Search

Aim: Studies of the effects of COVID‐19, especially post‐acute COVID‐19 syndrome, on psychological health in non‐severe cases are limited. We aimed to evaluate the prevalence and associated risk factors of psychological symptoms, and quality‐of‐life in three groups of outpatients, hospitalized and intensive care patients. Methods: A total 276 patients, previously confirmed with SARS‐CoV‐2 infection, attending the COVID‐19 follow‐up outpatient clinic from December 2020 to July 2021 were interviewed face‐to‐face. In this cross‐sectional, retrospective study, all participants were asked our self‐designed demographic and screening questions to assess their psychological symptoms and administered the WHQOOL‐BREF survey to evaluate quality of life. Results: In screening questions, major depressive disorder symptoms were detected at a rate of 20.3%, generalized anxiety disorder symptoms at a rate of 16.7%, panic attack symptoms at a rate of 10.9%, post‐traumatic stress disorder symptoms at a rate of 28.6% and obsessive‐compulsive disorder symptoms at a rate of 18.1%. The outpatient group with COVID‐19 infection had a higher risk of developing psychological symptoms and decreased quality of life. Conclusion: COVID‐19 infection was found to have a considerable psychological impact on those treated as outpatients despite the less severe course of their illness. Summary statement: What is already known about this topic? Post‐intensive care syndrome affects physical, cognitive and psychological health.It is associated with symptoms such as generalized weakness, memory disturbances, cognitive function impairment, depression, anxiety and post‐traumatic stress disorder.Some physical and psychological symptoms persist for over 12 weeks in some patients and have been classified as 'Post‐acute COVID‐19 Condition or Syndrome' (PCS). What this paper adds? At the post‐acute‐COVID‐19 period, a considerable number of outpatients with COVID‐19 infection were at higher risk for psychological distress symptoms than those who had been treated in the hospital or intensive care unit.Depression, anxiety, panic disorder and PTSD symptoms were found to be higher in outpatients and those with these symptoms were also shown to have a lower quality of life.Our findings highlight the significant psychological impact of COVID‐19 on patients, even after their reported recovery from the acute manifestations of this disease. The implications of this paper: Ongoing psychological symptoms in the post‐COVID period are not associated with the severity of the disease in the acute phase.It is important that healthcare professionals are equally concerned not only with physical condition of post‐COVID‐19 patients but also with their psychological state and the patient's psychology‐related quality of life. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to verify if older adults with mixed anxiety-depressive disorder are more prone to euthanasia and identify factors that interfere with their satisfaction with health and capacity for well-informed decisions. Material and Methods: The study applied a paper questionnaire composed of a sociodemographic section and a battery of scales (to assess depression, anxiety, cognitive performance, suicide risk, therapeutic adhesion, functionality, loneliness, attitude towards euthanasia, decision pattern, personality, empathy, and health status) in the Psychogeriatric Unity of Senhora da Oliveira Hospital in Portugal. The sample was collected by convenience to include patients and controls of the same age. Six months later, a reassessment was performed. Patients and controls were compared using descriptive statistics and a multiple-regression model. Results: A total of 114 patients and 25 controls were included. Eighty-one point six percent of patients had four or fewer years of schooling. Contrary to controls, they presented mild depressive and anxiety symptoms, loneliness feelings, worse cognitive performance, a more fragile personality, higher personal distress, and a poorer health state. No statistically significant differences were found between controls and patients regarding their attitudes towards euthanasia. Patients more favourable to euthanasia had higher empathic concern, conscientiousness, and fantasy, and lower personal distress. Discussion and Conclusion: When addressing euthanasia in these patients, it is crucial to ensure they are fully self-determinate and that all the necessary treatment and support are available. It may not be the case when the educational level is low and a mild disease persists, significantly affecting their well-being and cognitive performance. [ABSTRACT FROM AUTHOR]

Background: In May 2023, Romagna, Italy, faced a devastating flood resulting in 16 fatalities, forced displacement of 26,000 citizens, and significant economic losses. Due to potential water contamination, implementing public health strategies became imperative for the Local Health Authority to mitigate the health consequences, analyze the flood's impact on the local population's health, and detect early anomalies requiring timely public health interventions. Methods: Between June and July 2023, general practitioners who were part of the RespiVirNet surveillance network completed weekly structured forms. These forms collected data on individuals exposed or not to floodwaters and clinical syndromes. Rates per 1000 resident population aged > 14 were stratified by district, week of observation, and symptomatology. Missing data were addressed by imputation using second-order autoregressive modeling. Results: An incidence of 3.52 syndromes potentially related to flood water exposure per 1000 individuals (95% CI 2.82–4.35) was estimated. Ravenna, the city most affected by the flood, recorded the highest rate (6.05 per 1000, 95% CI 4.59–7.82). Incidence decreased in the weeks post-event. Anxiety, or trauma and stress symptoms, exhibited higher rates among the exposed, diminishing over weeks. The incidence for the non-exposed (12.76 per 1000, 95% CI 10.55–15.29) showed no significant territorial differences compared to the exposed ones. Conclusions: Syndromic surveillance provided timely information on the flood's health impact, revealing a higher incidence of individual syndromes among the non-exposed. This study contributes to guiding the implementation of future public health preparedness and response strategies for populations facing similar natural disasters. [ABSTRACT FROM AUTHOR]

Objective Disruptive and conduct behaviors are the most common conditions used to help adolescent patients refer to mental health clinics for counseling. The prevalence of this disorder is increasing and it is necessary to concentrate on this topic. The comorbidity of conduct disorder (CD) with other emotional and behavioral problems is common. One of the comorbidity disorders for which contradictory results are reported is attention deficit hyperactivity disorder (ADHD). Several studies have demonstrated the comorbidity of these two disorders in patients with a younger age of onset, more severe symptoms, and more stable disease. Hence, this study determines the prognostic value of the Minnesota multiphasic personality inventory adolescent-restructured form (MMPI-A-RF) for CDs and investigates the effect of comorbidities, such as ADHD. Materials & Methods The sample of the present comparative casual study consisted of 295 adolescents who were selected by purposeful sampling, based on the current and the Kiddie schedule for affective disorder and schizophrenia-present and lifetime for school-age children (6-18 years old) and the final version of the MMPI-A-RF questionnaire. The Mean±SD of all the MMPI-A-RF scores were compared among three groups of patients with CD (n=40), patients with a comorbid diagnosis of conduct disorder and ADHD (n=68 people), and patients with other psychiatric disorders (mood and anxiety disorders). Analysis of variance was used to determine the significance of differences among the three groups. If the deviations were significant, the Games–Howell post hoc test was used to inspect differences between the groups. Results The comparison of CD and CD+ADHD patients with other disorders revealed meaningful differ)ences in almost all the indicators related to externalizing problems. The CD+ADHD group had markedly greater scores on the scales of antisocial behaviors (P<0.001), aggressive-revised personality (P<0.001), and conduct problems (P<0.001) compared to the CD group and other psychiatric disorders group. Conclusion The results are consistent with the background and revealed more severe symptoms and more functional degradation in the CD+ADHD group compared to the CD and other psychiatric disorders group. This subgroup can have different risk symptoms, clinical courses, and drug responses. MMPI-A-RF can supply valuable information about the comorbidity of psychiatric disorders. [ABSTRACT FROM AUTHOR]

Aim and objectives: To analyse the levels of anxiety, depression, post-traumatic stress, and burnout among nursing professionals working in the Imbabura region of Ecuador during the COVID-19 pandemic and identify the contributing socio-occupational factors. Background: The high demand for care of COVID-19 patients led to increased work pressure on nurses, owing to increased demands for care and shortages of medical supplies and protective equipment. Design: A cross-sectional study was conducted from September to December 2022 using a self-administered questionnaire addressed to nursing professionals who cared for COVID-19 patients. Methods: The questionnaire included socio-demographic characteristics, the Spanish adaptation of Hospital Anxiety and Depression Scale (HADS-Spanish), Impact of Event Scale–Revised (IES-R) for the evaluation of post-traumatic stress disorder (PTSD), and the Spanish adaptation of the Maslach Burnout Inventory–Human Services Survey (MBI-HSS-Spanish) for burnout assessment. Univariate and multivariate analyses were performed. Results: Of the 782 participants, 88.6% had a high level of burnout (MBI-HSS-Spanish scale score > 27). Female nurses, nurses with eight-hour work shifts, and older professionals exhibited high levels of anxiety and depression. Prolonged working hours in COVID-19 patient care services were found to be a risk factor for burnout and post-traumatic stress. Conclusions: Participating nurses presented with a high level of chronic work stress and exhibited signs of anxiety and depression during the period under consideration. Providing nurses with psychological support measures and performing liaison consultations will alleviate the psychological burden on nurses. Relevance to clinical practice: The study has shown that accounting for the environments where the emotional impact is greatest and how to reduce it would not only reduce anxiety, depression, and burnout in nurses but also improve the quality of care, not only in pandemic. Patient or public contribution: Nurses contributed to the conduct of the study by participating in the data collection via questionaries. [ABSTRACT FROM AUTHOR]

Anxiety disorders are among the most common disorders in early childhood. Although many older children and adolescents with anxiety disorders recover and remain well, little is known about the continuity of early childhood anxiety and the factors that predict persistence/recurrence in later childhood and adolescence. We followed 129 children who met anxiety disorder criteria at age 3 and/or 6 and determined how many continued to experience an anxiety disorder between age 7 and 15, as well as the continuity of specific anxiety disorders. We explored whether biological sex, number of anxiety disorders, early childhood persistence (i.e., anxiety diagnosis at both age 3 and 6), childhood comorbidities, temperamental behavioral inhibition, a maternal history of anxiety, and authoritarian and overprotective parenting predicted persistence/recurrence of an anxiety disorder from age 7 to 15. Sixty-five (50.4%) of the adolescents with an early childhood anxiety disorder met anxiety disorder criteria during the age 7–15 interval. Homotypic continuity from early childhood to school-age/mid-adolescence was observed for social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). Early childhood agoraphobia predicted school-age/mid-adolescent GAD and early childhood GAD predicted school-age/mid-adolescent specific phobia. In bivariate analyses, number of anxiety disorders, persistence of anxiety from age 3 to 6, and having a mother with a history of anxiety predicted the persistence/recurrence of anxiety disorders from age 7 to 15. Only early childhood persistence of anxiety uniquely predicted the persistence/recurrence of an anxiety disorder over and above the other predictors. Early intervention efforts should focus on identifying and intervening with young children who demonstrate a protracted course of anxiety. [ABSTRACT FROM AUTHOR]

The potential impact on mental health of home schooling and social isolation due to COVID-19 lockdowns has led to widespread concern, particularly for adolescents. However, studies including pre-pandemic data from longitudinal cohorts with an assessment of the longer-term impact of the Covid-19 pandemic beyond the first months of 2020 are scarce. This longitudinal study of 1534 adolescents attending a secondary school in Hunan province investigated self-reported symptoms of anxiety and depression using two validated scales (Screen for Child Anxiety Related Disorders, Child Mood and Feelings Questionnaire) at six time points before, during, and after the 2020 national lockdown restrictions in China. Perceived COVID-related stress was assessed by an author-developed scale at two timepoints during the lockdown. We investigated trends in symptoms over time with a fixed effects model and multiple imputations of missing data. Counter to our expectations, depressive and anxiety symptoms were reduced during the 2020 lockdown relative to pre-lockdown (depression: b = − 3.37, SE = 0.345, Cohen's d = − 0.25, p < 0.0001; anxiety: b = − 4.55, SE = 0.382, Cohen's d = − 0.30, p < 0.0001). Symptoms remained significantly reduced even after lockdown restrictions eased. Higher symptom levels during lockdown were associated with greater self-reported COVID-related stress (depression: b = 0.11, SE = 0.026, p < 0.0001; anxiety: b = 0.11, SE = 0.036, p < 0.0001). Although COVID-related stresses correlated with higher levels of anxiety and depression, the lockdown period was associated with improved symptom levels in the adolescents taking part in our study. School closures may have improved the mental health of adolescents in China. We speculate this beneficial effect of lockdown can be explained by the adverse effects of attending school itself such as exposure to bullying and achievement pressures. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the relationship between attachment styles and Separation Anxiety Disorder (SAD) through the internalized symptoms and stress coping strategies in badly-cared and orphan adolescent girls living in Tehran in 2022. Method: This was a correlational study of a Structural Equation Modeling (SEM) type. The statistical population included all adolescent girls aged between 12 and 18 under the direct or indirect supervision of Tehran's welfare center, of whom 200 were selected by the convenience sampling method. The participants answered the questionnaires of Collins and Reed's attachment styles, Billings and Moss's coping strategies, Achenbach and Rascorella's adolescent self-report, and Morris et al.'s SAD. Results: The findings of SEM demonstrated that the hypothesized model of this study has a good fit in the studied sample. The findings reveal that the secure attachment style is related to separation anxiety both directly (T=-4.18 and b=-.22) and indirectly through problem-oriented coping style (P<.01 and Z=-10.83) and emotion-oriented coping style (P<.01 and Z=-7.23). Avoidant attachment style is directly (T=4.98 and b=.25) and indirectly related to separation anxiety through problem-oriented coping style (P<.01 and Z=4.33) and emotion-oriented coping style (P<.01 and Z=8.79) and internalized symptoms (P<.01 and Z=2.61). Finally, ambivalent attachment style had no significant correlation (P>.05) with separation anxiety. Conclusion: These results emphasize the importance of attachment patterns formed under the influence of adverse conditions of the vulnerable group, and the lifelong effects of these patterns in the mental health of them. [ABSTRACT FROM AUTHOR]

Anxiety disorders commonly occur in autism. Existing studies implicate intolerance of uncertainty, alexithymia, sensory processing differences and emotion regulation difficulties as influencing factors of anxiety in autism. To date, a few studies have considered the combination of these factors within the same sample. This study used structural equation modelling to test the prediction that intolerance of uncertainty and emotion regulation constitute more direct causes of anxiety in autism that mediate the influences of sensory processing difference and alexithymia as more sequential contributing factors. Autistic (n = 86) and non-autistic adults (n = 100) completed a battery of self-report questionnaires. Only when applied to each group separately, the broad predictions of the model were confirmed for the autistic group following data-driven additions of paths between sensory processing difference and anxiety and alexithymia implying that sensory processing difference contribute indirectly as well as directly to individual differences in anxiety. For the non-autistic group, model fit could only be achieved after removing autism-related traits and sensory processing differences as predictors of anxiety. These results suggest that aetiology and expression of anxiety in autism partially overlap with what is observed in the general population except that sensory processing differences appear to play a relatively unique role in the context of autism. Anxiety disorders are common in autism. Research studies have identified factors that influence anxiety in autism, such as difficulties with uncertain situations, difficulties understanding own emotions, differences in processing sensory input (related to our senses) and difficulties regulating emotions. To date, a few studies have considered the combination of these factors within the same sample. This study used structural equation modelling to test the contribution of these factors in autism. Autistic (n = 86) and non-autistic adults (n = 100) completed a battery of self-report questionnaires. Only when applied to each group separately, the broad predictions of the model were confirmed for the autistic group. The model confirmed that difficulties with uncertain situations and in regulating emotions play a central role in anxiety in autism. Difficulties understanding own emotions and differences in processing sensory input both contribute to anxiety indirectly through their respective interrelation with the other two factors (difficulties with uncertain situations and in regulating emotions). Importantly, the results imply that sensory processing differences contribute not only indirectly but also directly to individual differences in anxiety. For the non-autistic group, model fit could only be achieved after removing autism-related traits and sensory processing differences as predictors of anxiety. These results suggest that cause/development and expression of anxiety in autism partially overlap with what is observed in the general population except that sensory processing differences appear to play a relatively unique role in the context of autism. [ABSTRACT FROM AUTHOR]

Objective: Parent-only cognitive-behavioural therapy (CBT) interventions have promise for youth with anxiety disorders. Fear-Less Triple P (FLTP) is one such intervention that has been found comparable to child-focused CBT. Although traditionally administered in six sessions, a one-day workshop format of FLTP was developed to improve accessibility. The current study compared the effectiveness of the six-session and one-day workshop formats. Method: Seventy-three youth (mean age, 8.4 years; 74% male) were randomized to traditional FLTP (6-week group) or the one-day workshop format. Anxiety diagnostic status, self- and parent-reported anxiety symptoms scores, independent evaluator-rated improvement, treatment satisfaction, and measures of family functioning were included to assess treatment outcome. Data were collected prior to treatment, and 1-week, 6-months, and 12-months following treatment. Results: Both conditions resulted in significant improvement in child anxiety symptom scores per parent report (on both questionnaire and diagnostic interview measures). Furthermore, significant decreases in sibling anxiety were observed in both treatment conditions. There were no statistically significant differences between conditions on any outcome measure. Conclusions: Results of this study add to the growing evidence that brief, low-intensity, parent-only interventions can effectively target child psychopathology. These brief interventions are ideal for families for whom the resources and time required to commit to a standard multi-week intervention are prohibitive. Registration of Clinical Trials: This trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN 12615001284550). [ABSTRACT FROM AUTHOR]

Context: Mood and anxiety disorders appear to be overrepresented in adults with cardiovascular diseases (CVDs). These disorders have been associated with poorer biopsychosocial outcomes in this population. Mood and anxiety disorders often co-occur, but the prevalence of this comorbidity and their potential additive effects in patients with CVD remain understudied. Aims: This study aimed to estimate the prevalence and co-occurrence rates of mood and anxiety disorders in the general adult population living with CVD. Associations between mood and anxiety disorder status and sociodemographic characteristics, somatic comorbidities, perceived mental health, and health-care service use were also investigated. Methods: A total of 6,792 adults aged 25 years or older and living with CVD were selected from the 2015-2016 Canadian Community Health Survey. Mood and anxiety disorders were identified based on self-report diagnoses made by a qualified health professional. All other variables were assessed using questionnaires. Results: An estimated 17.7% of the studied population reported having been diagnosed with a mood or anxiety disorder. More precisely, 6.6% reported a mood disorder, 5.5% reported an anxiety disorder, and an additional 5.6% reported both. The presence of mood or anxiety disorders was associated with poorer perceived mental health and higher health-care service use, and these associations were stronger when mood and anxiety co-occurred. Conclusions: Approximately one in six adults with CVD reported suffering from mood or anxiety disorders, and a third of them presented both conditions. This study also suggests that co-occurring anxiety and mood disorders lead to greater vulnerability than either disorder in adults with CVD. [ABSTRACT FROM AUTHOR]