression (PHQ-2), and insomnia (ISI). CONCLUSIONS: A sizable portion of Ukrainian combatants reached cut-off levels for clinical symptoms of anxiety (44·4%), depression (43·3%), and insomnia (12·4%). Importantly, the mental health of Ukrainian combatants varied between professional soldiers and civilian combatants, as well as by gender, marital status, by whether or not they were located in Russian-occupied/active-combat areas, and dependent on whether they were personally involved in combat. This study provides early evidence on the mental health of Ukrainian combatants, pointing to their urgent need for mental health assistance in the ongoing war.

Predicting Managers' Mental Health Across Countries: Using Country-Level COVID-19 Statistics.

Background: There is limited research focusing on publicly available statistics on the Coronavirus disease 2019 (COVID-19) pandemic as predictors of mental health across countries. Managers are at risk of suffering from mental disorders during the pandemic because they face particular hardship. Objective: We aim to predict mental disorder (anxiety and depression) symptoms of managers across countries using country-level COVID-19 statistics. Methods: A two-wave online survey of 406 managers from 26 countries was performed in May and July 2020. We used logistic panel regression models for our main analyses and performed robustness checks using ordinary least squares regressions. In the sample, 26.5% of managers reached the cut-off levels for anxiety (General Anxiety Disorder-7; GAD-7) and 43.5% did so for depression (Patient Health Questionnaire-9; PHQ-9) symptoms. Findings: We found that cumulative COVID-19 statistics (e.g., cumulative cases, cumulative cases per million, cumulative deaths, and cumulative deaths per million) predicted managers' anxiety and depression symptoms positively, whereas daily COVID-19 statistics (daily new cases, smoothed daily new cases, daily new deaths, smoothed daily new deaths, daily new cases per million, and smoothed daily new cases per million) predicted anxiety and depression symptoms negatively. In addition, the reproduction rate was a positive predictor, while stringency of governmental lockdown measures was a negative predictor. Individually, we found that the cumulative count of deaths is the most suitable single predictor of both anxiety and depression symptoms. Conclusions: Cumulative COVID-19 statistics predicted managers' anxiety and depression symptoms positively, while non-cumulative daily COVID-19 statistics predicted anxiety and depression symptoms negatively. Cumulative count of deaths is the most suitable single predictor of both anxiety and depression symptoms. Reproduction rate was a positive predictor, while stringency of governmental lockdown measures was a negative predictor.

Mental health symptoms during the COVID-19 pandemic in developing countries: A systematic review and meta-analysis.

Background: This systematic review aims to 1) summarize the prevalence of anxiety, depression, distress, insomnia, and PTSD in the adult population during the first year of the COVID pandemic in developing countries and 2) uncover and highlight the uneven distribution of research on mental health in all developing countries across regions. Methods: Several literature databases were systemically searched for meta-analyses published by September 22, 2021, on the prevalence rates of mental health symptoms in developing countries worldwide. We meta-analysed the raw data of the individual empirical results from the previous meta-analysis papers in developing countries in different regions. Results: The prevalence rates of mental health symptoms were summarized based on 341 empirical studies with a total of 1 704 072 participants from 40 out of 167 developing countries in Africa, Asia (East, Southeast, South, and West), Europe, and Latin America. Comparatively, Africa (39%) and West Asia (35%) had the worse overall mental health symptoms, followed by Latin America (32%). The prevalence rates of overall mental health symptoms of medical students (38%), general adult students (30%), and frontline health care workers (HCWs) (27%) were higher than those of general HCWs (25%) and general populations (23%). Among five mental health symptoms, distress (29%) and depression (27%) were the most prevalent. Interestingly, people in the least developing countries suffered less than those in emergent and other developing countries. The various instruments employed lead to result heterogeneity, demonstrating the importance of using the well-established instruments with the standard cut-off points (eg, GAD-7, GAD-2, and DASS-21 for anxiety, PHQ-9 and DASS-21 for depression, and ISI for insomnia). Conclusions: The research effort on mental health in developing countries during COVID-19 has been highly uneven in the scope of countries and mental health outcomes. This meta-analysis, the largest on this topic to date, shows that the mental health symptoms are highly prevalent yet differ across regions. The accumulated systematic evidence from this study can help enable the prioritization of mental health assistance efforts to allocate attention and resources across countries and regions.

Mental disorder symptoms during the COVID-19 pandemic in Latin America - a systematic review and meta-analysis.

AIMS: There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America. METHODS: Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. Studies were assigned quality scores using the Mixed Methods Appraisal Tool. The double data extraction method was used to minimise data entry errors. RESULTS: A total of 62 studies with 196 950 participants in Latin America were identified. The pooled prevalence of anxiety, depression, distress and insomnia was 35%, 35%, 32% and 35%, respectively. There was a higher prevalence of mental health symptoms in South America compared to Central America (36% v. 28%, p < 0.001), in countries speaking Portuguese (40%) v. Spanish (30%). The pooled prevalence of mental health symptoms in the general population, general healthcare workers, frontline healthcare workers and students in Latin America was 37%, 34%, 33% and 45%, respectively. CONCLUSIONS: The high yet heterogenous level of prevalence of mental health symptoms emphasises the need for appropriate identification of psychological interventions in Latin America.

Meta-Regression on the Heterogenous Factors Contributing to the Prevalence of Mental Health Symptoms During the COVID-19 Crisis Among Healthcare Workers.

Objective: This paper used meta-regression to analyze the heterogenous factors contributing to the prevalence rate of mental health symptoms of the general and frontline healthcare workers (HCWs) in China under the COVID-19 crisis. Method: We systematically searched PubMed, Embase, Web of Science, and Medrxiv and pooled data using random-effects meta-analyses to estimate the prevalence rates, and ran meta-regression to tease out the key sources of the heterogeneity. Results: The meta-regression results uncovered several predictors of the heterogeneity in prevalence rates among published studies, including severity (e.g., above severe vs. above moderate, p < 0.01; above moderate vs. above mild, p < 0.01), type of mental symptoms (PTSD vs. anxiety, p = 0.04), population (frontline vs. general HCWs, p < 0.01), sampling location (Wuhan vs. Non-Wuhan, p = 0.04), and study quality (p = 0.04). Conclusion: The meta-regression findings provide evidence on the factors contributing to the prevalence rate of mental health symptoms of the general and frontline healthcare workers (HCWs) to guide future research and evidence-based medicine in several specific directions. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=220592, identifier: CRD42020220592.

Meta-analytic evidence of depression and anxiety in Eastern Europe during the COVID-19 pandemic.

Objective: To perform a systematic and meta-analysis on the prevalence rates of mental health symptoms including anxiety and depression during the COVID-19 pandemic in the general population in Eastern Europe, as well as three select sub-populations: students, general healthcare workers, and frontline healthcare workers. Data sources: Studies in PubMed, Embase, Web of Science, PsycINFO, and medRxiv up to 6 February 2021. Eligibility criteria and data analysis: Prevalence rates of mental health symptoms in the general population and key sub-populations during the COVID-19 pandemic in Eastern Europe. Data were pooled using a random-effects meta-analysis to estimate the prevalence rates of anxiety and depression. Results: The meta-analysis identifies and includes 21 studies and 26 independent samples in Eastern Europe. Poland (n = 4), Serbia (n = 4), Russia (n = 3), and Croatia (n = 3) had the greatest number of studies. To our knowledge, no studies have been conducted in eleven Eastern European countries including Hungary, Slovakia, and Slovenia. The pooled prevalence of anxiety in 18 studies with 22 samples was 30% (95% CI: 24-37%) pooled prevalence of depression in 18 studies with 23 samples was 27% (95% CI: 21-34%). Implications: The cumulative evidence from the meta-analysis reveals high prevalence rates of clinically significant symptoms during the COVID-19 pandemic in Eastern Europe. The findings suggest evidence of a potential mental health crisis in Eastern Europe during the ongoing COVID-19 pandemic. Our synthesis also reveals a relative lack of studies in certain Eastern European countries as well as high heterogeneities among the existing studies, calling for more effort to achieve evidence-based mental healthcare in Eastern Europe.

Objetivo: Realizar un metanálisis sistemático sobre las tasas de prevalencia de síntomas de salud mental, incluidos ansiedad y depresión durante la pandemia de COVID-19 en la población general de Europa del Este, así como en tres subpoblaciones seleccionadas: estudiantes, trabajadores sanitarios generales y trabajadores sanitarios de primera línea.Fuentes de datos: Estudios en PubMed, Embase, Web of Science, PsycINFO y medRxiv hasta el 6 de febrero de 2021.Criterios de elegibilidad y análisis de datos: Tasas de prevalencia de síntomas de salud mental en la población general y subpoblaciones claves durante la pandemia de COVID-19 en Europa del Este. Los datos se combinaron mediante un metanálisis de efectos aleatorios para estimar las tasas de prevalencia de ansiedad y depresión.Resultados: El metanálisis identifica e incluye 21 estudios y 26 muestras independientes en Europa del Este. Polonia (n = 4), Serbia (n = 4), Rusia (n = 3) y Croacia (n = 3) tuvieron el mayor número de estudios. Hasta donde sabemos, no se han realizado estudios en once países de Europa del Este, incluidos Hungría, Eslovaquia y Eslovenia. La prevalencia combinada de ansiedad en 18 estudios con 22 muestras fue de 30% (IC del 95%: 24­37%) y la prevalencia combinada de depresión en 18 estudios con 23 muestras fue de 27% (IC del 95%: 21­34%).Implicaciones: La evidencia acumulada del metanálisis revela altas tasas de prevalencia de síntomas clínicamente significativos durante la pandemia de COVID-19 en Europa del Este. Los hallazgos sugieren evidencia de una posible crisis de salud mental en Europa del Este durante la pandemia de COVID-19 en curso. Nuestra síntesis también revela una relativa falta de estudios en ciertos países de Europa del Este, así como una gran heterogeneidad entre los estudios existentes, lo que exige un mayor esfuerzo para lograr una atención de la salud mental basada en la evidencia en Europa del Este.

A Systematic Review and Meta-Analysis of Symptoms of Anxiety, Depression, and Insomnia in Spain in the COVID-19 Crisis.

BACKGROUND: General population, frontline healthcare workers (HCWs), and adult students in Spain are at risk of anxiety, depression, and insomnia symptoms during the COVID-19 crisis. A meta-analysis of the individual studies on these symptoms would provide systematic evidence to aid policymakers and researchers in focusing on prevalence, risk, and best interventions. OBJECTIVE: This paper aims to be the first meta-analysis and systematic review to calculate the prevalence of anxiety, depression, and insomnia symptoms in Spain's adult population (general population, frontline healthcare workers (HCWs), and adult students) during the Covid-19 epidemic. METHOD: Random-effect meta-analysis was used to estimate the prevalence of anxiety, depression, and insomnia. RESULTS: The meta-analysis includes 28 studies with 38 individual samples in Spain. The pooled prevalence of anxiety symptoms in 22 studies comprising a sample population of 82,024 was 20% (95% CI: 15-25%), that of depression symptoms in 22 articles with a total sample comprising 82,890 individuals was 22% (95% CI: 18-28%), and that of insomnia symptoms in three articles with a sample population of 745 was 57% (95% CI: 48-66%. CONCLUSIONS: The accumulative evidence reveals that adults in Spain suffered higher prevalence rates of mental symptoms during the COVID-19 crisis, with a significantly higher rate relative to other countries such as China. Our synthesis also reveals a relative lack of studies on frontline and general HCWs in Spain.

History-dependent dopamine release increases cAMP levels in most basal amygdala glutamatergic neurons to control learning.

Dopaminergic inputs to basal amygdala (BA) instruct learning of motivational salience. This learning depends on intracellular plasticity signals such as cyclic adenosine monophosphate (cAMP), which is regulated by activation of dopamine receptors. We examine the dynamics of dopamine release and downstream signaling during multiple salient events occurring within tens of seconds. We perform real-time tracking and manipulation of cAMP in BA neurons in vitro and in vivo. Optogenetically evoked release of dopamine drives proportional increases in cAMP in almost all BA glutamatergic neurons, suggesting widespread actions of dopamine across neurons preferring positive or negative valence. This cAMP response decreases across trials with short intertrial intervals owing to depression of dopamine release. No such depression is evident when photostimulating cAMP production directly. cAMP and protein kinase A responses to repeated appetitive or aversive stimuli also exhibit pronounced depression. Thus, history-dependent dynamics of dopamine and cAMP may regulate learning of temporally clustered, salient stimuli.

Correction to: Succumbing to the COVID-19 Pandemic-Healthcare Workers Not Satisfied and Intend to Leave Their Jobs.

[This corrects the article DOI: 10.1007/s11469-020-00418-6.].

Succumbing to the COVID-19 Pandemic-Healthcare Workers Not Satisfied and Intend to Leave Their Jobs.

Healthcare workers are under such a tremendous amount of pressure during the COVID-19 pandemic that many have become concerned about their jobs and even intend to leave them. It is paramount for healthcare workers to feel satisfied with their jobs and lives during a pandemic. This study aims to examine the predictors of job satisfaction, life satisfaction, and turnover intention of healthcare workers during the COVID-19 pandemic. Between 10 and 30 April 2020, 240 healthcare workers in Bolivia completed a cross-sectional online survey, which assessed their job satisfaction, life satisfaction, and turnover intention in the ongoing COVID-19 pandemic. The results revealed that their number of office days predicted job satisfaction, life satisfaction, and turnover intention, but the relationships varied by their age. For example, healthcare workers' office days negatively predicted job satisfaction for the young (e.g., at 25 years old: b = - 0.21; 95% CI: - 0.36 to - 0.60) but positively predicted job satisfaction for the old (e.g., at 65 years old: b = 0.25; 95% CI: 0.06 to 0.44). These findings provide evidence to enable healthcare organizations to identify staff concerned about job satisfaction, life satisfaction, and turnover intention to enable early actions so that these staffs can remain motivated to fight the prolonged COVID-19 pandemic.

Drilling under the COVID-19 pandemic: A diary study of professional football players' mental health and workout performance.

There is little research examining how individuals' daily experience during a pandemic affects their daily mental health status and work performance. To address this knowledge gap, we invoke conservation of resources theory to propose a resource-based framework explaining how individuals' daily COVID-19 intrusive experience affects their daily mental health status (depression and anxiety) and work performance via its effect on daily psychosocial resource loss and gain; We further examine whether their supervisors' daily visionary leadership behaviour alleviates the adverse impacts of daily COVID-19 intrusive experience. Results, based on daily diary data from 139 football players (or soccer players) at 15 professional football clubs over 5 days during the COVID-19 pandemic, provided support for our predictions. Our study extends the literature by providing previously undocumented evidence on daily within-person variations in mental health status and work performance during a pandemic and by offering theory-driven insights into the mediating and moderating mechanisms involved in within-person variations.

A systematic review and meta-analysis of the mental health symptoms during the Covid-19 pandemic in Southeast Asia.

AIMS: The Covid-19 pandemic has had a substantial impact on the mental health of the general public and high-risk groups worldwide. Due to its proximity and close links to China, Southeast Asia was one of the first regions to be affected by the outbreak. The aim of this systematic review was to evaluate the prevalence of anxiety, depression and insomnia in the general adult population and healthcare workers (HCWs) in Southeast Asia during the course of the first year of the pandemic. METHODS: Several literature databases were systemically searched for articles published up to February 2021 and two reviewers independently evaluated all relevant studies using pre-determined criteria. The prevalence rates of mental health symptoms were calculated using a random-effect meta-analysis model. RESULTS: In total, 32 samples from 25 studies with 20 352 participants were included. Anxiety was assessed in all 25 studies and depression in 15 studies with pooled prevalence rates of 22% and 16%, respectively. Only two studies assessed insomnia, which was estimated at 19%. The prevalence of anxiety and depression was similar among frontline HCWs (18%), general HCWs (17%), and students (20%) while being noticeably higher in the general population (27%). CONCLUSIONS: This is the first systematic review to investigate the mental health impact of the Covid-19 pandemic in Southeast Asia. A considerable proportion of the general population and HCWs reported mild to moderate symptoms of anxiety and depression; the pooled prevalence rater, however, remain significantly lower than those reported in other areas such as China and Europe.

The Relationship Between Age and Mental Health Among Adults in Iran During the COVID-19 Pandemic.

The evidence on the predictors of mental health in the COVID-19 pandemic has revealed contradictory findings, which prevent effective screening for mental health assistance. This study aims to identify the predictors of mental health issues, specifically examining age as a nonlinear predictor. Based on a survey of 474 adults using snowball sampling under the COVID-19 pandemic during April 1th-10th, 2020, in Iran, we found that age had a curvilinear relationship with nonsomatic pain, depression, and anxiety. Specifically, it predicted pain, depression, and anxiety disorders, negatively among adults younger than 45 years, yet positively among seniors older than 70 years. Adults who were female, were unsure about their chronic diseases, or exercised less were more likely to have mental health issues. This study, being the first paper to examine age curvilinearly, suggests future research to pay more attention to nonlinear predictors of mental health disorders in the COVID-19 pandemic.

Scientific evidence on mental health in key regions under the COVID-19 pandemic - meta-analytical evidence from Africa, Asia, China, Eastern Europe, Latin America, South Asia, Southeast Asia, and Spain.

This systematic review aims to summarize the prevalence of anxiety, depression, and insomnia in the general adult population and healthcare workers (HCWs) in several key regions worldwide during the first year of the COVID pandemic. Several literature databases were systemically searched for meta-analyses published by 22 September 2021 on the prevalence rates of mental health symptoms worldwide. The prevalence rates of mental health symptoms were summarized based on 388 empirical studies with a total of 1,067,021 participants from six regions and four countries. Comparatively, Africa and South Asia had the worse overall mental health symptoms, followed by Latin America. The research effort on mental health during COVID-19 has been highly skewed in terms of the scope of countries and mental health outcomes. The mental health symptoms are highly prevalent yet differ across regions, and such evidence helps to enable prioritization of mental health assistance efforts to allocate attention and resources based on the regional differences in mental health.

El objetivo de esa revisión sistemática es el de resumir la prevalencia de la ansiedad, la depresión y el insomnio, tanto en la población general adulta como en los trabajadores de salud de diferentes regiones clave alrededor del mundo durante el primer año de la pandemia por la COVID-19. Se revisaron de manera sistemática diversas bases de datos científicas buscando metaanálisis sobre la prevalencia de síntomas en salud mental alrededor del mundo, publicados hasta el 22 de setiembre del 2021. Se resumió la prevalencia de los síntomas de salud mental sobre la base de 388 estudios empíricos, comprendiendo a 1.067.021 participantes de cuatro países y de seis regiones. África y Asia meridional tuvieron, de manera general, los peores síntomas de salud mental, seguidas por Latinoamérica. El esfuerzo por realizar investigación en salud mental durante la pandemia por la COVID-19 ha estado altamente sesgado en torno a la envergadura de los países y de las medidas de resultado empleadas en salud mental. Los síntomas de salud mental son altamente prevalentes; no obstante, difieren a lo largo de diferentes regiones. Esta evidencia ayuda a permitir la priorización de los esfuerzos de atención en salud mental asignando la atención y recursos basados sobre las diferencias regionales en salud mental.