Mental health outcomes among health-care workers dealing with COVID-19/severe acute respiratory syndrome coronavirus 2 pandemic: A systematic review and meta-analysis.

INTRODUCTION: The psychological impact of COVID-19 on health-care workers (HCWs) has received attention from researchers to understand the extent of the effects of the ongoing pandemic on this population. The aim of this systematic review and meta-analysis was to synthesize the currently available literature on the topic to determine the prevalence of mental health problems in HCWs. MATERIALS AND METHODS: We conducted a systematic review and meta-analysis, searching PubMed, PsycINFO, Scopus, and Cochrane Library databases for articles published from December 2019 to August 15, 2020. We identified studies reporting the prevalence of any mental health condition in HCWs involved directly or indirectly in providing services during the COVID-19 pandemic. The prevalence proportion for individual outcome was extracted as an estimate of interest. We performed random-effects meta-analyses evaluated using Q statistic, I 2 statistic, subgroup analyses, and sensitivity analyses and assessed study quality. This review was done in adherence to the Reporting Items for Systematic Reviews and Meta-Analysis and Meta-analysis of Observational Studies in Epidemiology guidelines. The study protocol was registered prospectively at PROSPERO (CRD42020182005). RESULTS: We identified 1958 studies, of which 33 studies including 39703 participants (with a median = 393; range = 88-14825) were finally included for analysis. The estimated overall prevalence were as follows: depression 32.4% (95% confidence interval [CI]: 25.9-39.3, I 2 = 99%), anxiety 32.5% (95% CI: 26.4-39.0, I 2 = 99%), insomnia or sleep disturbance 36.6% (95% CI: 36.6-48.3, I 2 = 99%), and stress 37.7% (95% CI: 24.0-52.3, I 2 = 100%). CONCLUSION: HCWs who are dealing with the COVID-19 pandemic have a significant prevalence of depression, anxiety, insomnia and poor sleep quality, and stress. The health-care workforce needs to practice self-care now more than ever, while health-care managers and policymakers need to factor in the mental health consequences of COVID-19 on their workforce.

Impaired recollection-based episodic memory as a cognitive endophenotype in schizophrenia.

INTRODUCTION: Patients with schizophrenia show impaired recollection but largely preserved familiarity-based episodic memory. This study was done to clarify the endophenotypic nature of recollection and familiarity-based episodic memory in schizophrenia and the role of emotional valence of memoranda and degree of recall confidence in it. METHOD: Twenty-five patients with schizophrenia, one unaffected sibling of each patient, and twenty-three healthy controls completed two tasks assessing recollection and familiarity-based processes in episodic memory. In the first task, participants were asked to remember positive, negative, and neutral emotional valence words in a remember-know paradigm. In the second task, in addition to recollection and familiarity-based responses, participants were asked to make confidence judgments about their responses. RESULTS: Patients with schizophrenia and their first-degree relatives (FDRs) performed poorly on recollection but not familiarity-based responses, compared to healthy controls; performance of first-degree relatives was in between and significantly different from that of both patients and controls. The differences in recollection and familiarity-based responses across the three groups were not moderated by recall confidence judgments or emotional valence of memoranda. Furthermore, there was no correlation between recollection-based memory impairments and duration or severity of illness or current medication exposure. CONCLUSIONS: Impaired recollection-based memory constitutes a potential cognitive endophenotype in schizophrenia. Furthermore, selective impairment of recollection-based, but sparing of familiarity-based, memory in patients and their FDRs supports the distinct nature of recollection and familiarity-based episodic memories.

Lower P300 amplitudes for internally-generated events in patients with schizophrenia.

BACKGROUND: Patients with schizophrenia demonstrate difficulty differentiating internally-generated from externally-generated events. An excessive deployment of attention to external events as well as poor processing of self-generated events has been proposed to explain this misattribution. This study was done to understand the neurophysiological basis of source monitoring bias in schizophrenia. METHODS: Seventeen patients and fourteen healthy controls completed a two-stage source monitoring task involving solving a three-letter jumbled word either by the participant or a computer following which they had to identify the correct source of the word - solved by self (internal source monitoring, ISM) or by computer (external source monitoring, ESM) - while EEG was recorded. P300 amplitude and latency were computed separately for ISM and ESM conditions. RESULTS: P300 amplitude for ISM condition was lower in patients with schizophrenia compared to controls over right and left parietal regions. Additionally, P300 amplitude for ISM condition was lower compared to ESM condition in patients over right and left parietal regions. However, P300 amplitude for ESM condition did not differ significantly between the groups. In contrast to P300 amplitude, there was no significant difference in P300 latency in ISM or ESM condition within or between the groups. CONCLUSION: P300 amplitude was lower for internally-generated but not externally-generated events in patients with schizophrenia. These findings suggest that patients allocate less attentional resources to internally generated events resulting in poorer processing and consequent misattribution of their source of origin. This study provides the first specific electrophysiological evidence of impaired source monitoring in schizophrenia.