The impact of the COVID-19 pandemic on the mental health and daily life of adults with behavioral health disorders

Abstract People with behavioral health disorders may be particularly vulnerable to the impact of the COVID-19 pandemic, yet little is known about how they are faring. A mixed-methods, anonymous needs assessment was conducted to understand changes in the lives of adults with mental health and substance use disorders since the pandemic onset. A cross-sectional, online survey was completed by 272 adults in April and May 2020, recruited from statewide networks of community programs in New Jersey and New York. Measures included the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2 to screen for depressive and anxiety disorders. Also assessed was the pandemic’s impact on sleep and dietary patterns, exposure to COVID-19 infection, and access to health care and medications. Finally, respondents were asked to describe in their own words any changes in their lives since the pandemic began. Over one-third (35.1%) screened positive for generalized anxiety disorder and over one-quarter (29.6%) screened positive for major depressive disorder. The majority reported pandemic-related changes in eating and sleeping patterns and exposure to COVID-19 infection. Multivariable logistic regression analysis found that many changes attributed to the pandemic were positively and significantly associated with screening positive for anxiety and depressive disorders. Qualitative analysis confirmed these findings and identified participants’ resilience stemming from social support, emotion management, and self-care. These results can inform the design of services that assist this population to bolster self-management skills and reestablish daily habits to improve their lives during and following the pandemic.

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Validation of screening tools for common mental health disorders in the methadone maintenance population in Hanoi, Vietnam

BMC Psychiatry ◽

10.1186/s12888-021-03493-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anisa Y. Mughal ◽

Melissa A. Stockton ◽

Quynh Bui ◽

Vivian Go ◽

Tran Viet Ha ◽

...

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Methadone Maintenance ◽

Mental Health Disorders ◽

Screening Tools ◽

Generalized Anxiety ◽

Post Traumatic Stress ◽

Cross Sectional Survey ◽

Health Disorders

Abstract Background Common mental health disorders (CMDs), including depression, anxiety and post-traumatic stress disorder (PTSD) may worsen both HIV and drug use outcomes, yet feasible tools to accurately identify CMDs have received limited study in this population. We aimed to validate the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder screen (GAD-7) and Primary Care PTSD screen for DSM-5 (PC-PTSD-5) in a methadone maintenance therapy (MMT) patient population in Hanoi, Vietnam. Methods We conducted a cross-sectional survey. The PHQ-9, GAD-7, and PC-PTSD-5 were administered to MMT patients. A blinded interviewer administered the Mini-International Neuropsychiatric Interview (MINI) as the reference gold standard. Total scores of each tool were compared with the MINI diagnoses using a receiver operating characteristic curves, and we identified the optimal respective cut-off scores using the Youden’s Index. Results We enrolled 400 MMT patients. Approximately 99.3% were male (n = 397) and 21.8% (n = 87) were HIV positive. The prevalence of major depressive disorder, generalized anxiety disorder and PTSD, respectively, was 10.5, 4 and 2%. Optimal cut-off scores for the PHQ-9, GAD-7 and PC-PTSD were ≥ 5, ≥3, and ≥ 4 with a sensitivity/specificity of 95.2%/91.9, 93.8%/87.5, and 62.5%/95.2%. Conclusions The prevalence of CMDs in the MMT population was lower than expected. A lower cut-off score may be considered when screening for CMDs in this population. Further research should investigate the validity of somatic symptom-based screening tools among other drug-using or MMT populations.

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The Psychological Impact of the Coronavirus Disease 2019 Pandemic on Pregnant Women in China

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.628835 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zheng Zheng ◽

Ruoxi Zhang ◽

Tao Liu ◽

Pei Cheng ◽

Yanhong Zhou ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Anxiety Disorder ◽

Pregnant Women ◽

Psychological Stress ◽

Generalized Anxiety Disorder ◽

Psychological Impact ◽

Generalized Anxiety ◽

Third Trimester ◽

The Impact

Background: The coronavirus disease 2019 (COVID-19) pandemic has been reported to have negative psychological impact on mental health. Nonetheless, there are few studies investigating the impacts on pregnant women. This study investigated the psychological impact of COVID-19 pandemic on pregnant women, and the associated risk factors that moderated this impact.Methods and Materials: A total of 2,798 pregnant participants were recruited from the Guangzhou Women and Children's Medical Center. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI) were used to assess depression, generalized anxiety disorder and insomnia, respectively, during and before the COVID-19 pandemic. The Impact of Event Scale-Revised (IES-R) was used to assess psychological stress during the COVID-19 pandemic.Results: During the COVID-19 pandemic, over one third of pregnant participants reported mild depression, around 20% experienced mild generalized anxiety, about one third reported problems with sleeping, and more than 15% felt mild psychological stress. The occurrence of psychological problems was significantly higher during the COVID-19 pandemic when compared to before the outbreak. The previously described pattern that pregnant women in the first trimester are more likely to report depression, and those in the third trimester are more likely to report insomnia and psychological stress, was also recognized in our study population. Mental health issues existing before the outbreak were risk factors, while family support was a protective factor in the occurrence of the measured mental health problems during the COVID-19 pandemic.Conclusion: Our data suggest pregnant women's mental health is inevitably affected during the COVID-19 pandemic. Pregnant women in the first and third trimester and those who experienced mental issues before the outbreak may be particularly affected.

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Effects of SARS-CoV-2 Pandemic on the Mental Health of Spanish Ob-Gyn Specialists—A Nationwide Study

Journal of Clinical Medicine ◽

10.3390/jcm10245899 ◽

2021 ◽

Vol 10 (24) ◽

pp. 5899

Author(s):

Ernesto González-Mesa ◽

Jesus Salvador Jiménez-López ◽

Marta Blasco-Alonso ◽

Jose Ramon Anderica-Herrero ◽

Daniel Lubián-López

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Online Survey ◽

Work And Family ◽

Obstetrics And Gynecology ◽

Generalized Anxiety ◽

Post Traumatic Stress ◽

General Anxiety Disorder ◽

The Impact

It has been reported that frontline health professionals have suffered from an increased rate of mental disorders as a consequence of the SARS-CoV-2 pandemic. Objective: This study aims to evaluate the impact of the pandemic on the mental health of Spanish specialists in the obstetrics and gynecology fields after the fifth Spanish COVID-19 wave. Methods: Psychometric screening of the professionals was performed using a nationwide online survey designed by the Psychosocial Obstetrics and Gynecology taskforce. Post-traumatic stress disorder (PTSD), depression, and general anxiety disorder were screened. Results: We found high scores for PTSD, depression, and generalized anxiety disorder. Up to 12.4% of specialists met the PTSD criteria, 12.8% showed complex PTSD, 37% showed depression, and up to 37% had a positive screening for generalized anxiety disorder. Our results showed that the pandemic has particularly affected the group of female Ob-Gyn specialists, with significant higher scores in depression and anxiety scales. Conclusions: As a lesson learned for the future in case of new health emergencies, it would be very important to provide professionals with adequate psychological support, ensuring enough human and material resources, flexible work shifts, and facilities to reconcile work and family-life, especially in the case of female specialists.

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Generalized Anxiety Disorder and Depressive Symptoms among Pakistani Population during the Second Wave of the COVID-19 Pandemic: A Regression Analysis

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0380 ◽

2021 ◽

Vol 105 (4) ◽

pp. 915-923

Author(s):

Farah Yasmin ◽

Kartik Dapke ◽

Muhammad Rahman Khalid ◽

Hina Naz ◽

Farah Naz ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Generalized Anxiety ◽

Cross Sectional Survey ◽

Pakistani Population ◽

The World ◽

The Impact ◽

Second Wave

ABSTRACT. Over a span of 1 year, with millions infected, COVID-19 has spread to every part of the world and now poses a health threat to each and every one of us. The outbreak has consequently resulted in multiple health problems such as stress, anxiety, depressive symptoms, insomnia, panic, and denial globally. Several factors have contributed to this rising number of psychiatric consults all over the world. The primary objective of this study was to investigate the impact of COVID-19 pandemic on the mental health of Pakistani population during the second wave of the pandemic in this region. We conducted an online web-based cross-sectional survey comprising 500 participants. The questionnaire assessed the demographic information, attitude, and knowledge concerning COVID-19 outbreak in addition to generalized anxiety disorder (GAD) utilizing the GAD-7 scale and depressive symptoms using the Center for Epidemiology Scale for Depression (CES-D) scale. The response rate of the study was 90.9%. The results of the survey indicated a prevalence of 25.4% of GAD, and 18.8% of depressive symptoms. Furthermore, nearly 34.8% of participants feared contracting COVID-19, 62.8% obtained constant critical updates regarding COVID-19, while 17.6% did not understand the knowledge regarding COVID-19. In the multivariate regression models, GAD was significantly associated with gender, age, and checking constantly of critical updates regarding COVID-19. Similarly, participants under 30 years had a higher risk of developing depressive symptoms than those above (> 30 years). Lastly, participants with no formal education were also found to be more prone to developing depression. We identified a potential threat to mental health during the pandemic.

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Cognitive functions in young adults with generalized anxiety disorder

European Psychiatry ◽

10.1016/j.eurpsy.2018.10.008 ◽

2018 ◽

Vol 56 (1) ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Kiara Leonard ◽

Amitai Abramovitch

Keyword(s):

Anxiety Disorder ◽

Cognitive Load ◽

Generalized Anxiety Disorder ◽

Cognitive Functions ◽

Theoretical Models ◽

Generalized Anxiety ◽

Neuropsychological Battery ◽

Compensatory Mechanisms ◽

Neuropsychological Profile ◽

The Impact

AbstractBackground:Anxiety and worry are central symptoms of Generalized Anxiety Disorder (GAD) that have been theorized to negatively impact cognitive functions. However, most of the research has focused on threat-related or emotionally-charged stimuli, and a surprisingly small number of investigations examined ‘cold’ cognitive functions using classic neuropsychological tests. Such investigations are particularly important given that some theoretical models suggest compensatory mechanisms associated with anxiety that in certain circumstances may result in intact performance. The aim of the present study is to assess the neuropsychological profile associated with GAD, using a comprehensive neuropsychological battery.Methods:A sample of 23 college students meeting criteria for DSM-5 GAD and 20 control participants completed a psychometrically valid comprehensive computerized neuropsychological battery and clinical questionnaires.Results:The GAD sample presented with significantly elevated symptomatic rates of anxiety, worry, depression and stress. However, no significant differences were found on any neuropsychological outcome measures or domain indexes. Effect sizes were small, some of which favored the GAD sample.Conclusion:Despite substantial psychopathological burden, GAD exhibited intact cognitive functioning. These results support the Cognitive Control Theory of Anxiety, suggesting that elevated primary anxiety may not impact ‘cold’ cognitive functions in the absence of threat or substantial cognitive load. Given that this is one of the only studies employing a comprehensive neuropsychological battery in GAD, more research is needed in this population to replicate these results and to examine the impact of anxiety on cognitive functions at varying degrees of cognitive load in this population.

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Relationships between stroke, depression, generalized anxiety disorder and physical disability: some evidence from the Canadian Community Health Survey-Mental Health

Psychiatry Research ◽

10.1016/j.psychres.2020.113074 ◽

2020 ◽

Vol 290 ◽

pp. 113074

Author(s):

Xinyuan Li ◽

Xianquan Wang

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Community Health ◽

Generalized Anxiety Disorder ◽

Health Survey ◽

Physical Disability ◽

Canadian Community Health Survey ◽

Generalized Anxiety ◽

Community Health Survey

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Insomnia and Quality of Life in Generalized Anxiety Disorder: Impact on Clinical Presentation and Response to Pregabalin and Venlafaxine-XR

European Psychiatry ◽

10.1016/s0924-9338(09)70767-9 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1 ◽

Cited By ~ 1

Author(s):

M.A. Mychaskiw ◽

J.M. Alvir ◽

B.K. Herman ◽

S. Pallanti ◽

A. Joshi

Keyword(s):

Quality Of Life ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Sleep Problems ◽

Generalized Anxiety ◽

Medical Outcomes ◽

Double Blind ◽

Disturbance Factor ◽

The Impact

Aims:To assess the impact of insomnia on quality of life (QoL) and functioning in patients with generalized anxiety disorder (GAD), and evaluate the efficacy of pregabalin and venlafaxine-XR in improving sleep and QoL.Methods:A double-blind trial in adults who met DSM-IV criteria for GAD, with a HAM-A total score ≥20,randomized to 8-weeks of flexible-dose treatment with pregabalin (300-600 mg/d, N=121), venlafaxine-XR (75-225 mg/d, N=125), or placebo (N=128).Results:At baseline, 64% of all subjects had insomnia (according to the Medical Outcomes Study Sleep scale [MOS]-Sleep Problems Index [SPI] criteria).While HAM-A total scores (minus the insomnia item) were similar for patients with and without baseline insomnia (25.7 vs. 25.0) those with reported significantly more impairment on the Quality of Life, Enjoyment, and Satisfaction Questionnaire (Q-LES-Q; 45.4 vs. 53.6; p< 0.0001) and Sheehan Disability Scale (SDS; 17.5 vs.14.3; p< 0.0001) than those without. At endpoint, there was a significantly greater mean improvement in MOS-sleep disturbance factor and MOS-SPI with pregabalin (-29.0 and -21.1, respectively) than venlafaxine-XR (-14.7 and -11.0) or placebo (-15.2 and -12.5; all p< 0.05). In more pregabalin (64%) than venlafaxine-XR (51%) or placebo (52%) subjects, abnormal baseline sleep had normalized by endpoint. Endpoint change in MOS-SPI significantly correlated with improvement in both Q-LES-Q and SDS-total scores (Spearman r-values, -0.48 and 0.46, respectively; both p< 0.0001; all subjects).Conclusion:Significantly greater impairment in QoL and functioning was observed in patients with high (vs. low) levels of insomnia. Pregabalin produced significantly greater improvement in insomnia than venlafaxine-XR or placebo.

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Prevalence and correlates of generalized anxiety disorder in Singapore: Results from the second Singapore Mental Health Study

Journal of Anxiety Disorders ◽

10.1016/j.janxdis.2019.102106 ◽

2019 ◽

Vol 66 ◽

pp. 102106 ◽

Cited By ~ 3

Author(s):

Sherilyn Chang ◽

Edimansyah Abdin ◽

Saleha Shafie ◽

Rajeswari Sambasivam ◽

Janhavi Ajit Vaingankar ◽

...

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Health Study ◽

Generalized Anxiety ◽

Mental Health Study

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Impact of Progression of Parkinson's Disease and Various Other Factors on Generalized Anxiety Disorder

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_52_18 ◽

2018 ◽

Vol 09 (03) ◽

pp. 287-290 ◽

Cited By ~ 2

Author(s):

Abdul Qayyum Rana ◽

Hamza Ansari ◽

Abdul Rehman M. Qureshi ◽

Eraad Rahman

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Ethnically Diverse ◽

Influential Factors ◽

Generalized Anxiety ◽

Increased Risk ◽

The Impact ◽

The Relationship

ABSTRACT Objective: While much research has been conducted toward understanding the relationship between prevalence of Parkinson's disease (PD) and generalized anxiety, little has been done considering additional influential factors in the relationship by means of a large ethnically diverse sample. Our study strives to fulfill these deficits in the literature as we set out to determine the impact of progression of PD, age, gender, and Hoehn and Yahr (H and Y) staging of PD on generalized anxiety. Methods: A retrospective chart review analysis was performed on PD patients who were regularly examined in a community-based PD and movement disorders center from 2005 to 2010. Results: This study consisted of 310 patients with PD among whom 12% had generalized anxiety. Neither age nor gender was significant onset predictors at P = 0.05. The impact of progression of H and Y Stages 2–3 and 2–4 increased the odds of generalized anxiety disorder (GAD) prevalence though it was statistically insignificant at P = 0.05. Conclusions: Clinicians should not expect the risk of developing anxiety to depend on gender nor change as a function of age though it may increase with symptomatic progression of PD as outlined by H and Y. To the best of our knowledge, this is the largest and most ethnically diverse prevalence study with a focus on generalized anxiety and PD. Significant Outcomes and Limitations: The symptomatic progression of PD, but not age or gender, may be associated with an increased risk for GAD. This study lacked adjustment for potential confounders such as depression and PD medications.

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