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1.
BMC Psychiatry ; 21(1): 327, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215220

RESUMO

BACKGROUND: The COVID-19 pandemic and relevant prevention and control measures may affect the mental health and induce depressive symptoms in fathers with concurrent partner delivery exposure. This study aims to investigate the prevalence of depression in fathers with simultaneous exposure to COVID-19 pandemic and the effects of family functions on paternal perinatal depression (PPD) risk. METHODS: A cross-sectional study was conducted among the perinatal fathers recruited in a large tertiary hospital in Wuhan across the whole pandemic period from 31 December 2019 to 11 April 2020. Edinburgh Postnatal Depression Scale (EPDS) and APGAR family function scale were used to evaluate PPD and family function, respectively. Chi-square test and multivariable-adjusted logistic regression model were applied for data analysis. RESULTS: Among the 1187 participants, the prevalence of PPD was 13.82% throughout the COVID-19 pandemic. Compared with that in the time period before the announcement of human-to-human transmission on 19 January 2020, the depression risk was significantly lower during the traffic restriction (OR = 0.54, 95% CI: 0.34, 0.86) and public transportation reopening periods (OR = 0.29, 95% CI: 0.14, 0.59). Poor/fair family functions was associated with elevated depression risk (OR = 2.93, 95% CI: 1.90, 4.52). Individuals reporting a low family income and smoking had high depression risks. CONCLUSIONS: A declined risk of PPD was observed over the traffic restriction period of the COVID-19 pandemic. An improved family function may help alleviate the risk of PPD during the pandemic. Health authorities are recommended to formulate targeted prevention and control strategies to handle PPD.


Assuntos
COVID-19 , Depressão Pós-Parto , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão Pós-Parto/epidemiologia , Pai , Feminino , Humanos , Masculino , Pandemias , Gravidez , Prevalência , Medição de Risco , Fatores de Risco , SARS-CoV-2
2.
Reprod Health ; 18(1): 136, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193196

RESUMO

BACKGROUND: Prenatal depression may have adverse health effects on mothers and their offspring. Perceived stress is an important risk factor for depression during pregnancy. Studies have shown that both perceived stress and depression may negatively influence birth outcomes. While 20% of pregnancies in Suriname, a middle-income Caribbean country located in northern South America, results in adverse birth outcomes, data on prenatal depression and its risk factors are lacking. This study aimed to assess the influence of perceived stress on depression during pregnancy in Surinamese women. METHODS: Survey data were used from 1143 pregnant women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study that addresses the impact of chemical and non-chemical environmental exposures in mother/child dyads in Suriname. The Edinburgh Depression Scale and Cohen Perceived Stress Scale were used to screen for probable depression (cut-off ≥ 12) and high stress (cut-off ≥ 20), respectively. The association between perceived stress and depression was examined using bivariate and multiple logistic regression analyses, adjusted for social support (including resilience) and maternal demographics. RESULTS: The prevalence of high perceived stress during the first two trimesters and the third trimester were 27.2% and 24.7% respectively. 22.4% of the participants had probable depression during first or second trimester and 17.6% during the third trimester. Women experiencing high stress levels during the first two trimesters had 1.92 increased odds (95% CI 1.18-3.11, p = 0.008) of having probable depression during the third trimester of pregnancy than those with low stress levels. Pregnant women with low individual resilience during early pregnancy (52.1%) had 1.65 (95% CI 1.03-2.63, p = 0.038) increased odds of having probable depression during later stages of pregnancy compared to those with high individual resilience. Low educational level (p = 0.004) and age of the mother (20-34 years) (p = 0.023) were significantly associated with probable depression during the third trimester. CONCLUSIONS: Early detection and management of stress and depression during pregnancy are important. Health education programs, targeting the reduction of stress during pregnancy, may help to reduce depression and its potential adverse health effects on the mother and child.


Assuntos
Depressão/epidemiologia , Complicações na Gravidez/psicologia , Gestantes/psicologia , Estresse Psicológico/epidemiologia , Adulto , Região do Caribe , Feminino , Humanos , Gravidez , Complicações na Gravidez/epidemiologia , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Suriname/epidemiologia , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-34198849

RESUMO

The COVID-19 pandemic had a massive impact on the Italian healthcare systems, which became overwhelmed, leading to an increased risk of psychological pressure on ICU workers. The present study aimed to investigate the prevalence of distress (anxiety, depression and insomnia symptoms), burnout syndrome and resilience in healthcare workers during the COVID-19 pandemic and to detect potential factors associated with their psychological response. This cross-sectional, survey-based study enrolled 136 healthcare workers assisting COVID-19 patients in the new COVID-19 ward (Intensive Care Unit), at Milano Fiera, Lombardy. Participants completed an online survey that comprised different validated and standardized questionnaires: Maslach Burnout Inventory (MBI), Resilience Scale for adults (RSA), Hospital Anxiety and Depression scale (HADS) and Insomnia Severity Index (ISI). Socio-demographic and work characteristics were also collected. Out of 136 ICU specialists, there were 84 nurses (62%) and 52 physicians (38%). Over half (60%) met the criteria for burnout, with nearly the same percentages among nurses and physicians. Nurses reported significantly higher scores of anxiety and insomnia levels. Forty-five percent of participants reported symptoms of depression (of whom 13.9% in the clinical range) and most of the staff showed moderate to high levels (82.4%) of resilience. The COVID-19 pandemic can have a significant impact on ICU staff. Effective interventions are needed to maintain healthcare professionals' mental health and relieve burnout. Follow-up and tailored procedures should be provided to alleviate the psychological burden in the frontline staff at highest risk.


Assuntos
Esgotamento Profissional , COVID-19 , Adulto , Esgotamento Profissional/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Humanos , Unidades de Terapia Intensiva , Itália/epidemiologia , Pandemias , SARS-CoV-2
4.
Artigo em Inglês | MEDLINE | ID: mdl-34199516

RESUMO

The COVID-19 pandemic has caused an increase in anxiety and depression levels across broad populations. While anyone can be infected by the virus, the presence of certain chronic diseases has been shown to exacerbate the severity of the infection. There is a likelihood that knowledge of this information may lead to negative psychological impacts among people with chronic illness. We hypothesized that the pandemic has resulted in increased levels of anxiety and depression symptoms among people with chronic illness. We recruited 540 participants from the ongoing Prospective Urban and Rural Epidemiology (PURE) study in British Columbia, Canada. Participants were asked to fill out an online survey that included the Hospital Anxiety Depression Scale (HADS) to assess anxiety and depression symptoms. We tested our hypothesis using bivariate and multivariable linear regression models. Out of 540 participants, 15% showed symptoms of anxiety and 17% reported symptoms of depression. We found no significant associations between having a pre-existing chronic illness and reporting higher levels of anxiety or depression symptoms during COVID-19. Our results do not support the hypothesis that having a chronic illness is associated with greater anxiety or depression symptoms during the COVID-19 pandemic. Our results were similar to one study but in contrast with other studies that found a positive association between the presence of chronic illness and developing anxiety or depression during this pandemic.


Assuntos
COVID-19 , Pandemias , Ansiedade/epidemiologia , Colúmbia Britânica/epidemiologia , Depressão/epidemiologia , Humanos , Saúde Mental , Estudos Prospectivos , SARS-CoV-2
5.
Artigo em Inglês | MEDLINE | ID: mdl-34199953

RESUMO

OBJECTIVE: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. METHODS: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. RESULTS: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). CONCLUSIONS: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.


Assuntos
COVID-19 , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Pessoal de Saúde , Humanos , Masculino , SARS-CoV-2 , Arábia Saudita/epidemiologia
6.
Front Public Health ; 9: 675380, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34211954

RESUMO

Background: As the coronavirus disease 2019 (COVID-19) pandemic progressed globally, school closures and home quarantine may cause an increase in problematic Internet use among students in universities. Such a traumatic stress event may also contribute to the development of posttraumatic stress disorder (PTSD), depressive, and anxiety symptoms. This study aimed to evaluate the prevalence of PTSD, depressive, and anxiety symptoms as well as the predictive role of problematic Internet use in the above-mentioned psychological problems in university students. Methods: A cross-sectional study was conducted through an online survey of 8,879 students in China between April 20 and April 26, 2020. The presence of PTSD, depressive, and anxiety symptoms and problematic Internet use were evaluated using PTSD Checklist for DSM-5, the Center for Epidemiologic Studies Depression 9-item scale, the generalized anxiety disorder 7-item scale, and the Young diagnostic questionnaire, respectively. Sociodemographic information and the knowledge, attitude, and practice (KAP) toward COVID-19 data were also collected. Results: A total of 4,834 (54.4%) participants were female, and 7,564 (85.2%) were undergraduate students. A total of 615 students (6.9%) reported PTSD symptoms; 5.2% (465) and 10.1% (896) reported moderate to severe depressive and anxiety symptoms, respectively. The problematic Internet use was significantly associated with higher risk of PTSD, depressive, and anxiety symptoms (odds ratio 2.662 [95% CI, 2.239-3.165], odds ratio 4.582 [95% CI, 3.753-5.611], odds ratio 3.251 [95% CI, 2.814-3.757], respectively; all P < 0.001). Lower attitude and practice scores also contributed to the risk of depressive, anxiety, and PTSD symptoms (P < 0.05). Conclusions: Psychological problems should be paid more attention, and problematic Internet use may be a predictor when screening high-risk students for psychological problems. Our results will aid in timely psychological screening, which is meaningful in the prevention and intervention of psychological problems.


Assuntos
COVID-19 , Universidades , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Surtos de Doenças , Feminino , Humanos , Uso da Internet , SARS-CoV-2 , Estudantes
7.
Clinics (Sao Paulo) ; 76: e3007, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34231710

RESUMO

OBJECTIVES: The COVID-19 pandemic brought abrupt changes when quarantine measures were implemented. Most medical students had distance learning as their main content delivery mode, but in clerkship (fifth and sixth years), in-person activities were maintained under new protocols. These different modes may have affected student mental health. This study examines mental burden and empathy in medical students during the beginning of the COVID-19 pandemic according to the year of attendance. METHODS: All students attending first to the sixth year in the same medical school were invited to participate. The Hospital Anxiety and Depression Scale (HADS), the Self-Reporting Questionnaire (SRQ-20), the Interpersonal Reactivity Index (IRI), and the Mindful Attention Awareness Scale (MAAS) were provided. RESULTS: HADS scores for Anxiety and Depression (n=347) were 9.8±4.3 and 7.1±3.6, respectively; the SRQ-20 (n=373) score was 8.1±4.5; all scores were negatively correlated with the year of attendance. IRI (n=373) scores were: 2.6±0.5 (Empathic Concern), 2.7±0.7 (Perspective Taking), 2.5±0.9 (Fantasy), and 1.7±0.7 (Personal Distress). Fantasy was negatively correlated with the year of attendance. MAAS scores were positively correlated with the year of attendance. Worse mental health scores were found for first-year students across all scales. CONCLUSIONS: We found high levels of mental burden in medical students in the early period of the COVID-19 pandemic, especially in first-year students, who may have fewer resources to deal with stress. Moreover, as they entered college a short time before the pandemic, they were unable to experience academic life fully or create important new social support networks to deal with adversities.


Assuntos
COVID-19 , Estudantes de Medicina , Ansiedade , Depressão/epidemiologia , Humanos , Saúde Mental , Pandemias , Quarentena , SARS-CoV-2
8.
Rev Bras Enferm ; 74(suppl 3): e20201269, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34320124

RESUMO

OBJECTIVE: To analyze the participants' perception of risk and protective factors for depressive symptoms and their relationship with suicidal behavior in a general adult population. METHOD: Exploratory-descriptive, qualitative research, using Content Analysis. Interviews with 200 participants over 18 years old, domiciled in Poços de Caldas/MG, between January 2017 and October 2018. RESULTS: Risk factors were sadness, loneliness, problematic family relationships, losses/difficulties in emotional relationships, unemployment/financial difficulties, depressive symptoms, worsening of the feeling of depression, inability to frustration, problems in experiencing spirituality. Protective factors were family, emotional relationships, and spirituality. Suicidal behavior was related to the severity of depression, feelings of hopelessness, psychiatric comorbidities, and unemployment. FINAL CONSIDERATIONS: Perception of risk factors was linked to family problems, sadness, loss of emotional relationships, unemployment, loneliness, and inability to experience frustrations; and the protective ones perceived were family and spirituality. There was a relationship between depressive symptoms and suicidal behavior.


Assuntos
Depressão , Ideação Suicida , Adolescente , Adulto , Depressão/epidemiologia , Depressão/etiologia , Humanos , Solidão , Fatores de Proteção , Fatores de Risco
9.
J Coll Physicians Surg Pak ; 31(8): 998-1000, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34320725

RESUMO

The aim of this study is to explore whether there is an association between the genotype of serotonin-transporter-linked polymorphic region (5-HTTLPR) and migraine combined with depression. One hundred and sixteen patients with migraine and depressive disorder (Group A) and 116 patients with simple migraine (Group B) admitted in Mental Health Center, Zhejiang University School of Medicine, China, from January 2018 to April 2020 were included in the present study. Polymerase chain reaction (PCR) and restriction fragment length polymorphism techniques were used for detection of 5-HTTLPR genotype. The 5-HTTLPR genotype and allele frequency between the two groups were compared. The results showed that there was no significant difference in 5-HTTLPR genotype (L/L, L/S and S/S) frequency and allele (S and L) frequency between Group A and Group B (p=0.794 and 0.491, respectively). In conclusion, 5-HTTLPR genotype might not be related to the onset of migraine combined with depression. Key Words: Migraine, Depressive disorder, Serotonin-transporter-linked polymorphic region (5-HTTLPR).


Assuntos
Transtornos de Enxaqueca , Serotonina , Alelos , China/epidemiologia , Depressão/epidemiologia , Depressão/genética , Genótipo , Humanos , Transtornos de Enxaqueca/genética , Polimorfismo Genético , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética
10.
Artigo em Inglês | MEDLINE | ID: mdl-34204059

RESUMO

Social networks protect individuals from mental health conditions of depression and anxiety. The association between each social network type and its mental health implications in the Indian population remains unclear. The study aims to determine the association of depression and anxiety with different social network types in the participants of a community cohort. We conducted a cross-sectional household survey among people aged ≥30 years in geographically defined catchment areas of Kerala, India. We used cross-culturally validated assessment tools to measure depression, anxiety and social networks. An educated male belonging to higher income quartiles, without any disability, within a family dependent network has lower odds of depression and anxiety. Furthermore, 28, 26.8, 25.7, 9.8 and 9.7% of participants belonged to private restricted, locally integrated, wider community-focused, family-dependent and locally self-contained networks, respectively. Close ties with family, neighbours, and community had significantly lower odds of anxiety and depression than private restricted networks. The clustering of people to each social network type and its associated mental health conditions can inform social network-based public health interventions to optimize positive health outcomes in the community cohort.


Assuntos
Ansiedade , Depressão , Ansiedade/epidemiologia , Estudos de Coortes , Estudos Transversais , Depressão/epidemiologia , Humanos , Índia/epidemiologia , Masculino , Rede Social , Apoio Social
11.
Artigo em Inglês | MEDLINE | ID: mdl-34204130

RESUMO

Although the relationship between environment and public depression has aroused heated debate, the empirical research on the relationship between environmental quality perception and public depression is still relatively insufficient. This paper aims to explore the influence of environmental quality perception on public depression and the mediating role of subjective social class between environmental quality perception and public depression. Using the China Family Panel Studies data of 2016 for empirical analysis, this study's results show that environmental quality perception has a significant effect on public depression and subjective social class also has a significant effect on public depression. In addition, we found that subjective social class can play a partial mediating role between environmental quality perception and public depression, and the intermediary effect only comes from the contribution of the perception of living environmental quality, not the perception of overall environmental quality. That is to say, the perception of living environment quality deeply affects the subjective social class, and then induces public depression. In order to alleviate the relationship between environmental quality and public depression, it is recommended that the state environmental protection department and civil affairs department strengthen the improvement of public living environment so as to promote individual subjective social class and reduce the risk of public depression. Moreover, it is suggested that research with longitudinal design and comprehensive indicators be undertaken in the future.


Assuntos
Depressão , Qualidade de Vida , China , Depressão/epidemiologia , Percepção , Classe Social
12.
Artigo em Inglês | MEDLINE | ID: mdl-34204145

RESUMO

Depressive symptoms are a common mental health problem among adolescents, which may affect their physical and mental health development and impose heavy burdens on individual families and society. This study aimed to examine the associations between sleep duration, academic pressure, and depressive symptoms among Chinese adolescents and to construct the mediation model to explore the mediating effect of sleep duration. The data are from the China Family Panel Studies (CFPS). Methodologically, the aforementioned associations were explored by constructing a structural equation model and applying multivariate multilevel logistic regression. In this study, we found that approximately 6.49% of the 3724 Chinese adolescents had depressive symptoms. Sleep duration of <6 h/night (OR = 2.39, 95%CI = 1.33-4.32) and high/maximum academic pressure (high: OR = 1.43, 95%CI = 1.02-1.99; maximum: OR = 2.43, 95%CI = 1.58-3.73) were both associated with an increased risk of depressive symptoms in adolescents. Meanwhile, the multiplicative interaction between sleep duration and academic pressure was significantly associated with depressive symptoms in adolescents (p < 0.001). The sleep duration played a partial mediating role in the relationship between academic pressure and depressive symptoms (a*b = 0.006, 95%BootCI = 0.001-0.012). Our study highlights that it is essential to mitigate the academic pressure of adolescents to increase their sleep duration and further reduce the occurrence of depressive symptoms by adopting corresponding preventive measures.


Assuntos
Depressão , Saúde Mental , Adolescente , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Depressão/epidemiologia , Humanos , Sono
13.
BMC Pregnancy Childbirth ; 21(1): 473, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210276

RESUMO

BACKGROUND: In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, likely with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers. METHODS: We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological well-being and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women. RESULTS: We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %. CONCLUSIONS: The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage "home" physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.


Assuntos
COVID-19/psicologia , Estilo de Vida , Saúde Mental , Mães/psicologia , Parto/psicologia , Gestantes/psicologia , Quarentena , Adulto , Ansiedade/epidemiologia , Aleitamento Materno , Depressão/epidemiologia , Dieta Saudável , Exercício Físico , Feminino , Acesso aos Serviços de Saúde , Humanos , Itália/epidemiologia , Pessoa de Meia-Idade , Gravidez , SARS-CoV-2 , Adulto Jovem
14.
MMWR Morb Mortal Wkly Rep ; 70(26): 947-952, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34197362

RESUMO

Increases in mental health conditions have been documented among the general population and health care workers since the start of the COVID-19 pandemic (1-3). Public health workers might be at similar risk for negative mental health consequences because of the prolonged demand for responding to the pandemic and for implementing an unprecedented vaccination campaign. The extent of mental health conditions among public health workers during the COVID-19 pandemic, however, is uncertain. A 2014 survey estimated that there were nearly 250,000 state and local public health workers in the United States (4). To evaluate mental health conditions among these workers, a nonprobability-based online survey was conducted during March 29-April 16, 2021, to assess symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal ideation among public health workers in state, tribal, local, and territorial public health departments. Among 26,174 respondents, 53.0% reported symptoms of at least one mental health condition in the preceding 2 weeks, including depression (32.0%), anxiety (30.3%), PTSD (36.8%), or suicidal ideation (8.4%). The highest prevalence of symptoms of a mental health condition was among respondents aged ≤29 years (range = 13.6%-47.4%) and transgender or nonbinary persons (i.e., those who identified as neither male nor female) of all ages (range = 30.4%-65.5%). Public health workers who reported being unable to take time off from work were more likely to report adverse mental health symptoms. Severity of symptoms increased with increasing weekly work hours and percentage of work time dedicated to COVID-19 response activities. Implementing prevention and control practices that eliminate, reduce, and manage factors that cause or contribute to public health workers' poor mental health might improve mental health outcomes during emergencies.


Assuntos
Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , Pessoal de Saúde/psicologia , Saúde Pública , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Ideação Suicida , Adulto , COVID-19/epidemiologia , Feminino , Pessoal de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Trabalho/estatística & dados numéricos
15.
MMWR Morb Mortal Wkly Rep ; 70(26): 937-941, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34197364

RESUMO

Disasters can adversely affect population health, resulting in increased need for health services. Hurricane Irma made landfall in the Florida Keys (Monroe County) as a Category 4 hurricane on September 10, 2017. The hurricane caused substantial damage to 65% of homes and resulted in 40 persons injured and 17 deaths from hurricane-related causes.* During 2018, the county suicide rate increased to 34.9 per 100,000 population from the 5-year (2013-2017) average of 25.2 per 100,000 population (1). In May 2019, 20 months after the hurricane, the Florida Department of Health (FDOH) conducted a modified Community Assessment for Public Health Emergency Response (CASPER) to assess the community's mental, physical, and economic health and develop public health interventions to decrease the suicide rate. A consenting adult member from 231 households was interviewed, and a weighted cluster analysis was conducted to estimate the number and percentage of households throughout the Florida Keys with a particular response, as well as the number and percentage of persons at risk for suicide. During the 20 months since Hurricane Irma, 17% of households reported a need for a mental health care provider; 37.9% of these did not receive those services. A modified CASPER was used to calculate population estimates of suicide risk in an area of high landfall for hurricanes; estimated population suicide risk was 7.3%. Respondents reported worsening of respiratory conditions (17.7%), anxiety (17.0%), and depression (11.3%). Emergency preparedness plans should consider strengthening mental health service delivery after a hurricane, particularly during the long-term recovery phase.


Assuntos
Tempestades Ciclônicas , Desastres , Determinação de Necessidades de Cuidados de Saúde , Saúde Pública , Adulto , Idoso , Ansiedade/epidemiologia , Serviços Comunitários de Saúde Mental , Depressão/epidemiologia , Florida/epidemiologia , Humanos , Pessoa de Meia-Idade , Medição de Risco , Suicídio
16.
Acta Biomed ; 92(3): e2021215, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34212903

RESUMO

In the last two decades the awareness of depression as a public health issue has increased and the literature has flourished towards its primary and secondary prevention. Whereas timely targeting of depression risk factors is a frontier towards reducing the incidence of the disorder, nowadays the early diagnosis is of primary importance. Screening depressive disorders is paramount, since there are several types of depression. Besides, early diagnosis would improve the outcome of treatment, reduce the frequency of relapses and generally lead to higher levels of quality of life. We highlight the feasibility of depression screening in primary care and the need of a comprehensive public health approach.


Assuntos
Depressão , Qualidade de Vida , Depressão/diagnóstico , Depressão/epidemiologia , Diagnóstico Precoce , Humanos , Programas de Rastreamento , Atenção Primária à Saúde
17.
PLoS One ; 16(7): e0254074, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34197540

RESUMO

BACKGROUND: The 2019 coronavirus disease (COVID-19) epidemic is a global health emergency which has been shown to pose a great challenge to mental health, well-being and resilience of healthcare workers, especially nurses. Little is known on the impact of COVID-19 among nurses in sub-Saharan Africa. METHODS: A cross sectional study was carried out between August and November 2020 among nurses recruited from the Aga Khan University Hospital, Nairobi. The survey questionnaire consisted of six components- demographic and work title characteristics, information regarding care of COVID-19 patients, symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardized questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health disorders. RESULTS: Of 255 nurses, 171 (67.1%) consented to complete the survey. The median age of the participants was 33.47 years, 70.2% were females and 60.8% were married. More than half, 64.9% were frontline workers directly engaged in COVID-19 care. Only 1.8% reported a prior history or diagnosis of any mental health disorder. Depression, anxiety, insomnia, distress, and burnout were reported in 45.9%, 48.2%, 37.0%, 28.8% and 47.9% of all nurses. Frontline nurses reported experiencing more moderate to severe symptoms of depression, distress and burnout. Furthermore, females reported more burnout as compared to males. Multivariate logistic regression analysis showed that after adjustment, working in the frontlines was an independent risk variable for depression and burnout. CONCLUSION: This is one of the few studies looking at mental health outcomes among nurses during the COVID-19 pandemic in Kenya. Similar to other studies from around the world, nurses directly involved with COVID-19 patients reported higher rates of mental health symptoms. Burnout threatens to exacerbate the pre-existing severe nursing workforce shortage in low-resource settings. Cost-effective and feasible mitigating strategies, geared to low-middle income countries, are urgently needed to help cope with mental health symptoms during such a pandemic.


Assuntos
Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , COVID-19 , Depressão/epidemiologia , Enfermeiras e Enfermeiros , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adulto , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Quênia/epidemiologia , Masculino , Saúde Mental , Angústia Psicológica , Centros de Atenção Terciária
18.
Artigo em Inglês | MEDLINE | ID: mdl-34199477

RESUMO

Given the frequent concomitance between depression and gastroesophageal reflux disease (GERD), it is important to evaluate the change of depression in patients with GERD, especially considering the presence of esophageal mucosal breaks (MB). This study aimed to examine the change in the levels of depression in patients with GERD during proton-pump inhibitors (PPI) therapy. We designed a prospective cohort study to explore the profile of the alteration in depression with respect to the impact of esophageal MB. This study recruited 172 eligible patients with GERD between February 2016 and May 2018. The change in depression was defined as the difference between the respective Taiwanese Depression Questionnaire (TDQ) scores obtained at baseline and after PPI therapy. Multivariate linear regression models were used to estimate the factors associated with the change in depression. The results revealed statistically significant improvements in the TDQ score (mean score: baseline = 13.2, after PPI therapy = 10.9, p < 0.01, Cohen's d = 0.30) during PPI therapy for GERD. Moreover, the MB was an independent variable associated with changes in the TDQ score [B = 3.31, 95% confidence interval (CI): (1.12, 5.51), p < 0.01] and the improvement in depression [odds ratio = 0.38, 95% CI: (0.17, 0.86), p = 0.02]. Our findings revealed that depressive symptoms improved slightly following PPI therapy. Moreover, MB was an unfavorable prognostic factor for the improvement in depression.


Assuntos
Refluxo Gastroesofágico , Inibidores da Bomba de Prótons , Depressão/tratamento farmacológico , Depressão/epidemiologia , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/epidemiologia , Humanos , Estudos Prospectivos , Inibidores da Bomba de Prótons/uso terapêutico , Resultado do Tratamento
19.
BMC Health Serv Res ; 21(1): 697, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34266438

RESUMO

BACKGROUND: Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity. METHODS: Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009-2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, talking therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models. RESULTS: We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving talking therapy (42.3-63.4 %), long consultations (56.4-71.8 %), and referral to secondary care (16.6-21.6 %) increased, while those receiving drug treatment (31.3-25.9 %) and sick-listing (58.1-50 %) decreased. The trends were different for gender (women had a greater increase in talking therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in talking therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in talking therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity). CONCLUSIONS: The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.


Assuntos
Medicina Geral , Clínicos Gerais , Adulto , Estudos de Coortes , Depressão/diagnóstico , Depressão/tratamento farmacológico , Depressão/epidemiologia , Feminino , Humanos , Masculino , Noruega/epidemiologia , Encaminhamento e Consulta , Sistema de Registros
20.
Artigo em Inglês | MEDLINE | ID: mdl-34265874

RESUMO

Objective: To measure the mental health effects (perceived stress, anxiety, and depression) among health care workers and medical students in Lebanon during the coronavirus disease 2019 (COVID-19) pandemic and subsequent to the Beirut blast.Methods: In this cross-sectional study, a self-administered online questionnaire was developed and distributed between late December 2020 and early February 2021 among health care workers and medical students via social media. The 10-item Perceived Stress Scale (PSS-10) and the 4-item Patient Health Questionnaire for Depression and Anxiety (PHQ-4) were administered. P values between variables were calculated using χ2 test.Results: Overall, 98% of the respondents had a low PSS-10 score and 89% had a low PHQ-4 score. About 58.1% of health care workers and 69.0% of student respondents had moderate to severe stress on the PSS-10, and 48.7% and 46.8%, respectively, reported moderate to severe anxiety and depression on the PHQ-4. Prevalence of depression and anxiety was relatively higher among health care workers with monthly incomes < LBP 4 million (57.1%) and higher in women (39.9%) compared to men (17.2%). Furthermore, the prevalence of depression and anxiety was higher among health care workers traveling between different districts (63.0%) compared to those with residence and work location within the same district and was higher among females (65.4%) compared to males (34.6%).Conclusions: The resilience of the Lebanese people as well as their ability to adapt in the face of trauma, tragedy, threats, or any significant source of stress is remarkable and seen in their everyday lives, especially subsequent to the Beirut blast. However, the psychological well-being and mental health of health care workers and medical students in Lebanon should be carefully surveilled and recorded during the COVID-19 pandemic, especially within the ongoing socioeconomic crisis.


Assuntos
COVID-19 , Desastres , Pessoal de Saúde/psicologia , Saúde Mental , Pandemias , Estudantes de Medicina/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Recessão Econômica , Feminino , Humanos , Líbano , Masculino , Pessoa de Meia-Idade , Prevalência , Resiliência Psicológica , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
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