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1.
Ann R Coll Surg Engl ; 103(2): 114-119, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33559558

RESUMO

INTRODUCTION: Non-injury-related factors have been extensively studied in major trauma and have been shown to have a significant impact on patient outcomes. Mental illness and associated medication use has been proven to have a negative effect on bone health and fracture healing. MATERIALS AND METHODS: We collated data retrospectively from the records of orthopaedic inpatients in a non-COVID and COVID period. We analysed demographic data, referral and admission numbers, orthopaedic injuries, surgery performed and patient comorbidities, including psychiatric history. RESULTS: There were 824 orthopaedic referrals and 358 admissions (six/day) in the non-COVID period, with 38/358 (10.6%) admissions having a psychiatric diagnosis and 30/358 (8.4%) also having a fracture. This was compared with 473 referrals and 195 admissions (three/day) in the COVID period, with 73/195 (37.4%) admissions having a documented psychiatric diagnosis and 47/195 (24.1%) having a fracture. DISCUSSION: There was a reduction in the number of admissions and referrals during the pandemic, but a simultaneous three-fold rise in admissions with a psychiatric diagnosis. The proportion of patients with both a fracture and a psychiatric diagnosis more than doubled and the number of patients presenting due to a traumatic suicide attempt almost tripled. CONCLUSION: While total numbers using the orthopaedic service decreased, the impact of the pandemic and lockdown disproportionately affects those with mental health problems, a group already at higher risk of poorer functional outcomes and non-union. It is imperative that adequate support is in place for patients with vulnerable mental health during these periods, particularly as we look towards a potential 'second wave' of COVID-19.


Assuntos
Fraturas Ósseas/epidemiologia , Hospitalização/tendências , Transtornos Mentais/epidemiologia , Encaminhamento e Consulta/tendências , Tentativa de Suicídio/tendências , Adulto , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Comorbidade , Transtorno Depressivo/epidemiologia , Feminino , Corpos Estranhos/epidemiologia , Corpos Estranhos/cirurgia , Fraturas Ósseas/cirurgia , Humanos , Luxações Articulares/epidemiologia , Luxações Articulares/cirurgia , Londres/epidemiologia , Masculino , Transtornos Mentais/tratamento farmacológico , Procedimentos Ortopédicos , Psicotrópicos/uso terapêutico , Estudos Retrospectivos , Lesões dos Tecidos Moles/epidemiologia , Lesões dos Tecidos Moles/cirurgia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/cirurgia
2.
Span J Psychol ; 24: e8, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33551011

RESUMO

In the midst of the COVID-19 epidemic, Spain was one of the countries with the highest number of infections and a high mortality rate. The threat of the virus and consequences of the pandemic have a discernible impact on the mental health of citizens. This study aims to (a) evaluate the levels of anxiety, depression and well-being in a large Spanish sample during the confinement, (b) identify potential predictor variables associated to experiencing both clinical levels of distress and well-being in a sample of 2,122 Spanish people. By using descriptive analyses and logistic regression results revealed high rates of depression, anxiety and well-being. Specifically, our findings revealed that high levels of anxiety about COVID-19, increased substance use and loneliness as the strongest predictors of distress, while gross annual incomes and loneliness were strongest predictors of well-being. Finding of the present study provide a better insight about psychological adjustment to a pandemic and allows us to identify which population groups are at risk of experiencing higher levels of distress and which factors contribute to greater well-being, which could help in the treatments and prevention in similar stressful and traumatic situations.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Saúde Mental , Angústia Psicológica , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Renda , Internet , Solidão/psicologia , Masculino , Pessoa de Meia-Idade , Gravidez , Qualidade de Vida/psicologia , Fatores de Risco , Espanha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
3.
PLoS One ; 16(2): e0246515, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33544772

RESUMO

BACKGROUND: During health disaster events such as the current devastating havoc being inflicted on countries globally by the SARS-CoV-19 pandemic, mental health problems among survivors and frontline workers are likely concerns. However, during such health disaster events, stakeholders tend to give more precedence to the socio-economic and biomedical health consequences at the expense of mental health. Meanwhile, studies show that regardless of the kind of disaster/antecedent, all traumatic events trigger similar post-traumatic stress symptoms among survivors, families, and frontline workers. Thus, our study investigated the prevalence of anxiety, depression and insomnia symptoms among survivors of the 2014-2016 Ebola virus disease that plagued the West African sub-region. METHODS: We systematically retrieved peer-reviewed articles published between 1970 and 2019 from seven electronic databases, including Google Scholar, MEDLINE, PsychInfo, PubMed, Scopus, Springer Link, Web of Science on Ebola and post-traumatic stress disorder symptoms. A comprehensive hand search complemented this literature search. Of the 87 articles retrieved, only 13 met the inclusion criteria for this meta-analysis. RESULTS: After heterogeneity, influence, and publication bias analysis, our meta-analysis pooled proportion effects estimates showed a moderate to a high prevalence of anxiety (14%; 99% CI: 0.05-0.30), depression (15%; 99% CI: 0.11-0.21), and insomnia (22%; 99% CI: 0.13-0.36). Effect estimates ranging from (0.13; 99% CI: 0.05, 0.28) through to (0.11; 99% CI: 0.05-0.22), (0.15; 99% CI: 0.09-0.25) through to (0.13; 99% CI: 0.08-0.21) and (0.23; 99% CI: 0.11-0.41) to (0.23; 99% CI: 0.11-0.41) were respectively reported for anxiety, depression and insomnia symptoms. These findings suggest a significant amount of EVD survivors are struggling with anxiety, depression and insomnia symptoms. CONCLUSION: Our study provided the first-ever meta-analysis evidence of anxiety, depression, and insomnia symptoms among EVD survivors, and suggest that the predominant biomedical health response to regional and global health disasters should be complemented with trauma-related mental health services.


Assuntos
Ansiedade/complicações , Depressão/complicações , Doença pelo Vírus Ebola/complicações , Distúrbios do Início e da Manutenção do Sono/complicações , África Ocidental/epidemiologia , Ansiedade/epidemiologia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/complicações , Transtorno Depressivo/epidemiologia , Ebolavirus/isolamento & purificação , Doença pelo Vírus Ebola/epidemiologia , Humanos , Prevalência , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Sobreviventes
4.
Arq Bras Oftalmol ; 84(1): 31-36, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33470339

RESUMO

PURPOSE: Our goal was to analyze the prevalence of depression and anxiety among patients with glaucoma and to identify risk factors related to these disorders. METHODS: A cross-sectional study was carried out between August 2016 and August 2017 at the Hospital das Clínicas of Universidade Estadual de Campinas and at the Hospital Oftalmológico de Brasília to evaluate the prevalence of depressive and anxiety disorders among patients diagnosed with glaucoma. All patients underwent a complete ophthalmologic examination with standard automated perimetry to confirm the diagnosis of glaucoma. All participants were asked to complete the Hospital Anxiety and Depression Scale questionnaire. RESULTS: One hundred and twenty-nine patients were included in the study. Seventy-four were men (57.36%) and 55 (42.64%) were women. The mean age of the patients was 70.14 ± 15.8 years. Ninety participants were white (69.77%) and 38 (29.46%) were black. The study demonstrated a prevalence of depression and/or anxiety at 10.08%. Logistic regression revealed that women were at higher risk for anxiety and/or depression (OR: 5.25, p=0.015) and patients with a larger number of comorbidities also were at higher risk for anxiety and/or depressive disorders (OR: 2.82, p=0.038). CONCLUSION: A significant proportion of patients with glaucoma present with depression and/or anxiety. Females and patients with comorbidities are at greater risk for these disorders.


Assuntos
Transtorno Depressivo , Glaucoma , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Transtorno Depressivo/epidemiologia , Feminino , Glaucoma/complicações , Glaucoma/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários
5.
Asian J Psychiatr ; 56: 102547, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33465749

RESUMO

OBJECTIVE: We aim to evaluate the prevalence of depression and anxiety among general public and healthcare workers during COVID-19 in China and the changes of prevalence before and after the peak of the epidemic occurred. METHODS: Studies were searched from following database: PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), WANGFANG DATA, from inception to 1 st May 2020. Random-effects model was applied to pool the prevalence. Comparative analysis was also applied to evaluate the changes of prevalence before and after the peak of the epidemic occurred. RESULTS: 34 articles were finally included. Prevalence of depression and anxiety was higher among healthcare worker than general public. Among general public, 26 % (95 %CI: 17 %-36 %) were suffering from depression and 22 % (95 %CI: 15 %-30 %) were having anxiety during COVID-19, while the prevalence of depression and anxiety among healthcare workers was 31 % (95 %CI: 25 %-37 %) and 40 % (95 %CI: 33 %-46 %) respectively. Comparative analysis showed healthcare workers (depression: 40 %, anxiety: 38 %) had higher percentage of having depression and anxiety than the general public (depression: 33 %, anxiety: 24 %) before the peak. Then a descended prevalence among healthcare workers (depression: 22 %, anxiety: 22 %) was detected compared with that before, while the prevalence among the general public raised (depression: 62 %, anxiety: 44 %) after the peak occurred. CONCLUSION: The COVID-19 epidemic had a potential psychiatric impact on general public and healthcare workers in China, which is more severer among healthcare workers. However, the psychiatric status of the general public trend to deteriorated, while healthcare workers trend to improve after the peak of epidemic.


Assuntos
Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , China/epidemiologia , Pessoal de Saúde/psicologia , Humanos , Prevalência
6.
Lancet Psychiatry ; 8(2): 141-149, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33308420

RESUMO

BACKGROUND: There is major concern about the impact of the global COVID-19 outbreak on mental health. Several studies suggest that mental health deteriorated in many countries before and during enforced isolation (ie, lockdown), but it remains unknown how mental health has changed week by week over the course of the COVID-19 pandemic. This study aimed to explore the trajectories of anxiety and depression over the 20 weeks after lockdown was announced in England, and compare the growth trajectories by individual characteristics. METHODS: In this prospective longitudinal observational study, we analysed data from the UCL COVID-19 Social Study, a panel study weighted to population proportions, which collects information on anxiety (using the Generalised Anxiety Disorder assessment) and depressive symptoms (using the Patient Health Questionnaire) weekly in the UK since March 21, 2020. We included data from adults living in England who had at least three repeated measures between March 23 and Aug 9, 2020. Analyses were done using latent growth models, which were fitted to account for sociodemographic and health covariates. FINDINGS: Between March 23, and Aug 9, data from over 70 000 adults were collected in the UCL COVID-19 Social Study. When including participants living in England with three follow-up measures and no missing values, our analytic sample consisted of 36 520 participants. The average depression score was 6·6 (SD=6·0, range 0-27) and the average anxiety score 5·7 (SD=5·6, range 0-21) in week 1. Anxiety and depression levels both declined across the first 20 weeks following the introduction of lockdown in England (b=-1·93, SE=0·26, p<0·0001 for anxiety; b=-2·52, SE=0·28, p<0·0001 for depressive symptoms). The fastest decreases were seen across the strict lockdown period (between weeks 2 and 5), with symptoms plateauing as further lockdown easing measures were introduced (between weeks 16 and 20). Being a woman or younger, having lower educational attainment, lower income, or pre-existing mental health conditions, and living alone or with children were all risk factors for higher levels of anxiety and depression at the start of lockdown. Many of these inequalities in experiences were reduced as lockdown continued, but differences were still evident 20 weeks after the start of lockdown. INTERPRETATION: These data suggest that the highest levels of depression and anxiety occurred in the early stages of lockdown but declined fairly rapidly, possibly because individuals adapted to circumstances. Our findings emphasise the importance of supporting individuals in the lead-up to future lockdowns to try to reduce distress, and highlight that groups already at risk for poor mental health before the pandemic have remained at risk throughout lockdown and its aftermath. FUNDING: Nuffield Foundation, UK Research and Innovation, Wellcome Trust.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Inglaterra/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Angústia Psicológica , Risco , Fatores de Tempo , Adulto Jovem
7.
Psychiatry Res ; 296: 113654, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33360965

RESUMO

The COVID-19 pandemic put global medical systems under massive pressure for its uncertainty, severity, and persistence. For detecting the prevalence of suicidal and self-harm ideation (SSI) and its related risk factors among hospital staff during the COVID-19 pandemic, this cross-sectional study collected the sociodemographic data, epidemic-related information, the psychological status and need, and perceived stress and support from 11507 staff in 46 hospitals by an online survey from February 14 to March 2, 2020. The prevalence of SSI was 6.47%. Hospital staff with SSI had high family members or relatives infected number and the self-rated probability of infection. Additionally, they had more perceived stress, psychological need, and psychological impact. On the contrary, hospital staff without SSI reported high self-rated health, willingness to work in a COVID-19 ward, confidence in defeating COVID-19, and perceived support. Furthermore, they reported better marital or family relationship, longer sleep hours, and shorter work hours. The infection of family members or relatives, poor marital status, poor self-rated health, the current need for psychological intervention, perceived high stress, perceived low support, depression, and anxiety were independent factors to SSI. A systematic psychological intervention strategy during a public health crisis was needed for the hospital staff's mental well-being.


Assuntos
Transtornos de Ansiedade/epidemiologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Transtorno Depressivo/epidemiologia , Recursos Humanos em Hospital/estatística & dados numéricos , Comportamento Autodestrutivo/epidemiologia , Ideação Suicida , Adulto , Transtornos de Ansiedade/psicologia , Grupo com Ancestrais do Continente Asiático/psicologia , China , Estudos Transversais , Transtorno Depressivo/psicologia , Feminino , Humanos , Incidência , Masculino , Recursos Humanos em Hospital/psicologia , Comportamento Autodestrutivo/psicologia , Incerteza , Adulto Jovem
8.
Psychiatry Res ; 296: 113660, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33373808

RESUMO

The novel coronavirus disease (COVID-19) poses mental health challenges globally; however, to date, there is limited community level data. This study reports on the COLLATE project (COvid-19 and you: mentaL heaLth in AusTralia now survEy), an ongoing study aimed at understanding the impact of the COVID-19 pandemic on Australian mental health and well-being. We addressed prevailing primary concerns related to the COVID-19 pandemic, current levels of negative emotions and risk factors predicting negative emotions. On April 1st to 4th 2020, 5158 adults from the general public completed an online survey. Participants ranked their top ten current primary concerns about COVID-19, and completed standardized measures of negative emotions. The top three primary concerns were related to health and well-being of family and loved ones. Levels of negative emotion were high. Modelling of predictors of negative emotions established several risk factors related to demographic variables, personal vulnerabilities, financial stresses, and social distancing perceptions; particularly being young, female, or having a mental illness diagnosis. The data provides important characterization of the current Australian mental health. It appears that specific groups may need special attention to ensure their mental health is protected. These results may provide direction for international researchers characterizing similar issues.


Assuntos
/epidemiologia , Transtornos Mentais/epidemiologia , Pandemias/estatística & dados numéricos , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Austrália/epidemiologia , Comorbidade , Estudos Transversais , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Vigilância da População , Qualidade de Vida/psicologia , Fatores de Risco , Adulto Jovem
9.
J Affect Disord ; 278: 144-148, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32961409

RESUMO

BACKGROUND: It is well known that unexpected pandemic has led to an increase in mental health problems among a variety of populations. METHODS: In this study, an online non-probability sample survey was used to anonymously investigate the anxiety and depression symptoms among medical staff under the COVID-19 outbreak. The questionnaire included Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder 7-Item Scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Factors associated with anxiety and depression symptoms were estimated by logistic regression analysis. RESULTS: A total of 1090 medical staff were investigated in this study. The estimated self-reported rates of anxiety symptoms, depression symptoms and both of the two were 13.3%, 18.4% and 23.9% respectively. Factors associated with self-reported anxiety symptoms include married status (OR=2.3, 95%CI: 1.2, 4.4), not living alone (OR=0.4, 95%CI: 0.2, 0.7), never confiding their troubles to others (OR=2.2, 95%CI: 1.4, 3.5) and higher stress (OR=14.4, 95%CI: 7.8, 26.4). Factors associated with self-reported depression symptoms include not living alone (OR=0.4, 95%CI: 0.3, 0.7), sometimes/often getting care from neighbours (OR=0.6, 95%CI: 0.4, 0.9), never confiding their troubles to others (OR=2.0, 95%CI: 1.3, 3.0) and higher stress (OR=9.7, 95%CI: 6.2, 15.2). LIMITATIONS: The study was a non-probability sample survey. Besides, scales used in this study can only identify mental health states. CONCLUSIONS: Under outbreak of COVID-19, self-reported rates of anxiety symptoms and depression symptoms were high in investigated medical staff. Psychological interventions for those at high risk with common mental problems should be integrated into the work plan to fight against the epidemic.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Corpo Clínico/psicologia , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Corpo Clínico/estatística & dados numéricos , Pandemias , Questionário de Saúde do Paciente , Prevalência
10.
J Affect Disord ; 278: 365-371, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33007626

RESUMO

INTRODUCTION: As the Novel Corona Virus Disease (COVID-19) was declared by the world health organization a pandemic in March 2020, thousands of healthcare workers (HCWs) worldwide were on the frontlines fighting against the pandemic. Herein, we selected two Middle East countries; Egypt and Saudi Arabia to investigate the psychological impacts of the COVID-19 pandemic on their HCWs. METHODS: In this cross-sectional study, a Google survey was used to access HCWs in many hospitals in Egypt and Saudi Arabia between the 14th and 24th of April 2020. The survey assessed HCWs regarding their sociodemographic and occupational features, sleeping hours, and psychological impacts of the COVID-19 pandemic using the Depression Anxiety Stress Scale-21 (DASS-21). RESULTS: This study included 426 HCWs (48.4% physicians, 24.2% nurses, and 27.4% other HCWs). Of them, 69% had depression, 58.9% had anxiety, 55.9% had stress, and 37.3% had inadequate sleeping (<6 h/day). Female sex, age ≤30 years, working in Egypt, attending emergency and night shifts, watching/reading COVID-19 news ≥2 h/day, and not getting emotional support from family, society, and hospital were associated with a high likelihood of depression, anxiety, stress, and inadequate sleeping. LIMITATIONS: the cross-sectional design restricted our ability to distinguish between preexisting and emerging psychological symptoms. CONCLUSION: HCWs on the frontlines in Egypt and Saudi Arabia experienced depression, anxiety, stress, and inadequate sleeping during the COVID-19 pandemic.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Pessoal de Saúde/psicologia , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Fatores Etários , Transtornos de Ansiedade/psicologia , Estudos Transversais , Transtorno Depressivo/psicologia , Egito/epidemiologia , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Arábia Saudita/epidemiologia , Fatores Sexuais , Estresse Psicológico/psicologia , Adulto Jovem
11.
Medicine (Baltimore) ; 99(51): e23754, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371135

RESUMO

BACKGROUND: Insomnia with high incidence is usually accompanied by many other diseases, especially mental disorders with the under-diagnosis and under-treatment. Some studies demonstrated that acupuncture may be effective for emotional disorders accompanied by insomnia. The systematic review protocol is designed to guiding analysis the effectiveness and safety of acupuncture for emotional disorders in patients with insomnia. METHODS: Seven databases, Cochrane central register of controlled trials, Medline, Embase, China National Knowledge Infrastructure, Chinese Biomedical Literature database, VIP database and Wanfang database, will be searched from initial to December 2020. Randomized controlled trials (RCTs) of acupuncture for insomnia with emotional disorders (depression and anxiety) outcomes, which were reported in Chinese or English, will be included. The primary outcome is the change of degree of anxiety and depression. Study selection, data extraction and assessment of the risk of bias will be performed independently by 2 or more reviewers. Available data will be synthesized and statistically analyzed in RevMan V.5.3. The model of fixed effects will be used for the pooled data when the heterogeneity tests show little or no statistical heterogeneity (I2 < 50%). The random-effects model will be taken with heterogeneous data (50% ≤ I2 < 75%). RESULTS: The effect of acupuncture on emotional disorders in patients with insomnia will be assessed on Hamilton anxiety Scale, Hamilton anxiety Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Self-rating Anxiety Scale, Self-rating Depressive Scale and the number of participants secede and the number of patients reported adverse events. CONCLUSION: the emotional disorders interaction with insomnia and the increase of risk on disease evolving and insomnia-related burden, it is so momentous to know that the role of insomnia treatment on comorbidities. We should concern about the management of emotional disorders when treat insomnia, and acupuncture treatment anxiety and depression caused by insomnia may be effective. ETHICS AND DISSEMINATION: Ethics approval is not be needed because the data will not contain individual patient data, and there are no concerns about privacy. The results of this meta-analysis will be disseminated through publication in a peer-reviewed academic journal or relevant conference. INPLASY REGISTRATION NUMBER: INPLASY2020100115.


Assuntos
Terapia por Acupuntura/métodos , Transtornos de Ansiedade/terapia , Transtorno Depressivo/terapia , Distúrbios do Início e da Manutenção do Sono/terapia , Terapia por Acupuntura/efeitos adversos , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Índice de Gravidade de Doença , Sono , Distúrbios do Início e da Manutenção do Sono/epidemiologia
12.
Global Health ; 16(1): 119, 2020 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-33339523

RESUMO

BACKGROUND: The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with overall quality of life (overall QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. METHODS: This was a multicenter, cross-sectional study. Fatigue, depressive symptoms, pain, insomnia symptoms, and overall QOL were assessed with standardized instruments. RESULTS: A total of 1063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1-50.1%). An analysis of covariance revealed that overall QOL was significantly lower in patients with fatigue compared to those without (P = 0.011). A multiple logistic regression analysis revealed that more severe depressive symptoms (OR = 1.15, P < 0.001), insomnia symptoms (OR = 1.08, P < 0.001) and pain (OR = 1.43, P < 0.001) were significantly associated with fatigue. CONCLUSIONS: Fatigue is common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on overall QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.


Assuntos
/complicações , Fadiga/complicações , Transtornos Mentais/complicações , Dor/complicações , Qualidade de Vida , Índice de Gravidade de Doença , Distúrbios do Início e da Manutenção do Sono/complicações , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , /psicologia , Estudos Transversais , Depressão/complicações , Depressão/epidemiologia , Transtorno Depressivo/complicações , Transtorno Depressivo/epidemiologia , Surtos de Doenças , Fadiga/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Dor/epidemiologia , Prevalência , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Isolamento Social/psicologia , Inquéritos e Questionários
13.
JAMA Netw Open ; 3(10): e2026064, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33104209

RESUMO

Importance: An immediate research priority is to investigate and monitor the psychological well-being among high-risk groups during the coronavirus disease 2019 (COVID-19) pandemic. Objective: To examine levels of severity of depressive symptoms over time among individuals with high risk in the UK during the COVID-19 pandemic. Design, Setting, and Participants: This cohort study is part of an ongoing large panel study of adults aged 18 years and older residing in the UK, the COVID-19 Social Study, established on March 21, 2020. Data analysis was conducted in May 2020. Exposures: Sociodemographic risk factors included belonging to the Black, Asian, and minority racial/ethnic communities, low socioeconomic position (SEP), and essential worker roles (eg, workers in health and social care, education, childcare, or key public services). Health-related and psychosocial risk factors included preexisting physical and mental health conditions, experience of psychological or physical abuse, and low social support. Main Outcomes and Measures: Depressive symptoms were measured on 7 occasions from March 21 to April 2, 2020, using the 9-item Patient Health Questionnaire (PHQ-9). Group-based depressive symptom trajectories were derived using latent growth mixture modeling. Results: The analytical sample comprised 51 417 adults aged 18 years and older (mean [SD] age, 48.8 [16.8] years; 26 276 [51.1%] women; 6145 members [12.0%] of Black, Asian, and minority racial/ethnic communities). Among these, 17 143 participants (33.3%) were in the lowest SEP quartile, and 11 342 participants (22.1%) were classified as essential workers. Three levels of severity of depressive symptoms were identified: low (30 850 participants [60.0%]), moderate (14 911 participants [29.0%]), and severe (5656 participants [11.0%]). After adjusting for covariates, experiences of physical or psychological abuse (odds ratio [OR], 13.16; 95% CI, 12.95-13.37; P < .001), preexisting mental health conditions (OR, 12.99; 95% CI, 12.87-13.11; P < .001), preexisting physical health conditions (OR, 3.41; 95% CI, 3.29-3.54; P < .001), low social support (OR, 12.72; 95% CI, 12.57-12.86; P < .001), and low SEP (OR, 5.22; 95% CI, 5.08-5.36; P < .001) were significantly associated with severe depressive symptoms. No significant association was found for race/ethnicity (OR, 1.07; 95% CI, 0.85-1.28; P = .56). Participants with essential worker roles were less likely to experience severe depressive symptoms (OR, 0.66; 95% CI, 0.53-0.80; P < .001). Similar patterns of associations were found for the group of participants with moderate depressive symptoms (abuse: OR, 5.34; 95% CI, 5.15-5.54; P < .001; mental health condition: OR, 4.24; 95% CI, 4.24-4.24; P < .001; physical health condition: OR, 1.89; 95% CI, 1.80-1.98; P < .001; low social support: OR, 4.71; 95% CI, 4.60-4.82; P < .001; low SEP: OR, 1.97; 95% CI, 1.87-2.08; P < .001). Conclusions and Relevance: In this cohort study of UK adults participating in the COVID-19 Social Study, people with psychosocial and health-related risk factors, as well as those with low SEP, were at the most risk of experiencing moderate or severe depressive symptoms during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/psicologia , Depressão , Transtorno Depressivo , Nível de Saúde , Pandemias , Pneumonia Viral/psicologia , Índice de Gravidade de Doença , Classe Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/virologia , Depressão/epidemiologia , Depressão/etiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Emprego , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/etnologia , Pneumonia Viral/virologia , Grupos Populacionais/psicologia , Fatores de Risco , Reino Unido , Adulto Jovem
14.
PLoS One ; 15(10): e0240646, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33104711

RESUMO

The COVID-19 pandemic puts health workers at increased risk of adverse mental health outcomes. However, no studies have assessed health workers' experiences using qualitative methods during the COVID-19 outbreak in the United States to identify novel factors that could relate to their mental health. In May 2020, we distributed an online survey to health workers across 25 medical centers throughout the United States. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care-Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise and associated cutoff values were used to assess rates of probable major depression, generalized anxiety disorder, post-traumatic stress disorder, and alcohol use disorder, respectively. To provide insight into the factors shaping these and other mental health conditions, we included two open-ended questions asking respondents to recount their most upsetting and hopeful experiences during the COVID-19 pandemic and how it made them feel. Using a hybrid inductive-abductive approach and thematic content analysis, we created a Social Ecological Model to represent themes among health workers' experiences within five ecological levels: individual, interpersonal, organization, community, and public policy. Of the 1,132 participants who completed the survey, 14.0% had probable major depression, 15.8% probable generalized anxiety disorder, 23.1% probable post-traumatic stress disorder, and 42.6% probable alcohol use disorder. Individual level themes included participants' personal health and self-care behaviors. Interpersonal level themes included the health of their social circle, family functioning, and social support. Organization level themes included their hospital's management, resources, patient care, routine, and teams. Themes in the community level included the media, scientific knowledge about COVID-19, morale, behavior, and support of health workers. Lastly, government and health system leadership and shelter-in-place policy were themes within the public policy level. Our findings provide insights into novel factors that have impacted health workers' wellbeing during the COVID-19 pandemic. These factors should be further explored to inform interventions and public policy that mitigate mental health morbidities among health workers during this and future outbreaks.


Assuntos
Alcoolismo/etiologia , Transtornos de Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Transtorno Depressivo/etiologia , Pessoal de Saúde/psicologia , Pandemias , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Adulto , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Relações Comunidade-Instituição , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Transtorno Depressivo/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Política de Saúde , Humanos , Relações Interpessoais , Masculino , Modelos Teóricos , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/etiologia , Questionário de Saúde do Paciente , Pneumonia Viral/epidemiologia , Determinantes Sociais da Saúde , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estados Unidos
15.
J Korean Med Sci ; 35(41): e372, 2020 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-33107230

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak has exposed healthcare workers to extreme physical workloads and psychological challenges. Thus, we aimed to assess the immediate correlates of emotional stress and to identify which specific jobs, departments, and exposure types are risk factors for emotional stress in healthcare workers. METHODS: In this cross-sectional study conducted from April 2 to 10, 2020, university hospital workers were administered self-reported questionnaires that covered general characteristics and included the Patient Health Questionnaire, Generalized Anxiety Disorder scale, and a visual analog scale. At-risk groups for depression and anxiety were identified, and the odds ratios for depression and anxiety were analyzed after adjusting for age, gender, education, marital status, and duration of employment. RESULTS: The data of 1,003 participants were analyzed. Of these, 14.2% worked in wards for confirmed COVID-19 cases and 15.2% had had direct contact with these patients. Treating patients with COVID-19 was associated with depression and anxiety, while dealing with COVID-19 test samples was associated with depression. Exposure to random or unspecified patients was also associated with depression. Lastly, social rejection and other negative experiences were associated with depression and anxiety. CONCLUSION: The COVID-19 outbreak is correlated with healthcare workers' emotional stress, and specific types of jobs and duties involving close contact with these patients can be risk factors. Interestingly, even low-exposure groups reported significant depression and anxiety as a result of social stigma and uncertainty. Adequate and timely management measures for emotional stress are required for vulnerable and at-risk groups.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Estresse Ocupacional , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adulto , Estudos Transversais , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias , República da Coreia/epidemiologia , Fatores de Risco , Autorrelato , Carga de Trabalho , Adulto Jovem
16.
JAMA Netw Open ; 3(10): e2025591, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33095252

RESUMO

Importance: The coronavirus disease 2019 (COVID-19) pandemic and quarantine measures have raised concerns regarding their psychological effects on populations. Among the general population, university students appear to be particularly susceptible to experiencing mental health problems. Objectives: To measure the prevalence of self-reported mental health symptoms, to identify associated factors, and to assess care seeking among university students who experienced the COVID-19 quarantine in France. Design, Setting, and Participants: This survey study collected data from April 17 to May 4, 2020, from 69 054 students living in France during the COVID-19 quarantine. All French universities were asked to send an email to their students asking them to complete an online questionnaire. The targeted population was approximately 1 600 000 students. Exposure: Living in France during the COVID-19 quarantine. Main Outcomes and Measures: The rates of self-reported suicidal thoughts, severe distress, stress, anxiety, and depression were assessed using the 22-item Impact of Events Scale-Revised, the 10-item Perceived Stress Scale, the 20-item State-Trait Anxiety Inventory (State subscale), and the 13-item Beck Depression Inventory, respectively. Covariates were sociodemographic characteristics, precariousness indicators (ie, loss of income or poor quality housing), health-related data, information on the social environment, and media consumption. Data pertaining to care seeking were also collected. Multivariable logistic regression analyses were performed to identify risk factors. Results: A total of 69 054 students completed the survey (response rate, 4.3%). The median (interquartile range) age was 20 (18-22) years. The sample was mainly composed of women (50 251 [72.8%]) and first-year students (32 424 [47.0%]). The prevalence of suicidal thoughts, severe distress, high level of perceived stress, severe depression, and high level of anxiety were 11.4% (7891 students), 22.4% (15 463 students), 24.7% (17 093 students), 16.1% (11 133 students), and 27.5% (18 970 students), respectively, with 29 564 students (42.8%) reporting at least 1 outcome, among whom 3675 (12.4%) reported seeing a health professional. Among risk factors identified, reporting at least 1 mental health outcome was associated with female gender (odds ratio [OR], 2.10; 95% CI, 2.02-2.19; P < .001) or nonbinary gender (OR, 3.57; 95% CI, 2.99-4.27; P < .001), precariousness (loss of income: OR, 1.28; 95% CI, 1.22-1.33; P < .001; low-quality housing: OR, 2.30; 95% CI, 2.06-2.57; P < .001), history of psychiatric follow-up (OR, 3.28; 95% CI, 3.09-3.48; P < .001), symptoms compatible with COVID-19 (OR, 1.55; 95% CI, 1.49-1.61; P < .001), social isolation (weak sense of integration: OR, 3.63; 95% CI, 3.35-3.92; P < .001; low quality of social relations: OR, 2.62; 95% CI, 2.49-2.75; P < .001), and low quality of the information received (OR, 1.56; 95% CI, 1.49-1.64; P < .001). Conclusions and Relevance: The results of this survey study suggest a high prevalence of mental health issues among students who experienced quarantine, underlining the need to reinforce prevention, surveillance, and access to care.


Assuntos
Infecções por Coronavirus/psicologia , Transtornos Mentais/etiologia , Pandemias , Pneumonia Viral/psicologia , Isolamento Social/psicologia , Estudantes/psicologia , Ideação Suicida , Universidades , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Depressão/epidemiologia , Depressão/etiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Razão de Chances , Aceitação pelo Paciente de Cuidados de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Prevalência , Quarentena , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários , Adulto Jovem
18.
Psychiatr Danub ; 32(Suppl 3): 386-395, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030459

RESUMO

The use of violence and aggression on civilians during the war has become one of the most prominent military events of the 20th and 21st centuries, resulting in an increasing number of refugees and displaced persons in the midst of regional and tribal conflicts. We are witnessing a daily increase in the number of migrants when people are fleeing from their homes because of human rights violations, persecution, poverty, and conflict. When found in "host" countries, they often encounter bad conditions, with uncertainty and instability. Many come to Europe in search of economic and personal opportunities for progress, where they face different types of process of acculturation. 'Place loss', acute and chronic trauma, family disorders, and family reunification issues became more and more important issues. Refugees, asylum seekers and irregular migrants have a higher risk for certain mental health disorders, including posttraumatic stress, depression and psychosis. In addition to being exposed to various risk factors for mental disorders, migrants often face barriers to access to adequate health care to address these issues. Some of the biggest challenges for migrant populations within "host" countries include: lack of knowledge of health care rights and health systems; poor knowledge of the language; different belief systems and cultural expectations of health care; and the general lack of trust in experts and in government. The rates of depressive and anxiety disorders usually increase over time, and poor mental health is associated with poor socioeconomic conditions - particularly with social isolation and unemployment. Acculturative stress often implies a high discrepancy in the acculturation between parents and their children. This dislocation of families in new conditions has been caused by the different degrees of acceptance of "new culture" by children and parents, which causes serious difficulties, especially in bilingual terms.


Assuntos
Aculturação , Saúde Mental/estatística & dados numéricos , Refugiados , Migrantes , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Europa (Continente) , Humanos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Migrantes/psicologia , Migrantes/estatística & dados numéricos
19.
Artigo em Inglês | MEDLINE | ID: mdl-33031651

RESUMO

Objective: Amid the ongoing coronavirus disease 2019 (COVID-19) pandemic, health care workers of multiple disciplines have been designated as frontline doctors. This unforeseen situation has led to psychological problems among these health care workers. The objective of this study was to evaluate the mental health status of pan-Indian frontline doctors combating the COVID-19 pandemic. Methods: A cross-sectional, observational study was conducted among frontline doctors of tertiary care hospitals in India (East: Kolkata, West Bengal; North: New Delhi; West: Nagpur, Maharashtra; and South: Thiruvananthapuram, Kerala) from May 23, 2020, to June 6, 2020. Doctors involved in clinical services in outpatient departments, designated COVID-19 wards, screening blocks, fever clinics, and intensive care units completed an online questionnaire. The 9-item Patient Health Questionnaire and the Perceived Stress Scale were used to assess depression and perceived stress. Results: The results of 422 responses revealed a 63.5% and 45% prevalence of symptoms of depression and stress, respectively, among frontline COVID-19 doctors. Postgraduate trainees constituted the majority (45.5%) of the respondents. Moderately severe and severe depression was noted in 14.2% and 3.8% of the doctors, respectively. Moderate and severe stress was noted in 37.4% and 7.6% of participants, respectively. Multivariate regression analysis showed working ≥ 6 hours/day (adjusted odds ratio: 3.5; 95% CI, 1.9-6.3; P < .0001) to be a significant risk factor for moderate or severe perceived stress, while single relationship status (adjusted odds ratio: 2.9; 95% CI, 1.5-5.9; P = .002) and working ≥ 6 hours/day (adjusted odds ratio: 10.3; 95% CI, 4.3-24.6; P < .0001) significantly contributed to the development of moderate, moderately severe, or severe depression. Conclusions: The pandemic has taken a serious toll on the physical and mental health of doctors, as evident from our study. Regular screening of medical personnel involved in the diagnosis and treatment of patients with COVID-19 should be conducted to evaluate for stress, anxiety, and depression.


Assuntos
Infecções por Coronavirus , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Pandemias , Médicos/psicologia , Pneumonia Viral , Estresse Psicológico/epidemiologia , Adulto , Betacoronavirus , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Internato e Residência , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Admissão e Escalonamento de Pessoal , Médicos/estatística & dados numéricos , Prevalência , Características de Residência , Fatores de Risco , Carga de Trabalho , Adulto Jovem
20.
Cir Cir ; 88(5): 562-568, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064695

RESUMO

Objective: The objective of the study was to determine the state of anxiety, depression, and stress present in the society during the development of the 2019 coronavirus pandemic. Methods: Mixed methods study; a three-section questionnaire was developed which included sociodemographic, perceptions, emotions, and behaviors related to the 2019 coronavirus pandemic, and two emotional assessment psychometric tests. The proportions and confidence intervals of the variables were calculated and compared using the Chi-square test. Results: More than 40% of the subjects presented some degree of anxiety and 41.3% depression; the proportion of stress was < 30%. Of the subjects who experienced anxiety, 18.6% also had moderate-to-very severe depression or stress. Conclusion: There are emotional indicators derived from the 2019 coronavirus pandemic in almost half of the study population. The identification and timely treatment of these states could lessen the psychological impact due to 2019 coronavirus.


Assuntos
Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Depressão/etiologia , Pandemias , Pneumonia Viral/psicologia , Estresse Psicológico/etiologia , Adulto , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Emoções , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , México , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Psicometria , Assunção de Riscos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
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