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1.
PLoS One ; 15(11): e0241895, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33175894

RESUMO

Despite the profound health and economic implications of Covid-19, there is only limited knowledge to date about the role of economic concerns, health worries and social distancing for mental health outcomes during the pandemic. We analyze online survey data from the nationally representative "Understanding America Study" (UAS) covering the period of March 10-31st 2020 (sample size: 6,585). Mental health is assessed by the validated PHQ-4 instrument for measuring symptoms of depression and anxiety. About 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms over the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential implications of the virus for respondents' own health and social distancing also predicted increases in symptoms of depression and anxiety during the early stages of the pandemic in the US, albeit less strongly. Our findings point towards the possibility of a major mental health crisis unfolding simultaneously with the pandemic, with economic concerns being a key driving force of this crisis. These results highlight the likely importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response.


Assuntos
Infecções por Coronavirus/patologia , Status Econômico , Saúde Mental , Pneumonia Viral/patologia , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia
3.
Ann Glob Health ; 86(1): 128, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33102148

RESUMO

Background: COVID-19 first appeared in China in December 2019, with a high rate of infectivity and morbidity, which brought tremendous psychological pressure to healthcare workers. Purpose: To understand the psychological health status of healthcare workers during the COVID-19 outbreak and decline, and to provide a theoretical reference for the future establishment of a psychological crisis intervention system. Methods: Healthcare workers were recruited using convenience sampling and snowball sampling methods, and the electronic version of the SCL-90 scale and a sociodemographic questionnaire were administered. In the pretest, a total of 5018 responses were collected; after six weeks, random sampling was performed. The SCL-90 and measures of other epidemic-related problems were administered, with 1570 responses received; then, the final data analysis was performed. Results: After six weeks, the post-test GSI score; SCL-90 total score; and PST, PSDI, O-C, I-S, DEP, ANX, PHOB, PAR, PSY, and HOS scores were significantly lower than the corresponding pretest scores (p < 0.05). The results by occupational category showed that the scores of nursing staff decreased significantly for 12 indexes and that the scores of the doctors and other hospital staff also significantly decreased. There was a significant difference between the pretest (50.78 ± 28.18) and post-test (45.00 ± 28.49) scores for the degree of worry about the epidemic. Healthcare workers believed that the top three aspects of life affected by the epidemic were economic problems (816 people), interpersonal communication problems (731 people), and mental health (728 people). Conclusion: Over the course of the epidemic, the item scores generally declined significantly. Therefore, during an outbreak period, attention should be paid to psychological crisis interventions for healthcare workers; problems caused by psychological pressure, and even other psychological conditions, can be significantly alleviated to reduce the probability of subsequent health problems.


Assuntos
Ansiedade , Infecções por Coronavirus , Intervenção na Crise/métodos , Depressão , Pessoal de Saúde/psicologia , Pandemias , Pneumonia Viral , Estresse Psicológico , Adulto , Ansiedade/diagnóstico , Ansiedade/etiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Depressão/etiologia , Feminino , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Estresse Ocupacional/classificação , Estresse Ocupacional/diagnóstico , Estresse Ocupacional/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Escalas de Graduação Psiquiátrica , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia
4.
JCO Glob Oncol ; 6: 1494-1509, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33017179

RESUMO

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs. METHODS: A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected. RESULTS: A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates. CONCLUSION: Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.


Assuntos
Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , Cuidadores/psicologia , Infecções por Coronavirus/psicologia , Neoplasias/psicologia , Pneumonia Viral/psicologia , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/psicologia , Betacoronavirus/patogenicidade , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/psicologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Estudos Transversais , Medo/psicologia , Feminino , Pessoal de Saúde/psicologia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Humanos , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Masculino , Oncologia/organização & administração , Oncologia/normas , Pessoa de Meia-Idade , Neoplasias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Prevalência , Singapura/epidemiologia , Carga de Trabalho/psicologia
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3707-3710, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018806

RESUMO

There is a recent interest in finding neurophysiological biomarkers which will facilitate the diagnosis and understanding of the neural basis of different psychiatric disorders. In this paper, we evaluated the resting-state global EEG connectivity as a potential biomarker for depressive and anxiety symptoms. For this, we evaluated a population of 119 subjects, including 75 healthy subjects and 44 patients with major depressive disorder. We calculated the global connectivity (spectral coherence) in a setup of 60 EEG channels, for six different spectral bands: theta, alpha1, alpha2, beta1, beta2, and gamma. These global connectivity scores were used to train a Support Vector Regressor to predict symptoms measured by the Beck Depression Inventory (BDI) and the Spielberger Trait Anxiety Inventory (TAI). Experiments showed a significant prediction of both symptoms, with a mean absolute error (MAE) of 8.07±6.98 and 11.52±8.7 points, respectively. Among the most discriminating features, the global connectivity in the alpha2 band (10.0-12.0Hz) presented significantly positive Spearman's correlation with the depressive (rho = 0.32, pFDR <0.01), and the anxiety symptoms (rho = 0.26, pFDR<0.01).Clinical relevance-This study demonstrates that EEG global connectivity can be used to predict depression and anxiety symptoms measured by widely used questionnaires.


Assuntos
Transtorno Depressivo Maior , Ansiedade/diagnóstico , Transtornos de Ansiedade/diagnóstico , Depressão/diagnóstico , Eletroencefalografia , Humanos
6.
J Perinat Med ; 48(9): 965-970, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-32887191

RESUMO

Objectives With clinical experience from previous coronavirus infections, public health measures and fear of infection may have negative psychological effects on pregnant women. This study aimed to compare the level of anxiety and depression in the same pregnant women before and during the COVID-19 pandemic. Methods The pregnant women continuing pregnancy who participated in the first study which was undertaken to clarify the factors associated with mental health of pregnant women before the COVID-19 pandemic, were included for the current study during the outbreak. Anxiety and depression symptoms of the same pregnant women were evaluated by using the Inventory of Depression and Anxiety Symptoms II and Beck Anxiety Inventory twice before and during the pandemic. Results A total of 63 pregnant women completed questionnaires. The mean age of the women and the mean gestational age was 30.35±5.27 years and 32.5±7 weeks, respectively. The mean total IDAS II score was found to increase from 184.78±49.67 (min: 109, max: 308) to 202.57±52.90 (min: 104, max: 329) before and during the SARS-CoV-2 pandemic. According to the BAI scores the number of patients without anxiety (from 10 to 6) and with mild anxiety (from 31 to 24) decreased and patients with moderate (from 20 to 25) and severe anxiety (from 2 to 8) increased after SARS-CoV-2 infection. Multivariate linear regression analysis revealed that obesity and relationship with her husband are the best predictors of IDAS II scores. Conclusions This study indicated that COVID-19 outbreak affects the mental health of pregnant women negatively which leads to adverse birth outcomes. The level of anxiety and depression symptoms of pregnant women during the COVID-19 infection significantly increased. Healthcare professionals should establish comprehensive treatment plans for pregnant women who are highly vulnerable population to prevent mental trauma during the infectious disease outbreaks.


Assuntos
Ansiedade/epidemiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pandemias , Pneumonia Viral/psicologia , Complicações na Gravidez/psicologia , Adulto , Ansiedade/diagnóstico , Depressão/diagnóstico , Feminino , Idade Gestacional , Humanos , Gravidez , Gestantes/psicologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Turquia/epidemiologia
7.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 641-648, 2020 Jun 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879120

RESUMO

OBJECTIVES: To understand the psychological status of the staff in a general hospital during the coronavirus disease 2019 and its influential factors, and to provide references for the mental health services to hospital staff. METHODS: Using star platform of questionnaire, the staff in the general hospital were investigated via Depression, Anxiety, Stress Scale (DASS-21), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). The influential factors were discussed by descriptive analysis, rank sum test, single factor analysis, correlation analysis and multiple factors binary logistic regression analysis. RESULTS: A total of 2 060 valid questionnaires were collected. The negative emotions of nurses and cleaners were the most obvious. The depression scores, anxiety scores and stress scores for nurses and cleaners were 5.06±7.47, 6.36±7.84, 9.75±8.65, and 6.72±8.84, 4.51±6.56, 9.69±9.56, respectively. Multivariate binary logistic regression analysis showed that staff types, education levels, job status, economic situation and concerns on the supplies of protective goods were the main influential factors for depression; staff types, contacting status with infected patients, economic situation, concerns on the supplies of protective goods, history of disease were the main influential factors for anxiety; contacting status with infected patients, economic situation, concerns on the supplies of protective goods were the main influential factors for stress. CONCLUSIONS: There are differences in psychological characteristics among different groups of staff in the general hospital under the outbreak. Thus psychological protection and intervention measures should be formulated according to different groups and work status.


Assuntos
Infecções por Coronavirus/psicologia , Recursos Humanos em Hospital/psicologia , Pneumonia Viral/psicologia , Estresse Psicológico , Adaptação Psicológica , Ansiedade/diagnóstico , Betacoronavirus , China , Estudos Transversais , Depressão/diagnóstico , Surtos de Doenças , Hospitais Gerais , Humanos , Pandemias , Inquéritos e Questionários
8.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 613-619, 2020 Jun 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879116

RESUMO

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is a global public health crisis, which elicits psychological problems in different population. This study is to investigate the impact of COVID-19 on mental health in the front-line staff. METHODS: Patient Health Questionnare-9 (PHQ-9), Self-Rating Anxiety Scale (SAS), and Fatigue Self-assessment Scale (FSAS) were used to assess the depression, anxiety, and fatigue in front-line staff. RESULTS: The detection rates of depression, anxiety, and fatigue were 49.1%, 21.8%, and 76.0% among the front-line staff. The rates of depression, anxiety, and fatigue in community workers were higher than those in medical workers and other occupational staff (P<0.01). The PHQ-9 of front-line staffs was negatively correlated with age, family income, family members' support, satisfaction of service objects, and sleep quality (all P<0.01), while positively correlated with education level, fatigue, fear of pneumonia, and the duration of daily attention to the COVID-19 (all P<0.01). SAS was negatively correlated with age, family income, family support, satisfaction of objects service, and sleep quality (all P<0.01), while positively correlated with gender, fatigue, fear of pneumonia, and duration of daily attention to the COVID-19 (all P<0.01). CONCLUSIONS: The front-line workers should manage work and rest time reasonably to adjust their negative mood and fatigue. The government and the society should pay more attention to the psychological state of the front-line staff, particularly for the staff working in the community or villages and towns in preventing the COVID-19 pandemic. Thus, front-line staff can be obtained mental intervention or be taken a rest from the high-intensive work.


Assuntos
Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Saúde Mental , Pneumonia Viral/psicologia , Ansiedade/diagnóstico , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Depressão/diagnóstico , Fadiga/diagnóstico , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
9.
Psychiatr Danub ; 32(Suppl 1): 5-9, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890353

RESUMO

The COVID-19 epidemic has been a major global public health problem during past months in Italy and in several other Countries and on the date of publication of this article, is still a serious public health problem. The health staff, engaged in the care of the sick and in the prevention of the spread of the infection have been subjected to a further increase in psychological difficulties and work-related stress, related to the workload for the continuous influx of sick and intense and close working shifts for the viral emergency. The SAVE-9 (Stress and Anxiety to Viral Epidemics - 9 items) scale has been developed as a tool for assessing work anxiety and stress in response to the viral epidemic of health professionals working to prevent the spread of the virus and to treat infected people.


Assuntos
Ansiedade/diagnóstico , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Estresse Ocupacional/diagnóstico , Pneumonia Viral/psicologia , Betacoronavirus , Humanos , Itália , Pandemias
10.
BMC Psychol ; 8(1): 99, 2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-32962764

RESUMO

BACKGROUND: Pregnancy as a sensitive period of a woman's life can be affected by various psychological factors that can have adverse effects on the woman, her fetus and future baby. Since COVID-19 is a new phenomenon with limited information available, it may have adverse psychological effects on pregnant women. Therefore, this study was conducted to determine the status of depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. METHODS: This descriptive-analytical cross-sectional study was performed on 205 pregnant women covered by Tabriz health centers in Iran. The sampling method used was cluster sampling. The data collection tool was the socio-demographic characteristics questionnaire and the DASS-21 (Depression, Anxiety and Stress Scale-21), which were completed online by pregnant women. The general linear model was used to determine the predictive factors of depression, anxiety and stress. RESULTS: The mean (SD) score of depression, stress, and anxiety were 3.91 (3.9), 6.22 (4.25), and 3.79 (3.39), respectively; the score range of 0 to 21. Depression, stress, and anxiety symptoms were observed in 32.7, 32.7, and 43.9% of the participants, respectively, with varying degrees from mild to very severe. Based on the adjusted general linear model, variables of education level, spouse's job and marital life satisfaction were the predictors of depressive symptoms. Variables of spouse's education level, spouse's support, marital life satisfaction and the number of pregnancies were the predictive factors of anxiety symptoms and the variables of spouse's education level, household income sufficiency, spouse's support and marital life satisfaction were predictors of stress symptoms. CONCLUSIONS: Considering the role of marital life satisfaction, high level of spouse's education and income in reducing symptoms of stress, anxiety, and depression in pregnant women in critical situations such as the prevalence of COVID-19, it seems that using strategies to promote marital life satisfaction and socio-economic status can play an effective role in controlling anxiety and reducing stress and depression in pregnant women.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Casamento , Pandemias , Pneumonia Viral , Complicações na Gravidez , Estresse Psicológico , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/prevenção & controle , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/prevenção & controle , Complicações na Gravidez/psicologia , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fatores Socioeconômicos , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/prevenção & controle
11.
Transl Psychiatry ; 10(1): 319, 2020 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-32950999

RESUMO

Coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide, with a staggering number of cases and deaths. However, available data on the psychological impacts of COVID-19 on pregnant women are limited. The purposes of this study were to assess the prevalence of psychiatric symptoms among pregnant women, and to compare them with non-pregnant women. From February 28 to March 12, 2020, a cross-sectional study of pregnant and non-pregnant women was performed in China. The online questionnaire was used to collect information of participants. The mental health status was assessed by patient health questionnaire, generalized anxiety disorder scale, insomnia severity index, somatization subscale of the symptom checklist 90, and post-traumatic stress disorder (PTSD) checklist-5. Totally, 859 respondents were enrolled, including 544 pregnant women and 315 non-pregnant women. In this study, 5.3%, 6.8%, 2.4%, 2.6%, and 0.9% of pregnant women were identified to have symptoms of depression, anxiety, physical discomfort, insomnia, and PTSD, respectively. However, the corresponding prevalence rates among non-pregnant women were 17.5%, 17.5%, 2.5%, 5.4%, 5.7%, respectively. After adjusting for other covariates, we observed that pregnancy was associated a reduced risk of symptoms of depression (OR = 0.23; 95% CI: 0.12-0.45), anxiety (OR = 0.26; 95% CI: 0.16-0.42), insomnia (OR = 0.19; 95% CI: 0.06-0.58), and PTSD (OR = 0.15; 95% CI: 0.04-0.53) during the COVID-19 epidemic. Our results indicate that during the COVID-19 epidemic in China, pregnant women have an advantage of facing mental problems caused by COVID-19, showing fewer depression, anxiety, insomnia, and PTSD symptoms than non-pregnant women.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Gestantes/psicologia , Distúrbios do Início e da Manutenção do Sono , Transtornos Somatoformes , Transtornos de Estresse Pós-Traumáticos , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Gravidez , Pesquisa Qualitativa , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia
12.
Medicine (Baltimore) ; 99(38): e22260, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957375

RESUMO

We explored the psychological changes in suspected patients during the coronavirus disease 2019 (COVID-19) epidemic and obtained evidence for early psychological guidance and intervention in this group. A total of 31 inpatients with suspected COVID-19 were identified at our hospital. The depression module of the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD)-7 scale, and the Self-Reporting Questionnaire (SRQ-20) mental health self-assessment questionnaire were used to assess depression, anxiety, and overall mental health. Among the patients, 32.3% had symptoms of depression and 19.4% had symptoms of anxiety. Levels of anxiety and fear varied. In comparing the PHQ-9 and 7-item Generalized Anxiety Disorder Scale scores of suspected and confirmed patients, there was no significant difference in the distribution of severity of anxiety or depression in the 2 groups. The PHQ-9 scores indicated mild depression symptoms in 25.8% of suspected patients, moderate symptoms in 0%, and severe symptoms in 6.5%. Overall, 50% of confirmed patients had symptoms, with 30.8% classified as mild, 15.4% classified as moderate, and 3.8% classified as severe. The 7-item Generalized Anxiety Disorder Scale scores in the group of suspected patients showed that 9.7% had mild symptoms, 0% had moderate symptoms, and 9.7% had severe symptoms. In the group of confirmed patients, 38.4% had symptoms (34.6% mild, 0% moderate, and 3.8% severe). Diagnosed patients had more visible symptoms of depression and different total PHQ-9 scores. During the COVID-19 epidemic, suspected and diagnosed patients had different levels of mental health problems. Diagnosed patients had more visible symptoms. The performance of suspected patients was higher, but their mental state was more polarized. It may thus be important to monitor the psychological state of suspected patients as early as possible to enable timely interventions that promote psychological rehabilitation.


Assuntos
Ansiedade/diagnóstico , Betacoronavirus , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Pneumonia Viral/psicologia , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/virologia , China/epidemiologia , Infecções por Coronavirus/virologia , Depressão/epidemiologia , Depressão/virologia , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Inquéritos e Questionários
13.
J Med Internet Res ; 22(10): e22635, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-32936777

RESUMO

BACKGROUND: The COVID-19 pandemic is impacting mental health, but it is not clear how people with different types of mental health problems were differentially impacted as the initial wave of cases hit. OBJECTIVE: The aim of this study is to leverage natural language processing (NLP) with the goal of characterizing changes in 15 of the world's largest mental health support groups (eg, r/schizophrenia, r/SuicideWatch, r/Depression) found on the website Reddit, along with 11 non-mental health groups (eg, r/PersonalFinance, r/conspiracy) during the initial stage of the pandemic. METHODS: We created and released the Reddit Mental Health Dataset including posts from 826,961 unique users from 2018 to 2020. Using regression, we analyzed trends from 90 text-derived features such as sentiment analysis, personal pronouns, and semantic categories. Using supervised machine learning, we classified posts into their respective support groups and interpreted important features to understand how different problems manifest in language. We applied unsupervised methods such as topic modeling and unsupervised clustering to uncover concerns throughout Reddit before and during the pandemic. RESULTS: We found that the r/HealthAnxiety forum showed spikes in posts about COVID-19 early on in January, approximately 2 months before other support groups started posting about the pandemic. There were many features that significantly increased during COVID-19 for specific groups including the categories "economic stress," "isolation," and "home," while others such as "motion" significantly decreased. We found that support groups related to attention-deficit/hyperactivity disorder, eating disorders, and anxiety showed the most negative semantic change during the pandemic out of all mental health groups. Health anxiety emerged as a general theme across Reddit through independent supervised and unsupervised machine learning analyses. For instance, we provide evidence that the concerns of a diverse set of individuals are converging in this unique moment of history; we discovered that the more users posted about COVID-19, the more linguistically similar (less distant) the mental health support groups became to r/HealthAnxiety (ρ=-0.96, P<.001). Using unsupervised clustering, we found the suicidality and loneliness clusters more than doubled in the number of posts during the pandemic. Specifically, the support groups for borderline personality disorder and posttraumatic stress disorder became significantly associated with the suicidality cluster. Furthermore, clusters surrounding self-harm and entertainment emerged. CONCLUSIONS: By using a broad set of NLP techniques and analyzing a baseline of prepandemic posts, we uncovered patterns of how specific mental health problems manifest in language, identified at-risk users, and revealed the distribution of concerns across Reddit, which could help provide better resources to its millions of users. We then demonstrated that textual analysis is sensitive to uncover mental health complaints as they appear in real time, identifying vulnerable groups and alarming themes during COVID-19, and thus may have utility during the ongoing pandemic and other world-changing events such as elections and protests.


Assuntos
Ansiedade/diagnóstico , Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Saúde Mental/estatística & dados numéricos , Processamento de Linguagem Natural , Pneumonia Viral/epidemiologia , Grupos de Autoajuda/estatística & dados numéricos , Mídias Sociais/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/psicologia , Betacoronavirus , Transtorno da Personalidade Borderline/epidemiologia , Transtorno da Personalidade Borderline/psicologia , Feminino , Saúde Global , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ideação Suicida , Adulto Jovem
14.
Cochrane Database Syst Rev ; 9: CD012417, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32897548

RESUMO

BACKGROUND: People living in 'humanitarian settings' in low- and middle-income countries (LMICs) are exposed to a constellation of physical and psychological stressors that make them vulnerable to developing mental disorders. A range of psychological and social interventions have been implemented with the aim to prevent the onset of mental disorders and/or lower psychological distress in populations at risk, and it is not known whether interventions are effective. OBJECTIVES: To compare the efficacy and acceptability of psychological and social interventions versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at preventing the onset of non-psychotic mental disorders in people living in LMICs affected by humanitarian crises. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMD-CTR), the Cochrane Drugs and Alcohol Review Group (CDAG) Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OVID), Embase (OVID), PsycINFO (OVID), and ProQuest PILOTS database with results incorporated from searches to February 2020. We also searched the World Health Organization's (WHO) International Clinical Trials Registry Platform and ClinicalTrials.gov to identify unpublished or ongoing studies. We checked the reference lists of relevant studies and reviews. SELECTION CRITERIA: All randomised controlled trials (RCTs) comparing psychological and social interventions versus control conditions to prevent the onset of mental disorders in adults and children living in LMICs affected by humanitarian crises. We excluded studies that enrolled participants based on a positive diagnosis of mental disorder (or based on a proxy of scoring above a cut-off score on a screening measure). DATA COLLECTION AND ANALYSIS: We calculated standardised mean differences for continuous outcomes and risk ratios for dichotomous data, using a random-effects model. We analysed data at endpoint (zero to four weeks after therapy) and at medium term (one to four months after intervention). No data were available at long term (six months or longer). We used GRADE to assess the quality of evidence. MAIN RESULTS: In the present review we included seven RCTs with a total of 2398 participants, coming from both children/adolescents (five RCTs), and adults (two RCTs). Together, the seven RCTs compared six different psychosocial interventions against a control comparator (waiting list in all studies). All the interventions were delivered by paraprofessionals and, with the exception of one study, delivered at a group level. None of the included studies provided data on the efficacy of interventions to prevent the onset of mental disorders (incidence). For the primary outcome of acceptability, there may be no evidence of a difference between psychological and social interventions and control at endpoint for children and adolescents (RR 0.93, 95% CI 0.78 to 1.10; 5 studies, 1372 participants; low-quality evidence) or adults (RR 0.96, 95% CI 0.61 to 1.50; 2 studies, 767 participants; very low quality evidence). No information on adverse events related to the interventions was available. For children's and adolescents' secondary outcomes of prevention interventions, there may be no evidence of a difference between psychological and social intervention groups and control groups for reducing PTSD symptoms (standardised mean difference (SMD) -0.16, 95% CI -0.50 to 0.18; 3 studies, 590 participants; very low quality evidence), depressive symptoms (SMD -0.01, 95% CI -0.29 to 0.31; 4 RCTs, 746 participants; very low quality evidence) and anxiety symptoms (SMD 0.11, 95% CI -0.09 to 0.31; 3 studies, 632 participants; very low quality evidence) at study endpoint. In adults' secondary outcomes of prevention interventions, psychological counselling may be effective for reducing depressive symptoms (MD -7.50, 95% CI -9.19 to -5.81; 1 study, 258 participants; very low quality evidence) and anxiety symptoms (MD -6.10, 95% CI -7.57 to -4.63; 1 study, 258 participants; very low quality evidence) at endpoint. No data were available for PTSD symptoms in the adult population. Owing to the small number of RCTs included in the present review, it was not possible to carry out neither sensitivity nor subgroup analyses. AUTHORS' CONCLUSIONS: Of the seven prevention studies included in this review, none assessed whether prevention interventions reduced the incidence of mental disorders and there may be no evidence for any differences in acceptability. Additionally, for both child and adolescent populations and adult populations, a very small number of RCTs with low quality evidence on the review's secondary outcomes (changes in symptomatology at endpoint) did not suggest any beneficial effect for the studied prevention interventions. Confidence in the findings is hampered by the scarcity of prevention studies eligible for inclusion in the review, by risk of bias in the studies, and by substantial levels of heterogeneity. Moreover, it is possible that random error had a role in distorting results, and that a more thorough picture of the efficacy of prevention interventions will be provided by future studies. For this reason, prevention studies are urgently needed to assess the impact of interventions on the incidence of mental disorders in children and adults, with extended periods of follow-up.


Assuntos
Países em Desenvolvimento , Transtornos Mentais/prevenção & controle , Psicoterapia , Problemas Sociais/psicologia , Estresse Fisiológico , Estresse Psicológico/complicações , Adolescente , Adulto , Fatores Etários , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Viés , Criança , Depressão/diagnóstico , Depressão/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Humanos , Transtornos Mentais/etiologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Listas de Espera
15.
J Med Internet Res ; 22(9): e19716, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32975521

RESUMO

BACKGROUND: Most people who experience a potentially traumatic event (PTE) recover on their own. A small group of individuals develops psychological complaints, but this is often not detected in time or guidance to care is suboptimal. To identify these individuals and encourage them to seek help, a web-based self-help test called Mobile Insight in Risk, Resilience, and Online Referral (MIRROR) was developed. MIRROR takes an innovative approach since it integrates both negative and positive outcomes of PTEs and time since the event and provides direct feedback to the user. OBJECTIVE: The goal of this study was to assess MIRROR's use, examine its psychometric properties (factor structure, internal consistency, and convergent and divergent validity), and evaluate how well it classifies respondents into different outcome categories compared with reference measures. METHODS: MIRROR was embedded in the website of Victim Support Netherlands so visitors could use it. We compared MIRROR's outcomes to reference measures of PTSD symptoms (PTSD Checklist for DSM-5), depression, anxiety, stress (Depression Anxiety Stress Scale-21), psychological resilience (Resilience Evaluation Scale), and positive mental health (Mental Health Continuum Short Form). RESULTS: In 6 months, 1112 respondents completed MIRROR, of whom 663 also completed the reference measures. Results showed good internal consistency (interitem correlations range .24 to .55, corrected item-total correlations range .30 to .54, and Cronbach alpha coefficient range .62 to .68), and convergent and divergent validity (Pearson correlations range -.259 to .665). Exploratory and confirmatory factor analyses (EFA+CFA) yielded a 2-factor model with good model fit (CFA model fit indices: χ219=107.8, P<.001, CFI=.965, TLI=.948, RMSEA=.065), conceptual meaning, and parsimony. MIRROR correctly classified respondents into different outcome categories compared with the reference measures. CONCLUSIONS: MIRROR is a valid and reliable self-help test to identify negative (PTSD complaints) and positive outcomes (psychosocial functioning and resilience) of PTEs. MIRROR is an easily accessible online tool that can help people who have experienced a PTE to timely identify psychological complaints and find appropriate support, a tool that might be highly needed in times like the coronavirus pandemic.


Assuntos
Inquéritos Epidemiológicos , Aplicativos Móveis , Encaminhamento e Consulta , Resiliência Psicológica , Autocuidado/métodos , Autocuidado/normas , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Ansiedade/diagnóstico , Lista de Checagem , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Análise Fatorial , Feminino , Humanos , Internet , Masculino , Países Baixos/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Psicometria , Reprodutibilidade dos Testes , Estresse Psicológico/diagnóstico
17.
Artigo em Inglês | MEDLINE | ID: mdl-32784694

RESUMO

The relationships between dimensions of personality (sociotropy and autonomy), coping strategies (rumination: brooding and reflection subtypes, and immature defenses) and symptoms of depression and anxiety were explored in patients with Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). A total of 279 patients completed questionnaires including measures of personality dimensions, rumination, immature defenses, depression and anxiety. Our findings suggested that sociotropy and autonomy may be associated with both depressive and anxious symptoms in patients with MDD and with GAD. Multiple mediation analyses indicated that brooding always acted as a mediating link between personality vulnerabilities (sociotropy and autonomy) and depressive and anxiety symptoms, independently of the patient group. In addition, in patients with MDD and those with GAD, brooding and immature defenses functioned together by linking sociotropy and autonomy, respectively, with depressive symptoms. Our results also showed that, in patients with GAD, both types of rumination explained the relationship between sociotropy and autonomy and anxiety symptoms. Overall, our findings provided evidence of the transdiagnostic role of the brooding, linking the vulnerability of personality dimensions and emotional symptoms. They also indicated that reflection and immature defenses can operate in conjunction with brooding, depending on the type of vulnerability and emotional context.


Assuntos
Sintomas Afetivos/psicologia , Ansiedade/psicologia , Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Adulto , Ansiedade/diagnóstico , Dependência Psicológica , Depressão/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Feminino , Humanos , Masculino , Pensamento
18.
J Stomatol Oral Maxillofac Surg ; 121(5): 478-483, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32828994

RESUMO

AIM: The aim of this study was to evaluate the anxiety levels of the parents of infants with cleft lip and palate (CLP) before and after primary lip surgery. MATERIALS AND METHOD: Forty mothers (mean ages: 31.9 ± 6.16 years) and 40 fathers (mean ages: 34.6 ± 5.91 years) of infants with CLP were included in this study. They were asked to answer the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and Spielberger's State-Trait Anxiety Inventory (STAI) just 1 h before the primary lip surgery (T0) and 1 month after (T1) surgery. Student t-test and Mann-Whitney U test were used for inter-group comparison, the paired-sample t was used for the intra-group comparisons (p < 0.05). RESULTS: There were no statistically significant differences for the comparisons of state (STAI-S) and trait (STAI-T) anxiety or APAIS scores between the parents. While state anxiety scores of the mothers increased significantly post-surgically, APAIS scores showed significant decreases in both parents (p < 0.05). APAIS scores of the fathers with bilateral CLP infants were significantly higher (p < 0.05) than the fathers of unilateral ones. The parents with local anesthesia experience showed significantly lower APAIS scores (p < 0.05). A negative correlation was present between maternal age and STAI-T, whereas a positive correlation was present between paternal age and the anxiety. CONCLUSIONS: The anxiety levels of the parents were similar. Parents asked for more information about the anesthesia than the surgery, therefore communication with the anesthesiologist in the preoperative period is important. Routine assessment of parents' stress and psychosocial support should be provided by the cleft team.


Assuntos
Fenda Labial , Fissura Palatina , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/etiologia , Fenda Labial/diagnóstico , Fenda Labial/epidemiologia , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico , Fissura Palatina/cirurgia , Humanos , Período Pré-Operatório
19.
J Stroke Cerebrovasc Dis ; 29(9): 105082, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807479

RESUMO

BACKGROUND: There is relatively limited information on the risk factors and outcome of new onset Poststroke Anxiety (PSA) in Low- and Middle-Income Countries. We estimated incidence, cumulative incidence, risk factors and outcome of new onset anxiety in the first year of stroke among African stroke survivors. METHODS: We analyzed the dataset of a completed clinical trial comprising patients enrolled to test an intervention designed to improve one-year blood pressure control among recent (≤ one month) stroke survivors in Nigeria. Anxiety was measured using the Hospital Anxiety and Depression Scale. Outcomes were assessed using the modified Rankin Scale (mRS), Community screening instrument for dementia (CSID) and Health Related Quality of Life in Stroke Patients (HRQOLISP-26). RESULTS: Among 322 stroke survivors who were free of anxiety at baseline, we found a one-year cumulative incidence of 34% (95% CI = 28.6-39.3). Rates were 36.2% (95% CI =29.6-42.7) for men and 29.2% (95% CI =19.9-38.3) for women. In multivariate Cox regression analyses, haemorrhagic stroke type was associated with higher risk of new onset PSA (Hazard Ratio=1.52, 95% CI =1.01-2.29). New onset PSA was independently associated with cognitive [(mean difference (MD) in CSID scores=1.1, 95% C.I=0.2, 1.9)] and motor decline (MD in mRS scores= -0.2, 95% C.I= -0.4, -0.02), as well as poorer quality of life overtime (MD in total HRQOLISP-26 scores=3.6, 95% C.I=1.0, 6.2). CONCLUSION: One in 3 stroke survivors in Nigeria had PSA at one year. Clinicians in SSA should pay special attention to survivors of haemorrhagic stroke as they are at higher risk of incident anxiety and therefore its consequences.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Ansiedade/psicologia , Hemorragias Intracranianas/psicologia , Acidente Vascular Cerebral/psicologia , Idoso , Ansiedade/diagnóstico , Ansiedade/etnologia , Ansiedade/fisiopatologia , Cognição , Avaliação da Deficiência , Emoções , Feminino , Humanos , Incidência , Hemorragias Intracranianas/diagnóstico , Hemorragias Intracranianas/etnologia , Hemorragias Intracranianas/fisiopatologia , Masculino , Pessoa de Meia-Idade , Atividade Motora , Nigéria/epidemiologia , Prognóstico , Qualidade de Vida , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/fisiopatologia , Inquéritos e Questionários , Fatores de Tempo
20.
BMJ Open ; 10(7): e039832, 2020 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-32737101

RESUMO

INTRODUCTION: The unprecedented COVID-19 pandemic has exposed healthcare professionals (HCPs) to exceptional situations that can lead to increased anxiety (ie, infection anxiety and perceived vulnerability), traumatic stress and depression. We will investigate the development of these psychological disturbances in HCPs at the treatment front line and second line during the COVID-19 pandemic over a 12-month period in different countries. Additionally, we will explore whether personal resilience factors and a work-related sense of coherence influence the development of mental health problems in HCPs. METHODS AND ANALYSIS: We plan to carry out a sequential qualitative-quantitative mixed-methods design study. The quantitative phase consists of a longitudinal online survey based on six validated questionnaires, to be completed at three points in time. A qualitative analysis will follow at the end of the pandemic to comprise at least nine semistructured interviews. The a priori sample size for the survey will be a minimum of 160 participants, which we will extend to 400, to compensate for dropout. Recruitment into the study will be through personal invitations and the 'snowballing' sampling technique. Hierarchical linear regression combined with qualitative data analysis, will facilitate greater understanding of any associations between resilience and mental health issues in HCPs during pandemics. ETHICS AND DISSEMINATION: The study participants will provide electronic informed consent. All recorded data will be stored on a secured research server at the study site, which will only be accessible to the investigators. The Bern Cantonal Ethics Committee has waiv ed the need for ethical approval (Req-2020-00355, 1 April 2020). There are no ethical, legal or security issues regarding the data collection, processing, storage and dissemination in this project. TRIAL REGISTRATION NUMBER: ISRCTN13694948.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Pessoal de Saúde , Pandemias , Pneumonia Viral , Angústia Psicológica , Adulto , Ansiedade/diagnóstico , Ansiedade/etiologia , Atitude do Pessoal de Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Depressão/diagnóstico , Depressão/etiologia , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Exposição Ocupacional , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Projetos de Pesquisa , Inquéritos e Questionários
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