Evolution of psychopathology, purpose in life, and moral courage in healthcare workers during the COVID-19 pandemic: a longitudinal study.

Introduction: Almost 2 years and five infection waves after the COVID-19 pandemic started, healthcare workers continued dealing with the pandemic situation and facing the health consequences and the mental health disorders it caused. This study aimed to evaluate the onset and progression of psychopathology as well as the role of predictor variables such as purpose in life and moral courage among healthcare workers during this time. Materials and methods: This was a longitudinal prospective study carried out with 45 Spanish healthcare workers who answered two questionnaires, the first questionnaire in April-May 2020 (T1) and the second questionnaire in September-October 2021 (T2). Results: Although 29.5% of the sample considered that their mental health had improved over this time, almost half of them (47.7%) said it had not changed, while 22.7% reported a decline in their mental health from the first time they were asked. Specifically, 46.8% presented anxiety, 23.4% depression, and 42.6% acute stress at T1, and 38.3% had anxiety, 17% depression, and 27.7% post-traumatic stress disorder at T2. Despite this, there were no differences between T1 and T2 anxiety scores (p = 0.53), although there was a decrease in depression (p = 0.03) and acute stress (p = 0.02) scores. Predictor variable outcomes such as purpose in life (p = 0.88) and moral courage (p = 0.86; p = 0.38) did not change over time, but when modelling the data, purpose in life predicted psychopathology at T1, which in turn affected the psychopathology results at T2. Conclusion: This study showed that, although psychopathology decreased over the months, its prevalence remained high. Even though the purpose in life predicted psychopathology at T1, it seems that once the psychopathology is established (T2), the factors that would improve it would be different from the protective factors that prevented its establishment, which become secondary.

Hope, resilience and subjective happiness among general population of Paraguay in the post COVID-19 pandemic.

BACKGROUND: Positive mental health includes not only the absence of mental disorders but also the presence of subjective well-being, good coping strategies for life stress, and strategies for adapting to community life. It is well known that the COVID-19 pandemic has challenged mental health in general population worldwide. However, research has not measured protective factors for mental health in the general population after the declared end of pandemic by the World Health Organization. METHODS: This observational, cross-sectional study surveyed 591 Paraguayan participants aged ⩾18 years, who were recruited through an online survey. Demographic characteristics, socioeconomic status were collected as well as mental health and validated tools for hope, resilience, subjective happiness were administered. RESULTS: Of the participants, 81.6% were women, 54% were married or in a relationship and 90.7% reported an university education. The main source of stress was economic issues (30.3%). A total of 22.7% had been previously diagnosed with a mental disorder, 22.2% had consulted a mental health professional and 10.8% had consumed prescription drugs. 42.6% reported flourishing, 36.2% reported moderate and 21.2% reported languishing mental health. CONCLUSIONS: This large survey has shown that most of participants reported a flourishing mental health with high ratings at hope, resilience, and subjective happiness scales. Also, the main sources of stress were economic issues, not consequently related to the pandemic. This may add evidences to the international debate on the long term effects of the global pandemic and probably suggests that recovery processes have been collectively adopted in Paraguay.

Trastornos psicóticos en Paraguay: ¿existen diferencias significativas entre zonas urbanas y rurales? / Psychotic disorders in Paraguay: Are there any significant differences between urban and rural areas?

Actualmente existe una tendencia mundial de desplazamiento de la población rural hacia áreas cada vez más urbanizadas. Existe evidencia que informa que el desarrollo de las enfermedades mentales tiene relación importante con factores tanto internos (por ejemplo, genéticos) y externos (el ambiente, entre otros). Con respecto a esto último, la manera en la que el entorno afecta a la salud mental es un objeto de estudio de interés global y se ha reportado que las áreas urbanas presentan mayores tasas de trastornos mentales comunes en comparación con las rurales. En el caso de la psicosis, por más de que el factor genético sea el más demostrado (y estudiado en los últimos años), el factor ambiental representando por el ambiente urbano ya ha sido analizado por investigadores a inicios del siglo 20. Desde allí, a lo largo de los años se obtuvo evidencia repetida que lo respalda como un factor de riesgo. Se ha encontrado que, además, existe relación con el grado de exposición, lo que hace pensar que la causa no solamente se limita a la transición del área rural al área urbana, sino que están involucrados factores sociales, económicos y medioambientales más profundos como la disparidad social, inseguridad, contaminación, entre otros 1. Ya en las últimas décadas del siglo 20, investigadores informaron de un aumento de la incidencia de esquizofrenia de 1,65 en hombres que vivían ciudades sobre sus contrapartes de origen rural. Años después, otros estudios han reportado esta variación en la incidencia de primeros episodios psicóticos a través del gradiente social urbano-rural, así como una relación entre el aumento de hospitalización por esquizofrenia con el grado de urbanización.

Violencia urbana y salud mental de adultos jóvenes de Paraguay / Urban violence and mental health of young adults in Paraguay

A nivel mundial, la violencia urbana se ha convertido en una preocupación importante para la salud pública. Investigaciones resaltan que la violencia es un factor de riesgo significativo para la salud mental de los individuos. La exposición a eventos traumáticos relacionados con la violencia urbana, como asaltos, robos o violencia interpersonal, puede tener consecuencias graves para la salud mental. En el contexto continental, América Latina se ha visto especialmente afectada por la violencia urbana. Estudios epidemiológicos en países latinoamericanos han demostrado que la violencia urbana está asociada con un mayor riesgo de trastornos de ansiedad, estrés y depresión en la población joven y adulta. A nivel nacional, el Paraguay enfrenta desafíos significativos en términos de violencia urbana. Aunque la situación ha mejorado en los últimos años, persisten altos índices de violencia relacionada con el crimen, pandillas y conflictos socioeconómicos. La población joven se encuentra particularmente expuesta a estos eventos traumáticos, lo que plantea preocupaciones sobre el impacto en su salud mental.

Asociación entre cronotipo y síntomas depresivos: un estudio exploratorio / Association between chronotype and depressive symptoms: an exploratory study

Introducción: el cronotipo es la predisposición natural de cada individuo a experimentar picos de energía o momentos de descanso en función de su ritmo circadiano. Los individuos pueden tener cronotipos matutinos, vespertinos o intermedios, que pueden tener relación con el desarrollo de depresión. Objetivo: determinar la existencia de asociación entre el cronotipo y la sintomatología depresiva en una muestra de adultos. Metodología: este estudio observacional, descriptivo y exploratorio se realizó en agosto de 2023. Se incluyeron en este estudio adultos de ambos sexos. Se recolectaron datos sociodemográficos, y los participantes respondieron el Morningness-Eveningness Questionnaire de Horne y Östberg para evaluar el cronotipo, y el Patient Health Questionnaire de 2 ítems (PHQ-2) para evaluar los síntomas depresivos. Se utilizaron estadísticas descriptivas para todas las variables. Para la estadística inferencial, se utilizó la prueba de chi-cuadrado con un nivel de confianza del 95 %. Se utilizó odds ratio para cuantificar las relaciones. Resultados: un total de 105 personas participaron en el estudio, de las cuales el 58 % eran mujeres. La edad media de la muestra era de 29,4 ± 11,6 años. El 69 % de la muestra presentaba el cronotipo matutino, mientras que el 31 % presentaba el cronotipo vespertino. Se observó que el 31 % de los participantes puntuaba positivamente para depresión (PHQ-2 ≥ 3). Se encontró una relación entre el cronotipo y los puntos de corte del PHQ-2 (p=0,036). Se halló una OR=2,5 (IC 95%: 1,05-5,95) a favor del cronotipo vespertino para el desarrollo de depresión. Conclusión: casi siete de cada diez participantes tenían un cronotipo matutino, mientras que tres de cada diez dieron positivo en depresión. Los individuos con cronotipos vespertinos son más propensos a desarrollar síntomas depresivos que aquellos con cronotipos matutinos.

Introduction: chronotype is the natural predisposition of each individual to experience peaks of energy or moments of rest according to their circadian rhythm. Individuals may have morning, evening, or intermediate chronotypes that may be related to the development of depression. Objective: to determine the existence of an association between chronotype and depressive symptomatology in a sample of adults. Methodology: this observational, descriptive, and exploratory study was conducted in August 2023. Adults of both sexes were included in this study. Sociodemographic data were collected, and participants answered the Morningness-Eveningness Questionnaire by Horne and Östberg to assess chronotype, and the 2-item Patient Health Questionnaire (PHQ-2) to assess depressive symptoms. Descriptive statistics were used for all the variables. For inferential statistics, the chi-squared test was used with a confidence level of 95 %. Odds ratio was used to quantify the relationships. Results: a total of 105 people participated in the study, 58 % of whom were women. The mean age of the sample was 29.4 ± 11.6 years. Sixty-nine percent of the sample presented the morning chronotype, while 31 % presented the evening chronotype. It was found that 31 % of the participants scored positively for depression (PHQ-2 ≥ 3). A relationship was found between chronotype and PHQ-2 cutoff points (p=0.036). An OR=2.5 (95 % CI 1.05-5.95) was found in favor of the evening chronotype for the development of depression. Conclusion: almost seven out of ten participants had a morning chronotype, whereas three out of ten were positive for depression. Individuals with evening chronotypes are more likely to develop depressive symptoms than those with morning chronotypes.

Dermatitis Artefacta: A Practical Guide for Diagnosis and Management.

Dermatitis artefacta (DA) is a psycho-dermatologic condition based on patients' behavioral patterns, characterized by an intentional production of cutaneous lesions on their own skin. The clinical presentation can be highly variable. Patients with DA seldom seek psychological support or psychiatric consultation. More often, they seek help from their primary care physician or dermatologist. This review article aims to provide a practical guide for the diagnosis and management of AD and affected patients. A broad literature search was performed using the PubMed and Google Scholar electronic online databases, using key words "dermatitis artefacta", "diagnosis", "management", and "psychodermatology". The search was limited to English and Spanish language articles and was supplemented with themed books and book chapters. DA can occur in a variety of clinical presentations, and physicians should suspect DA in patients with a history of psychiatric disorders or extensive use of healthcare services. The ultimate goal of DA treatment may be a proper referral to mental health services. However, the prognosis is poor even when successful mental health referrals are achieved, with low recovery rates. A useful approach may include the suggestion that a mental health provider can help with the anxiety and the distress generated by the lesions: in this case in this case it will be crucial to discuss this with the mental health provider after obtaining informed consent from the patient. Considering the difficulty in promoting patients' adherence to treatment, the ideal setting for DA treatment is a psycho-dermatologic clinic, where both dermatologic and psychological interventions can be seamlessly integrated.

Suicides among adults in Paraguay: An 18-year national exploratory study (2004-2022).

BACKGROUND: The number of suicides has been increasing worldwide, year after year, becoming the fourth leading cause of death among young people between 15 and 29 years of age. AIM: In this study, we explored the frequency and characteristics of suicides among the adult general population in Paraguay between 2004 and 2022, considering that suicide attempts and suicidal risk/ideation are frequent and relevant issues in the consultation activity, even if epidemiological evidence on the national rates of suicide is scarce. METHODS: In this observational, descriptive, and exploratory study, official records of all deaths by suicide were reviewed and information analyzed. In addition, an attempt was made to predict the number of suicides in the next 5 years according to a mathematical modeling. RESULTS: In the 18-year period, 5,527 suicides of adults were recorded. Patients' mean age was 36.8 ± 17 years old. A 76.77% of them were males, 77.44% were from an urban area and 25.98% from the Greater Asunción and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation (all 67.6%). The expected number of national suicides in the following years from 2023 to 2027 will range between 462 and 530. Limitations include the lack of information regarding diagnoses and personal history in the suicide reports as well as the possibility of underreporting of national suicide cases. CONCLUSION: Our results represent the first large national epidemiological report of suicides in Paraguay and may be of interest for mental health professionals and health authorities in order to reduce the suicide mortality rate within the country.

Ansiedad, depresión y vulnerabilidad al estrés en personas con diagnóstico de artritis reumatoidea: un estudio exploratorio del Hospital de Clínicas de la Universidad Nacional de Asunción / Anxiety, depression, and vulnerability to stress in people diagnosed with rheumatoid arthritis: An exploratory study at the Hospital de Clínicas of the Universidad Nacional de Asunción

Antecedentes: Estudios observacionales han descrito una alta prevalencia de depresión y ansiedad en la artritis reumatoidea: los trastornos depresivos mayores se detectan en el 17 % de los pacientes con la patología, y la inflamación local y sistémica desempeña un papel importante en la ansiedad y la depresión. Objetivos: El objetivo general de esta investigación fue determinar la frecuencia de ansiedad, depresión y vulnerabilidad al estrés en pacientes con diagnóstico de artritis reumatoidea. Materiales y métodos: Este fue un estudio observacional, descriptivo de asociación cruzada y temporalmente prospectivo. El muestreo fue no probabilístico de casos consecutivos. Se incluyó a personas adultas con diagnóstico de artritis reumatoide que consultaron en el Departamento de Reumatología del Hospital de Clínicas, entre agosto y octubre del 2022. Para el diagnóstico psiquiátrico se utilizaron los siguientes instrumentos: Escala de Ansiedad Generalizada (GAD-7), Patient Health Questionnaire (PHQ-2) y Escala de Vulnerabilidad al Estrés de Smith y Miller. Resultados: Se incluyó a 36 pacientes, todas mujeres, con edades comprendidas entre los 20 y 77 años. El 27,8 % tenía depresión, según los puntos de corte del PHQ-2. El 22,2 % presentaba ansiedad, según los puntos de corte de GAD-7. En cuanto al estrés, el 22,2 % tenía vulnerabilidad a este y el 5,6 % era seriamente vulnerable. Conclusión: Depresión, ansiedad y vulnerabilidad al estrés son comorbilidades frecuentemente observadas en pacientes con artritis reumatoidea. Se requieren de intervenciones específicas de salud mental para abordar estas cuestiones y mejorar la calidad de vida de los pacientes afectados.

Background: Observational studies have described a high prevalence of depression and anxiety in rheumatoid arthritis: major depressive disorders are detected in 17 % of patients with the pathology, and local and systemic inflammation play an important role in anxiety and depression. Objectives: The overall objective of this research was to determine the frequency of anxiety, depression, and vulnerability to stress in patients diagnosed with rheumatoid arthritis. Materials and methods: This was an observational, descriptive, temporally prospective, cross-association study. Sampling was non-probabilistic of consecutive cases. We included adults with a diagnosis of rheumatoid arthritis who consulted at the Rheumatology Department of the Hospital de Clínicas between August and October 2022. The following instruments were used for psychiatric diagnosis: Generalized Anxiety Scale (GAD-7), Patient Health Questionnaire (PHQ-2) and Smith and Miller's Stress Vulnerability Scale. Results: Thirty-six patients, all women, aged between 20 and 77 years, were included in the study. The 27.8 % had depression, according to the cut-off points of the PHQ-2. Anxiety was present in 22.2 %, according to the GAD-7 cut-off points. Regarding stress, 22.2 % were vulnerable to stress and 5.6 % were seriously vulnerable. Conclusion: Depression, anxiety and vulnerability to stress are frequently observed comorbidities in patients with rheumatoid arthritis. Specific mental health interventions are required to address these issues and improve the quality of life of affected patients.

Relationship of DRD5 and MAO-B VNTR polymorphisms with paranoid and antisocial personality disorders in polydrug users.

Although multiple studies have shown the role genetics plays in personality disorders and in addictions, few have studied the genetic aspects of their comorbidity. Here, we carried out a cross-sectional study in a sample comprising 303 Caucasian polydrug-consuming patients. The presence of personality disorders was evaluated using the International Personality Disorder Examination, and genes related to dopamine, serotonin and monoamine oxidase (MAO) were genotyped. A significant relationship was observed between the bp 279 DRD5 variable number of tandem repeat (VNTR) polymorphism and paranoid personality disorder OR 95 % CI = 2.186 1.074 ; 4.449 ; p = 0.006 . The bp 182 OR 95 % CI = 0.407 0.178 ; 0.931 ; p = 0.033 and bp 184 OR 95 % CI = 0.391 0.188 ; 0.813 ; p = 0.012 alleles of the MAOB VNTR were also associated with antisocial personality disorder. Among patients with addictions, paranoid personality disorder should also be considered in addition to the importance of antisocial and borderline personality disorders. The higher frequency of the bp 279 DRD5 VNTR allele found in patients with paranoid personality disorder, as well as the associations between alleles of the MAOB VNTR and antisocial personality disorder, support the monoaminergic bases of these personality disorders, especially when dealing with patients with addictions.

Satisfaction with Telepsychiatry during the COVID-19 pandemic: Patients' and psychiatrists' report from a University Hospital.

BACKGROUND: The COVID-19 pandemic has led to important changes in the approach to patients worldwide. Different agencies have proposed and implemented telemedicine-based care services in order to ensure access to health care for all people. AIM: The aim of this study was to determine the satisfaction of patients using the Telepsychiatry service offered by the Department of Psychiatry of the Hospital de Clínicas (National University of Asunción, Paraguay). METHODS: A cross sectional and descriptive study has been conducted. Participants were recruited through a phone-based survey. Satisfaction with Telepsychiatry has been measured with an adapted version of a satisfaction survey in Teleneurology. As a complement, psychiatrists from the Hospital de Clínicas were also interviewed about their rate of satisfaction with Telepsychiatry. RESULTS: A total of 530 patients were included, 51.3% of whom were women. The consultation satisfaction scale ranged between 2.15 and 4.30 with a mean score of 3.02 ± 0.32. Cronbach's alpha for the scale was .897, indicating a good internal consistency. Patients' satisfaction was higher for the perception of Telepsychiatry and lower for the doctor-patient relationship. Of the physicians, 87.5% were satisfied with the Telepsychiatry service. CONCLUSION: The satisfaction overall score indicates patients' general satisfaction with the quality of care in Telepsychiatry, mainly regarding the perception of health care. and lower satisfaction with the doctor-patient relationship. Nine out of 10 psychiatrists felt satisfied with the Telepsychiatry service and considered that the degree of patient's satisfaction was acceptable during the Telepsychiatry consultation.

The Chikungunya anxiety scale (CHIKAS): Development, validation, and relationship between its items and illness-related factors.

Background: Paraguay has recently experienced an exponential increase in chikungunya cases, leading to psychological distress, particularly anxiety. Aim: To develop and validate the Chikungunya Anxiety Scale (CHIKAS). Materials and Methods: An initial scale of 18 items was used, which was subjected to validation by expert judgment to obtain 14 items. To determine construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) have been employed, and internal and convergent validity were determined. Demographic, socioeconomic, and health status data were also collected. Results: The study included 974 participants. The final scale consisted of 12 items with evidence of a two-factor model (psychological and physical). The internal validity was good (McDonald's omega = 0.882). The CFA showed good adjustment indices. Regarding participant characteristics, a relationship was found between anxiety due to chikungunya and gender, employment, mental diagnosis, medication use, and chikungunya infection. Conclusion: The final 12-item CHIKAS had strong psychometric properties and was a two-factor model.

Factores asociados y propiedades psicométricas de la versión en español del Test Breve de Irritabilidad (BITe) en población paraguaya / Associated factors and psychometric properties of the Spanish version of the Brief Irritability Test (BITe) in Paraguayan population

Antecedentes: La irritabilidad, como síntoma transdimensional, está presente en varios trastornos mentales. Este estudio investigó las propiedades psicométricas de la versión española del Test Breve de Irritabilidad (BITe). Sujetos y métodos: el reclutamiento se realizó a través de una encuesta en línea lanzada a través de las redes sociales comunes (Facebook, Twitter) y aplicaciones de mensajería (WhatsApp, Telegram) del 1 al 31 de mayo de 2022. Los sujetos incluidos fueron personas ≥ 18 años de edad de ambos sexos 1920 individuos fueron calificados para el analisis de validacion. El BITe ha sido traducido al español y validado mediante análisis factorial confirmatorio. Los participantes también han sido puntuados con el Cuestionario de Agresión (AQ). Resultados: la prueba de Kaiser-Meyer-Olkin (KMO) fue adecuada (KMO=0,880) y la esfericidad se probó significativamente (p<0,001). El análisis confirmatorio que garantiza que la escala es unidimensional. El ajuste del modelo fue bueno, según todos los índices de ajuste. El alfa de Cronbach también garantiza una excelente consistencia interna (α=0,91). Las calculadoras entre las dos escalas (BITe y AQ) han mostrado una buena convergencia (r=0,512; p<0,001). Conclusiones: La versión en español del BITe es una escala unidimensional de cinco elementos tipo Likert que muestra buena validez interna y alta confiabilidad, lo que implica que esta versión tiene excelentes propiedades psicométricas tanto para hombres como para mujeres hispanohablantes.

Background: Irritability, as a trans dimensional symptom, is present in several mental disorders.This study investigated the psychometric properties of the Spanish version of the Brief Irritability Test (BITe). Subjects and Methods: The recruitment has been performed through an online survey launched through common social media (Facebook, Twitter) and messaging apps (WhatsApp, Telegram) from 1st to 31st May 2022. Subjects included were individuals ≥18 years old of age of both sexes. 1920 individuals were rated for the validation analysis. The BITe has been translated into Spanish and validated through confirmatory factor analysis. Participants have been also scored with the Aggression Questionnaire (AQ). Results: Kaiser-Meyer-Olkin (KMO) test was adequate (KMO=0.880) and sphericity tested significantly (p<0.001). The confirmatory analysis confirmed that the scale is one- imensional. The model adjustment was good, according to all fit indices. Cronbach's alpha also confirmed an excellent internal consistency (α=0.91). Scores between the two scales (the BITe and the AQ) have shown a good convergence (r=0.512; p<0.001). Conclusions: The Spanish version of the BITe is a unidimensional scale of five Likerttype items that shows good internal validity and high reliability, which implies that this version has excellent psychometric properties for both male and female Spanish-speakers

Burnout, psychopathology and purpose in life in healthcare workers during COVID-19 pandemic.

Background: The COVID-19 pandemic has led to a significant increase in the workload of healthcare workers that, together with the risks associated with exposure to this new virus, has affected their mental health. Objectives: The objective of the current study was to determine the prevalence of psychopathology and burnout syndrome in healthcare workers and the predictive role of purpose in life and moral courage in this relationship. Methods: A cross-sectional study was carried out in 115 Spanish healthcare workers. Results: Participants with burnout had higher anxiety (p = 0.001), depression (p < 0.001), post-traumatic stress (p = 0.01) and alcohol consumption (p = 0.03) levels. The different components of burnout (emotional fatigue and despersonalization) were associated with the occurrence of anxiety (OR = 0.31) and depression (OR = 0.26), respectively. A strong purpose in life decreased emotional fatigue (OR = -0.39) depersonalization (OR = -0.23) scores, increased personal accomplishment (OR = 0.52), subsequently reducing burnout levels (OR = -0.45). Conclusions: Purpose in life was most strongly related to decreased levels of burnout. Furthermore, an association between anxiety, depression and the components of burnout was found.

Anxiety, Addiction to Social Networks, Internet and Smartphones in Paraguayan Adolescents: A Brief Report.

Background: Several authors have pointed out that the use of smartphones might have an impact on mental health in general. Most of the evidences are focused on the incorrect or overblown use of smartphones, videogame or Internet, particularly focusing on related addiction problems among adolescents. Objective: The present study, although preliminary, aims to report the first evidence in Paraguay regarding the association between anxiety and addiction to social networks/internet as well as the use of smartphones among adolescents. Method: Participants (100 adolescents, aged 12- 17 years old) were assessed in a school setting with the Beck Anxiety Inventory (BAI) and the Scale of risk of Addiction to Social Networks and Internet for adolescents (ERA-RSI). Categorical variables and associations were statistically assessed. Results: The average smartphone use in boys rated 8.06 ±3.81 hours and in girls 9.46 ±4.4 hours. The BAI mean score was 20.71 ± 13.2. Of the participants, 27% reported moderate anxiety, and 36% severe anxiety and scores on this scale were not associated with hours of smartphone use. The ERA-RSI mean score was 1.94 ± 0.46 and anxiety was related to the symptoms-addiction, social-use, and nomophobia dimensions of the scale. Conclusion: The misuse of smartphones in the Paraguayan pediatric population has been reported to be closely related to anxious symptoms. Our results suggest further research with an impact on possible public health policies aimed at preserving the mental health of children and adolescents exposed to internet and electronic devices.

Technostress, anxiety, and depression among university students: A report from Paraguay.

BACKGROUND: Although technologies (including information, e-learning, and communication) have been daily employed by University students in the last years, the COVID-19 pandemic has led to a considerable increase in their use. Technostress is a modern term referring to levels of stress caused by the prolonged exposure to technology. AIM: The aim of this study is to assess the technostress and related anxiety and depression among Paraguayan University students, describing their sociodemographic characteristics and relevant associations. METHODS: A cross-sectional and descriptive study has been conducted. Participants were recruited through an Internet-based survey. Technostress, anxiety, and depression have been assessed with the Technostress Questionnaire (TechQ), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and the Patient Health Questionnaire-2 (PHQ-2), respectively. RESULTS: A total of 378 participants were included, 74.1% of whom were women. According to the TechQ scores, 47.4% of the participants reported a low/moderate level of technostress whereas 5.2% showed severe scores. About 58.5% of participants reported a GAD-7 score ⩾10, meeting diagnostic criteria for generalized anxiety. About 60.3% scored ⩾3 at the PHQ-2 reporting significant levels of depression. Technostress has been significantly associated with levels of anxiety (p < .001) as well as depression (p < .001). CONCLUSION: Our results suggest further research regarding the implications of technostress on the well-being of University students. Specific measures aimed to improve students' coping with the challenges of technology and technostress should be promoted.

"Coronaphobia" in Paraguay: Spanish Validation of the COVID-19 Phobia Scale.

BACKGROUND: The COVID-19 is a highly transmissible disease caused by a new zoonotic coronavirus called SARS-CoV-2 that has led to several health, social, and economic issues worldwide. Anxiety and stress are predominant symptoms in the population during the quarantine; also, levels of fear or phobia have been reported. SUBJECTS AND METHODS: This study validate the Spanish version of the COVID-19 Phobia Scale (C19P-S). Participants were recruited using an Internet-based survey. The survey was open from July 20 to July 31, 2021 and 1079 subjects were included. RESULTS: Kaiser-Meyer-Olkin test was adequate (KMO=0.956) and sphericity tested significantly (p<0.0001). The model of adjustment was good as shown by fit indices (S-B χ2=351.67, df=164, p>0.05; RMSEA=0.033; SRMSR=0.042; CFI=0.995, NFI=0.990). CONCLUSIONS: This confirms that the model of the Spanish version of the C19P-S may reproduce the same four-factors model from the original version of the scale and all items of these factors reported standardized loadings higher than 0.40 (p<0.001).