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1.
Eur. j. psychol. appl. legal context (Internet) ; 13(1): 29-36, ene.-jun. 2021. tab, graf
Artigo em Inglês | IBECS-Express | IBECS | ID: ibc-ET1-7183

RESUMO

Drugs are sold on both dark web services and on social media, but research investigating these drug purchases online is still emerging. The aim of this study is to analyze risk factors associated with buying drugs online. Utilizing theories of criminology and addiction research, it was hypothesized that social bonds, low levels of self-control, and poor mental health are associated with buying drugs online. Additionally, it was predicted that purchases of drugs online would mediate the relationship between low self-control and regular drug use. Participants of this nationwide study were 15 to 25 years old living in the United States (N = 1,212) and Spain (N = 1,212). Measures of impulsivity, a sense of mastery, social belonging, psychological distress, excessive behaviors (drinking, gambling and internet use) were utilized to predict purchasing drugs online. Two percent of the U.S. and Spanish respondents reported buying drugs online with 77% of them utilizing social media services to buy drugs. Results from multinomial logistic regression, penalized maximum-likelihood logistic regression, and binary mediation regression models indicated that buying drugs online was associated with lower self-control, higher psychological distress, and excessive gambling behavior and excessive Internet use. Having online friends was not a risk factor, but having strong social bonds with offline friends served as a protective factor. Additionally, buying drugs online mediated the relationship between low self-control and regular use of drugs. Results indicate that more focus should be placed on mainstream social media services as sources of drug acquisition as online drug buyers have multiple self-control and mental health problems


Las drogas se venden en páginas web oscuras y en las redes sociales, aunque la investigación de estas adquisiciones online está aún en sus comienzos. Este estudio tiene como objetivo examinar los factores de riesgo vinculados a la compra de drogas online. De acuerdo con las teorías de la criminología y la investigación sobre adicciones, se planteó la hipótesis de que los vínculos sociales, el bajo nivel de autocontrol y los problemas de salud mental están relacionados con la compra online de drogas. Además, se postuló que la adquisición online de drogas estaría mediada por la relación entre el bajo autocontrol y el consumo frecuente de drogas. Participaron en el estudio un total de 2,424 jóvenes residentes en Estados Unidos (N = 1,212) y en España (N = 1,212), que fueron evaluados en impulsividad, sensación de dominio, pertenencia social, malestar psicológico, comportamientos abusivos (bebida, juego y utilización de internet) , con el objetivo de predecir la compra online de drogas. El 2% de los participantes de EE UU y España dijeron que compraban drogas online, de los cuales el 77% utilizaba servicios de redes sociales para tal fin. Los resultados de una regresión logística multinomial, regresión logística de máxima verosimilitud penalizada y modelos de regresión de mediación binaria mostraron que la adquisición online de drogas se relaciona con un menor autocontrol y un mayor malestar emocional y abuso del juego, y del uso de internet. El hecho de tener amigos por internet no constituía un factor de riesgo y tener vínculos sociales estrechos con amigos fuera de internet constituía un factor protector. A su vez, la compra online de drogas es un factor que media la relación entre bajo autocontrol y uso habitual de drogas. Los resultados sugieren que debería prestarse mayor atención a las redes sociales como medio habitual de adquisición de drogas, dado que los compradores online de drogas tienen múltiples problemas de salud mental y autocontrol

2.
Int. j. clin. health psychol. (Internet) ; 21(1): 196-196, ene.-abr. 2021. graf, tab
Artigo em Inglês | IBECS | ID: ibc-194177

RESUMO

INTRODUCTION: COVID-19 pandemic, declared on March 11, 2020, constitute an extraordinary health, social and economic global challenge. The impact on people's mental health is expected to be high. This paper sought to systematically review community-based studies on depression conducted during the COVID-19 and estimate the pooled prevalence of depression. METHOD: We searched for cross-sectional, community-based studies listed on PubMed or Web of Science from January 1, 2020 to May 8, 2020 that reported prevalence of depression. A random effect model was used to estimate the pooled proportion of depression. RESULTS: A total of 12 studies were included in the meta-analysis, with prevalence rates of depression ranging from 7.45% to 48.30%. The pooled prevalence of depression was 25% (95% CI: 18%−33%), with significant heterogeneity between studies (I2=99.60%, p<.001). CONCLUSIONS: Compared with a global estimated prevalence of depression of 3.44% in 2017, our pooled prevalence of 25% appears to be 7 times higher, thus suggesting an important impact of the COVID-19 outbreak on people's mental health. Addressing mental health during and after this global health crisis should be placed into the international and national public health agenda to improve citizens' wellbeing


INTRODUCCIÓN: La pandemia de COVID-19, declarada el 11 de marzo de 2020, representa un reto global extraordinario a nivel sanitario, social y económico. Se espera un impacto alto en la salud mental de las personas. Este artículo tiene como objetivo realizar una revisión sistemática de estudios transversales basados en muestras comunitarias que proporcionaban la prevalencia de depresión durante la crisis del COVID-19. MÉTODO: Se realizó una búsqueda de estudios comunitarios publicados en Pubmed y Web of Science desde el 1 de enero del 2020 al 8 de mayo del 2020 y que informaron sobre la prevalencia de depresión. Se usó un modelo de efectos aleatorios para estimar la proporción agrupada de depresión. RESULTADOS: Un total de 12 estudios fueron incluidos en el meta-análisis, con prevalencias de depresión que oscilaban entre 7,45% y 48,30%. La prevalencia agrupada de depresión fue de 25% (95% CI: 18%-33%), con heterogeneidad significativa entre estudios (I2 = 99,60%, p < 0,001). CONCLUSIONES: En comparación con una estimación global de depresión en 2017 del 3,44%, nuestra prevalencia agrupada del 25% es 7 veces mayor, sugiriendo un impacto importante del brote de COVID-19 en la salud mental de las personas. El abordaje de la salud mental durante y después de esta crisis global sanitaria debe ser parte de las agendas de salud pública nacionales e internacionales para mejorar el bienestar de los ciudadanos


Assuntos
Humanos , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Depressão/psicologia , Depressão/epidemiologia , Pandemias , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Prevalência
3.
Int. j. clin. health psychol. (Internet) ; 21(1): 198-198, ene.-abr. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194909

RESUMO

BACKGROUND/OBJECTIVE: The objective of the study was to elucidate the underlying mechanism through which basic personality dimensions predict indicators of psychological functioning during the COVID-19 pandemic, including subjective well-being and perceived stress. As a personality characteristic highly contextualized in stressful circumstances, resilience was expected to have a mediating role in this relationship. METHOD: A sample of 2,722 Slovene adults, aged from 18 to 82 years filled in the Big Five Inventory, the Connor-Davidson Resilience Scale, the Perceived Stress Scale, and the Mental Health Continuum. A path analysis with the Bootstrap estimation procedure was performed to evaluate the mediating effect of resilience in the relationship between personality and psychological functioning. RESULTS: Resilience fully or partially mediated the relationships between all the Big Five but extraversion with subjective well-being and stress experienced at the beginning of the COVID-19 outburst. Neuroticism was the strongest predictor of less adaptive psychological functioning both directly and through diminished resilience. CONCLUSIONS: Resilience may be a major protective factor required for an adaptive response of an individual in stressful situations such as pandemic and the associated lockdown


ANTECEDENTES/OBJETIVO: El objetivo fue dilucidar el mecanismo subyacente a través del cual las dimensiones básicas de la personalidad predicen indicadores del funcionamiento psicológico durante la pandemia de COVID-19, incluido el bienestar subjetivo y el estrés percibido. Como característica de la personalidad altamente contextualizada en circunstancias estresantes, se esperaba que la resiliencia tuviera un papel mediador en esta relación. MÉTODO: Una muestra de 2.722 adultos eslovenos (18-82 años), completó el Big Five Inventory, la Connor-Davidson Resilience Scale, la Perceived Stress Scale y el Mental Health Continuum. Se realizó un análisis de ruta con el procedimiento de estimación Bootstrap para evaluar el efecto mediador de la resiliencia en la relación entre la personalidad y el funcionamiento psicológico. RESULTADOS: La resiliencia medió total o parcialmente las relaciones entre los Cinco Grandes, y la extraversión con bienestar subjetivo y el estrés experimentado, al comienzo del estallido de COVID-19. El neuroticismo fue el predictor más fuerte de un funcionamiento psicológico menos adaptativo, tanto directamente como a través de la disminución de la capacidad de resiliencia. CONCLUSIONES: La resiliencia puede ser un factor de protección importante y requerido para una respuesta adaptativa de un individuo en situaciones estresantes como la pandemia y el confinamiento asociado


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Resiliência Psicológica , Personalidade/fisiologia , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Pandemias , Inventário de Personalidade/normas , Psicometria/métodos , Neuroticismo/fisiologia
4.
Int. j. clin. health psychol. (Internet) ; 21(1): 201-201, ene.-abr. 2021. graf, tab
Artigo em Inglês | IBECS-Express | IBECS | ID: ibc-ET6-1886

RESUMO

BACKGROUND/OBJECTIVE: Long-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. METHOD: A registry-based sample of N=633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). RESULTS: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). CONCLUSIONS: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients' re-integration into society is successful could thus have important implications for well-being in adulthood


ANTECEDENTE/OBJETIVO: Los sobrevivientes a largo plazo de cáncer infantil (SCI) están en riesgo de sufrir efectos tardíos. Evaluamos la prevalencia de la soledad y su impacto en los síntomas psicológicos a lo largo del tiempo. MÉTODO: Una muestra de N=633 adultos con un pasado de SCI se sometió a evaluaciones médicas y psicológicas y participó en una encuesta de seguimiento 2,5 años después. Los síntomas psicológicos se midieron mediante el Patient Health Questionnaire. Calculamos modelos de regresión lineal de síntomas en el seguimiento para investigar el impacto de la soledad a lo largo del tiempo (controlando los síntomas al inicio y los factores de confusión relevantes). RESULTADOS: La soledad fue reportada por el 17,70% de SCI. La soledad seguía siendo predictiva de síntomas de ansiedad más graves e ideación suicida dos años después. La soledad no predijo los síntomas somáticos y de depresión durante el seguimiento (que aumentaron con la edad). CONCLUSIONES: La soledad fue un factor de riesgo para síntomas de ansiedad persistente e ideación suicida. La medida en que la reintegración de los pacientes jóvenes con cáncer en la sociedad tenga éxito podría tener importantes implicaciones para el bienestar en la edad adulta

5.
J. optom. (Internet) ; 14(1): 3-10, ene.-mar. 2021.
Artigo em Inglês | IBECS-Express | IBECS | ID: ibc-ET6-1890

RESUMO

Cases of dry eye disease involving a neuropathic basis for symptoms and a poor correlation between symptoms and objective signs of dry eye disease can be associated with unsatisfactory responses to treatments which are limited to attempts to restore lacrimal function unit deficiencies. This review examines a wider range of circumstances under which the same kind of poor correlation between signs, symptoms and treatment results can be found. Some cases of computer vision syndrome can present for examination at times when objective signs related to reported symptoms have dissipated. A thorough history should explain this type of presentation for which symptoms might otherwise appear to be unexplained. However, mental health disorders can also be the basis for apparently unexplained levels of symptoms of dry eye disease. Anxiety, depression, hypochondriasis, stress, sleep and mood disorders as well as neuroticism for example, may be associated with exacerbation of symptoms to degrees that are not consistent with the levels of tear homeostasis anomalies that are assessed. The conclusion is drawn that failure to consider mental health comorbidities may result in symptomatic patients being exposed to less successful attempts to remediate tear dysfunctions when, for example, the symptoms have a somatic basis. Appropriate screening and referral to a psychologist or psychiatrist may be the key to managing some patients whose symptoms do not correlate with objective evidence of dry eye disease


No disponible

7.
Pergunta e resposta em Português | SOF - Segunda opinião formativa | ID: sof-43324

RESUMO

O serviço de Atenção Psicossocial Municipal, que tem como responsabilização a organização da demanda e da rede de cuidados em saúde mental no âmbito do território e que possui papel regulador na porta de entrada na rede de assistência; deve ser buscado pela equipe de saúde para orientação e melhor solução do caso, de forma multidisciplinar. Decisões que pontuem o risco/benefício devem ser tomadas inicialmente a nível municipal.

A Estratégia Saúde da Família (ESF) deve acolher a família de forma integral e sistêmica, a qual é objeto e sujeito do processo de cuidado e de promoção da saúde pelas equipes(1). O acompanhamento deverá ser realizado por toda a equipe, sendo em domicílio e na Unidade Básica de Saúde (UBS), tendo apoio também do Núcleo Ampliado de Saúde da Família (NASF), com a presença principalmente do psicólogo e do assistente social(2).

O trabalho na atenção básica é longitudinal, ou seja, que o cuidado à saúde das pessoas deve acontecer ao longo do tempo, independentemente do usuário estar com alguma doença. A proximidade com o usuário, seu território e sua realidade vão auxiliar a construção deste processo de cuidado em que se espera uma fortificação do vínculo entre profissional de saúde e usuário. A criação do vínculo de confiança deve ser fortalecido por meio da escuta, do acolhimento, da garantia da participação da família na construção do Projeto Terapêutico Singular (PTS), da valorização da família enquanto participante ativa do tratamento(1) e organizando grupos de familiares para buscar criar laços de solidariedade entre seus membros participantes, para discutirem problemas comuns, enfrentarem situações difíceis e receberem orientação sobre o diagnóstico e participação no projeto terapêutico(3,4).


Assuntos
Transtornos Psicóticos , Equipe de Assistência ao Paciente
8.
Pergunta e resposta em Português | SOF - Segunda opinião formativa | ID: sof-43726

RESUMO

Habitualmente as crianças desenvolvem quadros leves e moderados da COVID-19, mas, assim como as demais síndromes gripais, as complicações desta infecção são, fundamentalmente, as respiratórias: Pneumonia e Síndrome da Angústia Respiratória Aguda (SARA). Complicações relacionadas a descompensação de doenças de base também podem ocorrer. Além de recomendar o uso de medicações sintomáticas e hidratação, os familiares devem estar atentos aos sinais de gravidade. Caso presentes, a criança deve ser avaliada imediatamente por um profissional de saúde. Entre os sinais de agravamento do quadro, destacam-se(1):

Persistência da febre por mais de 3 dias ou recorrência dela;

Falta de ar ou dificuldade para respirar;

Ronco, retração sub/intercostal severa;

Cianose central;

Batimento da asa de nariz;

Ritmo respiratório irregular;

Saturação de oximetria de pulso <95% em ar ambiente;

Taquipneia

Extremidades frias, tempo de enchimento capilar < 2 segundos;

Pulsos periféricos diminuídos ou ausentes

Inapetência para amamentação ou ingestão de líquidos;

Diminuição do débito urinário

Piora nas condições clínicas de doença de base;

Alteração do estado mental


Assuntos
Infecções por Coronavirus/complicações , Saúde da Criança
9.
Brasília, D.F.; OPAS; 2021-02-19. (OPAS-W/BRA/PHE/COVID-19/21-0008).
Não convencional em Português | PAHO-IRIS | ID: phr2-53296

RESUMO

Este documento faz referência ao manejo clínico da COVID-19 (Anexo 1). Ele descreve o manejo clínico multidisciplinar e coordenado de acordo com a qual o paciente entra depois de ter sido triado como sendo um caso suspeito de COVID-19, e segue a continuidade de seu tratamento até alta do manejo clínico. O objetivo é garantir uma assistência segura e de qualidade, ao mesmo tempo em que se impede a continuidade da transmissão do vírus. Todos os outros entram no sistema de saúde por outras vias, não relacionadas à COVID-19. Para a orientação técnica mais atualizada com relação à resposta à COVID-19, consulte o documento WHO Country & Technical Guidance (1) [Orientação Técnica da OMS e por País]. As competências básicas de apoio psicossocial estão no cerne de qualquer intervenção clínica relativa à COVID-19. Elas são indispensáveis para todos os envolvidos na resposta clínica à COVID-19, sejam eles identificados como provedores de saúde mental e serviços psicossociais ou não. As competências psicossociais básicas são essenciais para apoiar o bem-estar emocional das pessoas que têm COVID-19, que perderam alguém para a COVID-19 ou que são parentes e cuidadores que estão cuidando de alguém com COVID-19 ou que se recuperou da COVID-19.


Assuntos
Infecções por Coronavirus , Coronavirus , Infecções por Coronavirus , Betacoronavirus , Controle de Infecções , Pneumonia , Síndrome do Desconforto Respiratório do Adulto , Saúde Mental , Manifestações Neurológicas
10.
Brasília, D.F.; OPAS; 2021-02-19. (OPAS-W/BRA/PHE/COVID-19/21-0009).
Não convencional em Português | PAHO-IRIS | ID: phr2-53295

RESUMO

Esta orientação provisória reúne as informações sobre recursos humanos para a COVID-19 para que os gestores e formuladores de políticas de saúde em nível nacional, subnacional e de unidades de saúde planejem, gerenciem e preservem a força de trabalho necessária para manejo da pandemia da COVID-19 e mantenham os serviços essenciais de saúde. Esta orientação identifica as recomendações em nível individual, gerencial, organizacional e de sistema, reunindo em um único documento de referência as evidências iniciais das opções de políticas para a força de trabalho em saúde e para a pandemia em orientações sobre a COVID-19 publicadas pela Organização Mundial da Saúde (OMS). Ela será atualizada regularmente, beneficiando-se de ampla consulta aos departamentos e escritórios regionais da OMS, organizações internacionais, universidades e associações profissionais ativas na resposta à pandemia.


Assuntos
Infecções por Coronavirus , Infecções por Coronavirus , Coronavirus , Betacoronavirus , Controle de Infecções , Pessoal de Saúde , Pandemias , Epidemias , Orientação , Saúde Mental
11.
Preprint | medRxiv | ID: ppmedrxiv-21251042

RESUMO

ObjectivesTo estimate the prevalence of unpaid caregiving during the coronavirus disease 2019 (COVID-19) pandemic, and to identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation in this population, which provides critical support in health care systems by providing care to older adults and those with chronic conditions. MethodsIn June 2020, Internet-based surveys with questions about demographics, caregiving responsibilities, and mental health were administered to US adults aged [≥]18 years. Demographic quota sampling and survey weighting to improve cross-sectional sample representativeness of age, gender, and race/ethnicity. Prevalence ratios for adverse mental health symptoms were estimated using multivariable Poisson regressions. ResultsOf 9,896 eligible invited adults, 5,412 (54.7%) completed surveys; 5,011 (92.6%) respondents met screening criteria and were analysed, including 1,362 (27.2%) caregivers. Caregivers had higher prevalences of adverse mental health symptoms than non-caregivers, including anxiety or depressive disorder symptoms (57.6% vs 21.5%, respectively, p<0.0001) having recently seriously considered suicide (33.4% vs 3.7%, p<0.0001). Symptoms were more common among caregivers who were young vs older adults (e.g., aged 18-24 vs [≥]65 years, aPR 2.75, 95% CI 1.95-3.88, p<0.0001), Hispanic or Latino vs non-Hispanic White (1.14, 1.04-1.25, p=0.0044), living with vs without disabilities (1.18, 1.10-1.26, p<0.0001), and with moderate and high vs low Caregiver Intensity Index scores (2.31, 1.65-3.23; 2.81, 2.00-3.94; both p<0.0001). Suicidal ideation was more prevalent among non-Hispanic Black vs non-Hispanic White caregivers (1.48, 1.15-1.90, p=0.0022). ConclusionsCaregivers, who accounted for one in four US adult respondents in this nationally representative sample, more commonly reported adverse mental health symptoms than non-caregivers. Increased visibility of and access to mental health care resources are urgently needed to address mental health challenges of caregiving.

12.
Preprint | medRxiv | ID: ppmedrxiv-21250639

RESUMO

The mental being of healthcare workers with the COVID 19 pandemic is a determinant of their resilience. We investigated the psychological impact of healthcare workers during novel Coronavirus 2019-nCoV times in Morocco. A cross-sectional study conducted among healthcare workers of an University Hospital. We evaluated the knowledge of the protective means against nCov-19, incidence and the degree of anxiety and depression according to health workers characteristic. Among 287 health workers; 54% have been trained regarding protection procedures, and 94.8% declared that they are aware of individual protection measures. The incidence of anxiety and depression was respectively 77.4% and 73.9%. High degree of anxiety and depression was associated with female gender. However, Higher degree of anxiety was also related to function, specialty of practice, and knowledge of the protective measures against COVID-19.

13.
Preprint | medRxiv | ID: ppmedrxiv-21251069

RESUMO

BackgroundPeople with autoimmune or inflammatory conditions who take immunomodulatory/suppressive medications may have a higher risk of novel coronavirus disease 2019 (COVID-19). Chronic disease care has also changed for many patients, with uncertain downstream consequences. ObjectiveAssess whether COVID-19 risk is higher among those on immunomodulating or suppressive agents and characterize pandemic-associated changes to care. DesignLongitudinal registry study Participants4666 individuals with autoimmune or inflammatory conditions followed by specialists in neurology, rheumatology, cardiology, pulmonology or gastroenterology at Johns Hopkins MeasurementsPeriodic surveys querying comorbidities, disease-modifying medications, exposures, COVID-19 testing and outcomes, social behaviors, and disruptions to healthcare ResultsA total of 265 (5.6%) developed COVID-19 over 9 months of follow-up (April-December 2020). Patient characteristics (age, race, comorbidity, medication exposure) were associated with differences in social distancing behaviors during the pandemic. Glucocorticoid exposure was associated with higher odds of COVID-19 in multivariable models incorporating behavior and other potential confounders (OR: 1.43; 95%CI: 1.08, 1.89). Other medication classes were not associated with COVID-19 risk. Diabetes (OR: 1.72; 95%CI: 1.08, 2.73), cardiovascular disease (OR: 1.68; 95%CI: 1.24, 2.28), and chronic kidney disease (OR: 1.76; 95%CI: 1.04, 2.97) were each associated with higher odds of COVID-19. Pandemic-related disruption to care was common. Of the 2156 reporting pre-pandemic utilization of infusion, mental health or rehabilitative services, 975 (45.2%) reported disruptions. Individuals experiencing changes to employment or income were at highest odds of care disruption. LimitationsResults may not be generalizable to all patients with autoimmune or inflammatory conditions. Information was self-reported. ConclusionsExposure to glucocorticoids may increase risk of COVID-19 in people with autoimmune or inflammatory conditions. Disruption to healthcare and related services was common. Those with pandemic-related reduced income may be most vulnerable to care disruptions.

14.
Preprint | medRxiv | ID: ppmedrxiv-21250863

RESUMO

Government restrictions applied during the COVID-19 pandemic in the UK led to the disruption of many peoples physical activity routines, with sports and leisure facilities closed and outdoor exercise only permitted once per day. In this study we investigated which population groups were impacted most in terms of reduced physical activity levels during these periods, and which groups benefitted in terms of increasing their usual level of physical activity. We surveyed UK residents, sampled through users of a rewards-for-exercise app (Sweatcoin; n=749) and an online panel (Prolific; n=907). Of the app users, n=487 further provided daily step-count data collected by the app, prior to, and during the periods of restrictions between March and June 2020. Regression models were applied to investigate factors associated with subjective change (perceived change in physical activity) and objective change (log-percentage change in daily step-count) in physical activity during the periods of restrictions. ANOVAs were used to further investigate the significant factors identified. Key factors associated with a substantial subjective reduction in physical activity included those classed as obese, gym users and people living in urban areas. All participants had a reduced step count during restrictions, with Black, Asian and minority ethnic (BAME) groups, students and urban dwellers showing the largest reductions. Therefore, targeted interventions are required to ensure that the physical and mental health impacts of sedentary behaviour are not exacerbated over the long-term by significant reductions in physical activity identified in these groups, particularly those who are also more vulnerable to the COVID-19 virus.

15.
Preprint | medRxiv | ID: ppmedrxiv-21252284

RESUMO

BackgroundFor young people, just as in the general population, COVID-19 caused many changes in their lives, including an increased risk for mental illness symptoms. We aimed to study the impact of the COVID-19 pandemic in anxiety and depression symptoms in a cohort of university students. MethodsThis study is part of broader longitudinal research on university students mental health with data of the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information. Results341 university students (257 females and 84 males) were included, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived wellbeing loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. The proportion of students with scores equal to or above 15 in the PHQ-9 ranged between 22.6% and 25.5% in 2019 and 37.0% in June 2020. The proportion of GAD-7 scores above cut-off ten ranged between 46.0% and 47.8% in 2019 and 64.5% in 2020. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher. DiscussionCOVID-19 impacted negatively depressive and anxiety symptoms, confirming previous studies and young peoples vulnerability in such uncertain times.

16.
Preprint | medRxiv | ID: ppmedrxiv-21250929

RESUMO

ObjectiveThis paper provides a systematic review and meta-analysis on the prevalence rate of mental health issues of the major population, including general population, general healthcare workers (HCWs), and frontline healthcare workers (HCWs), in China over one year of the COVID-19 crisis. DesignA systematic review and meta-analysis. Data sourcesarticles in PubMed, Embase, Web of Science, and medRxiv up to November 16, 2020, one year after the first publicly known confirmed COVID-19 case. Eligibility criteria and data analysisany COVID-19 and mental disorders relevant English studies with frontline/general healthcare workers, general adult population sample, using validated scales. We pooled data using random-effects meta-analyses to estimate the prevalence rates of anxiety, depression, distress, general psychological symptoms (GPS), insomnia, and PTSD and ran meta-regression to tease out the heterogeneity. ResultsThe meta-analysis includes 131 studies and 171 independent samples. The overall prevalence of anxiety, depression, distress, GPS, insomnia, and PTSD are 11%, 13%, 20%, 13%, 19%, and 20%, respectively. The meta-regression results uncovered several predictors of the prevalence rates, including severity (e.g., above severe vs. above moderate, p<0.01; above moderate vs. above mild, p<0.01) and type of mental issues (e.g., depression vs. anxiety, p=0.04; insomnia vs. anxiety p=0.04), population (frontline HCWs vs. general HCWs, p<0.01), sampling location (Wuhan vs. non-Wuhan, p=0.04), and study quality (p=0.04). LimitationsFirst, we only focus on China population, which may limit the generalizability of the results. Second, 96.2% studies included in this meta-analysis were cross-sectional. Last, since we only included studies published in English, we expect to have a language bias. ConclusionOur pooled prevalence rates are significantly different from, yet largely between, the findings of previous meta-analyses, suggesting the results of our larger study are consistent with, yet fine-tune, the findings of the smaller, previous meta-analyses. Hence, this meta-analysis not only provides a significant update on the mental health prevalence rates in COVID-19 but also suggests the need to update meta-analyses continuously to provide more accurate estimates of the prevalence of mental illness during this ongoing health crisis. While prior meta-analyses focused on the prevalence rates of mental health disorders based on one level of severity (i.e., above mild), our findings also suggest a need to examine the prevalence rates at varying levels of severity. The one-year cumulative evidence on sampling locations (Wuhan vs. non-Wuhan) corroborates the typhoon eye effect theory. Our finding that the prevalence rates of distress and insomnia and those of frontline healthcare workers are higher suggest future research and interventions should pay more attention to those mental outcomes and populations. Trial registrationCRD42020220592

17.
Preprint | medRxiv | ID: ppmedrxiv-21250825

RESUMO

IntroductionThe new coronavirus infection (COVID-19) has caused distress and repercussions in mental and physical health of individuals. Depression, anxiety and worsening of sleep quality have been reported in several recent articles that surveyed populations all over the globe. Our work meant to access, through a cross-sectional study, these disorders in the Brazilian population, through the application of an online questionnaire conducted on the second trimester of 2020. Materials and MethodsWe applied an online questionnaire, filled with questions regarding social, economic, financial, educational and health status, as well as questions from the Hospital Anxiety and Depression Scale (HAD), and from the Pittsburgh Sleep Quality Index (PSQI). ResultsWe collected 2,695 valid answers, from April 24th to May 31st, 2020. Age ranged from 18 to 79 years, mean of 31.3. Women were 76.3%, men 23.7%. Symptoms of Anxiety were found in 56.5%, of depression in 46.1%, and of bad sleep in 49.2%. Some groups were more prone than others to one or more of those conditions, such as: younger people, women, mestizos, Northeasterners, people with lesser years of education, of lower income or whose income dropped significantly during the pandemic, caregivers, students, sedentary or people practicing less physical activity, people who followed more hours of news of COVID-19 and those less engaged in social and instrumental activities. Conclusionanxiety, depression and bad sleep quality were significantly high in our survey. Mental and sleep health is heterogeneously affected among individuals, depending on social, economic, financial, educational and health status. O_TEXTBOXHIGHLIGHTS - An online survey (DEGAS-CoV) was conducted between April 30th and May 31st, 2020, with people living in Brazil, aged 18 or more. The study obtained 2,695 valid answers. - Rates of possible anxiety, possible depression and bad sleep quality were 56.5%, 46.1% and 49.2%, respectively. Rates are similar to another Brazilian survey, with 45,161 participants, conducted in a similar time window. - Were more prone to mental and/or sleep conditions: younger participants, women, mestizos, unemployed, students, people with less years of education, people with lower income or with considerable drops of income during the virus outbreak, caregivers, people who followed more news of COVID-19, people less engaged in social and instrumental activities, smokers, sedentary or those who practiced less physical activity, and people who had symptoms suspected (confirmed or not) of SARS-CoV-2 infection. - Alcohol drinkers were slightly less likely to be possibly depressed. That finding needs more clarification and may be due to confounders. C_TEXTBOX

18.
Preprint | medRxiv | ID: ppmedrxiv-21250897

RESUMO

ObjectiveTo provide evidence on the effect of the COVID-19 pandemic on the mental health of adolescents and young adults who grew up in poverty in Low and Middle Income Countries (LMICs). DesignA phone survey implemented August-October 2020 to participants of a population-based cohort study since 2002 comprising two cohorts born in 1994-5 and 2001-2 in Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam. We examined associations between mental health and pandemic-related stressors, as well as structural factors (gender, location, wealth); and lifelong protective/risk factors (parent and peer relationship, past household wealth, long-term health problems, past emotional problems and subjective well-being) measured at younger ages. SettingA diverse, poverty focused sample, reaching those without mobile phones or internet access. Participants10,496 individuals were approached, 9,730 participated. Overall, 8,988 individuals were included in this study, 4,610 (51%) male and 4,378 (49%) female. Non-inclusion was due to non-location or missing data. Main outcome measuresAt least mild anxiety and depression were measured by Generalized Anxiety Disorder-7 (GAD-7, [≥]5) and Patient Health Questionnaire-8 (PHQ-8, [≥]5). ResultsRates of symptoms of at least mild anxiety (depression) were highest in Peru at 41% (32%) [95% CI, 38.63-43.12; (29.49-33.74)], and lowest in Vietnam at 9% (9%) [95% CI, 8.16-10.58; (8.33-10.77)], mirroring COVID-19 mortality rates. Females were most affected in all countries but Ethiopia. In all countries, pandemic-related stressors were associated with increased rates of anxiety and depression, though with varying levels of importance across countries. Prior parent and peer relationships were protective factors for mental health while having a long-term health problem or prior emotional problems were risk factors. ConclusionThe COVID-19 pandemic presents significant risks to the mental health of young people. Mental health support is limited in LMICs and young people have to date been lower priority for COVID-19 interventions. Strengths and limitations of this studyO_LIThe study uses data from adolescents and young adults who grew up in poverty in four LMICs which were diversely affected by the COVID-19 pandemic, therefore investigating a globally vulnerable, but understudied group both in terms of age and wealth. C_LIO_LIThis study reaches a broad sample of young people who grew up in poverty, including those without internet or mobile phone access. C_LIO_LIA key strength is combining a broad range of pandemic-related stressors from survey data on experiences of COVID-19 with previously measured information on longer-term risk and protective factors, therefore contributing to a more complete picture of COVID-19 effects. C_LIO_LIA limitation of the study is that it does not have a directly comparable pre-COVID baseline for depression/anxiety, however, proxy variables are used as a baseline and the explanatory variables capture dynamics that happened during the pandemic. C_LIO_LIA further limitation is possible underreporting due to stigma associated with mental health, despite piloting and validation, as well as possible bias in self-reported experiences of pandemic-related stressors due to feelings of anxiety or depression. C_LI

19.
Preprint | medRxiv | ID: ppmedrxiv-21250694

RESUMO

AimsMarkedly elevated adverse mental health symptoms were widely observed early in the coronavirus disease 2019 (COVID-19) pandemic. Unlike the U.S., where cross-sectional data indicate anxiety and depression symptoms have remained elevated, such symptoms reportedly declined in the U.K., according to analysis of repeated measures from a largescale longitudinal study. However, nearly 40% of U.K. respondents (those who did not complete multiple follow-up surveys) were excluded from analysis, suggesting that survivorship bias might partially explain this discrepancy. We therefore sought to assess survivorship bias among participants in our longitudinal survey study as part of The COVID-19 Outbreak Public Evaluation (COPE) Initiative. MethodsSurvivorship bias was assessed 4,039 U.S. respondents who completed surveys including the assessment of mental health as part of The COPE Initiative in April 2020 and were invited to complete follow-up surveys. Participants completed validated screening instruments for symptoms of anxiety, depression, and insomnia. Survivorship bias was assessed for (1) demographic differences in follow-up survey participation, (2) differences in initial adverse mental health symptom prevalences adjusted for demographic factors, and (3) differences in follow-up survey participation based on mental health experiences adjusted for demographic factors. ResultsAdjusting for demographics, individuals who completed only one or two out of four surveys had higher prevalences of anxiety and depression symptoms in April 2020 (e.g., one-survey versus four-survey, anxiety symptoms, adjusted prevalence ratio [aPR]: 1.30, 95% confidence interval [CI]: 1.08-1.55, P=0.0045; depression symptoms, aPR: 1.43, 95% CI: 1.17-1.75, P=0.00052). Moreover, individuals who experienced incident anxiety or depression symptoms had higher odds of not completing follow-up surveys (adjusted odds ratio [aOR]: 1.68, 95% CI: 1.22-2.31, P=0.0015, aOR: 1.56, 95% CI: 1.15-2.12, P=0.0046, respectively). ConclusionsOur findings revealed significant survivorship bias among longitudinal survey respondents, indicating that restricting analytic samples to only respondents who provide repeated assessments in longitudinal survey studies could lead to overly optimistic interpretations of mental health trends over time. Cross-sectional or planned missing data designs may provide more accurate estimates of population-level adverse mental health symptom prevalences than longitudinal surveys.

20.
Preprint | medRxiv | ID: ppmedrxiv-21250555

RESUMO

ObjectivesTo (1) compare changes in self-efficacy, social support, postpartum anxiety and postpartum depression in Canadian women collected before (Cohort 1) and during the COVID-19 pandemic (Cohort 2); (2) explore the women felt related to having a newborn during the pandemic; and (3) explore ways that women coped. MethodsPrior to the pandemic (October 1, 2019-January 1, 2020), an online survey was conducted with women had given birth within the past six months in one of the three Eastern Canadian Maritime provinces (Cohort 1). A second, similar survey was conducted between August 1, 2020 and October 31, 2020 (Cohort 2) during a period of provincial pandemic response to COVID-19. ResultsFor Cohort 1, 561 women completed the survey and 331 women in Cohort 2. Cohorts were similar in terms of age of women, parity, and age of newborn. There were no significant differences for self-efficacy, social support, postpartum anxiety, and depression between the cohorts. Difficulties that women reported as a result of COVID-19 restrictions included lack of support from family and friends, fear of COVID-19 exposure, feeling isolated and uncertain, negative impact on perinatal care experience, and hospital restrictions. Having support from partners and families, in-person/virtual support, as well as self-care and the low prevalence of COVID-19 during the summer of 2020 helped women cope. ConclusionWhile there was no significant difference in pre-pandemic and during pandemic psychosocial outcomes, there were still challenges and negative impacts that women identified. Consideration of vulnerable populations is important when making public health recommendations. What is already known on this subject?Previous work has shown the importance of social support in the postpartum transition in developing parenting self-efficacy and decreasing postpartum anxiety and depression. However, during the COVID-19 pandemic, womens mental health, particularly during the perinatal period, has seen an increases in rates of postpartum anxiety and depression. What this study adds?This study is able to compare self-efficacy, social support, postpartum anxiety and depression between two cohorts of postpartum women living in Eastern Canada - pre-COVID-19 pandemic and during. While there was no significant difference in pre-pandemic and during pandemic psychosocial outcomes, there were still challenges and negative impacts that women identified.

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