scholarly journals Mental health consequences of COVID-19: a nationally representative cross-sectional study of pandemic-related stressors and anxiety disorders in the USA

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e044125
Author(s):  
Salma M Abdalla ◽  
Catherine K Ettman ◽  
Gregory H Cohen ◽  
Sandro Galea

ObjectiveTo document the prevalence of anxiety disorders in the USA during the COVID-19 pandemic.DesignA cross-sectional analysis.SettingA nationally representative sample in the USA between 31 March and 13 April 2020.Participants1450 English-speaking adult participants in the AmeriSpeak Panel. AmeriSpeak is a probability-based panel designed to be representative of households in the USA.Main outcome measuresPrevalence of probable generalised anxiety disorder (GAD) using the GAD-7 and post-traumatic stress symptoms (PTSS) using the four-item PTSD (post-traumatic stress disorder) checklist. Both outcomes were stratified by demographics and COVID-19-related stressors.ResultsThe majority of participants were female (51.8%), non-Hispanic white (62.9%) and reported a household saving of $5000 or more. Those between 18 and 29 years old were the largest age group (38.1%) compared with 40–59 years (32.0%) and 60 years or more (29.9%). The prevalence of probable GAD was 10.9% (95% CI 9.1% to 13.2%) and the prevalence of PTSS was 21.7% (95% CI 19.1% to 24.6%). Among participants reporting five or more COVID-19-related stressors, the prevalence of probable GAD was 20.5% (95% CI 16.1% to 25.8%) and the prevalence of PTSS was 35.7% (95% CI 30.2% to 41.6%). Experiencing five or more COVID-19-related stressors was a predictor of both probable GAD (OR=4.5, 95% CI 2.3 to 8.8) and PTSS (OR=3.3, 95% CI 2.1 to 5.1).ConclusionsThe prevalence of probable anxiety disorders in the USA, as the COVID-19 pandemic and policies implemented to tackle it unfolded, is higher than estimates reported prior to the pandemic and estimates reported following other mass traumatic events. Exposure to COVID-19-related stressors is associated with higher prevalence of both probable GAD and PTSS, highlighting the role these stressors play in increasing the risk of developing anxiety disorders in the USA. Mitigation and recovery policies should take into account the mental health toll the pandemic had on the USA population.

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e033816
Author(s):  
Karel Willem Frank Scheepstra ◽  
Hannah S Pauw ◽  
Minouk Esmee van Steijn ◽  
Claire A I Stramrood ◽  
Miranda Olff ◽  
...  

ObjectiveTo compare the prevalence of work-related potential traumatic events (PTEs), support protocols and mental health symptoms across Dutch gynaecologists, orthopaedic surgeons and paediatricians.DesignCross-sectional study, supplementary analysis of combined data.SettingNationwide survey between 2014 and 2017.ParticipantsAn online questionnaire was sent to all Dutch gynaecologists, orthopaedic surgeons and paediatricians, including resident physicians (4959 physicians). 1374 questionnaires were eligible for analysis, corresponding with a response rate of 27.7%.Outcome measuresPrimary outcome measures were the prevalence of work-related PTEs, depression, anxiety, psychological distress and traumatic stress, measured with validated screening instruments (Hospital Anxiety and Depression Scale, Trauma Screening Questionnaire). Secondary outcomes were the association of mental health and defensive practice to traumatic events and support protocols.ResultsOf the respondents, 20.8% experienced a work-related PTE at least 4 weeks ago. Prevalence rates indicative of depression, anxiety or post-traumatic stress disorder (PTSD) were 6.4%, 13.6% and 1.5%, respectively. Depression (9.2% vs 5.2%, p=0.019), anxiety (18.2% vs 8.2%, p<0.001) and psychological distress (22.8% vs 12.5%, p<0.001) were significantly more prevalent in female compared with male attendings. The absence of a support protocol was significantly associated with more probable PTSD (p=0.022). Those who witnessed a PTE, reported more defensive work changes (28.0% vs 20.5%, p=0.007) and those with probable PTSD considered to quit medical work more often (60.0% vs 35.8%, p=0.032).ConclusionPhysicians are frequently exposed to PTEs with high emotional impact over the course of their career. Lacking a support protocol after adverse events was associated with more post-traumatic stress. Adverse events were associated with considering to quit medical practice and a more defensive practice. More awareness must be created for the mental health of physicians as well as for the implementation of a well-organised support system after PTEs.


2021 ◽  
Vol 12 ◽  
Author(s):  
Naif Al-Mutawa ◽  
Nourah Al-Mutairi

Background: In the Gulf Cooperation Council (GCC) countries (Kuwait, Qatar, Saudi Arabia, Bahrain, United Arab Emirates, and Oman), as in the rest of the world, the COVID-19 has been spreading since 2019, and it had a significant impact on various aspects of life. The outbreak and the restrictive measures imposed by countries to stop the spread of the virus could harm the mental health condition of the general population. This cross-sectional study aims to assess the impact of the pandemic on mental health and investigate the potential risk factors.Methods: An online survey was collected from individuals in GCC countries from May to October 2020. The final sample included 14,171 participants, 67.3% females and 60.4% younger than 35 years old. The survey consisted of depression, Anxiety, Insomnia, and post-traumatic stress questionnaires. Crude and adjusted Odds ratios are calculated using simple and multivariable logistic regressions to investigate the association between risk factors and mental health issues.Results: Endorsement rates for depression were 11,352 (80.1%), 9,544 (67.3%) for anxiety, 8,845 (63.9%) for insomnia and 9,046 (65.2%) for post-traumatic stress. Being female and younger age were associated with a higher likelihood of developing depression, anxiety, insomnia, and post-traumatic stress. In addition, participants with underlying psychological problems were three times more likely to develop depressive and post-traumatic stress symptoms.Conclusion: According to the findings, women, youth, singles, divorced individuals, and individuals with pre-existing psychological and medical conditions are subject to a higher risk of mental health problems during the pandemic, which policy-makers should consider when imposing restrictive measures.


2020 ◽  
pp. 088626052093586 ◽  
Author(s):  
Elif Çelebi ◽  
Jais Adam-Troian ◽  
Yara Mahfud

Police violence during protests occurs worldwide with varying levels ranging from physical abuse to lethal use of force. Although prior research has investigated the health consequences of exposure to police violence (EPV), EPV’s relationship with protesters’ mental health has not yet been examined. Therefore, we designed a cross-sectional study which included measures of self-reported EPV, depression, and post-traumatic stress symptoms. The computerized survey was disseminated among a large sample of Yellow Vests protesters in France ( N = 523; average protest attendance = 18). Overall, 49% of protesters displayed severe symptoms of depression and 15.5% met the criteria for provisory post-traumatic stress disorder (PTSD) diagnoses. Subsequent analyses revealed, as expected, positive associations between EPV, depression, and post-traumatic stress symptoms in our sample (.30 < d < .63). These were robust to adjustment on several potential confounds (e.g., physical injuries, demographics, political extremism) and similar when analyzing provisory diagnoses rates (1.65 < OR < 3.02). This study is the first to assess potentially detrimental effects of EPV on mental health during protests. Furthermore, prevalence rates for both provisory depression and PTSD diagnoses were comparable with those found among war-refugee populations. We call for further research on EPV among various protester samples and use longitudinal designs to investigate a potent risk factor for mental health issues among civilian populations.


2021 ◽  
Author(s):  
Edward A. Espinosa-Guerra ◽  
Edgar R. Rodríguez-Barría ◽  
Christl A. Donnelly ◽  
Jean-Paul Carrera

AbstractBackgroundA new coronavirus SARS-CoV-2 was associated with a newly identified respiratory syndrome, COVID-19 in Wuhan, China, in early December 2019. SARS-CoV-2 rapidly spread across the globe resulting in 117 million cases and 2.59 million deaths by March 2021. Rapidly increased numbers of COVID-19 cases overwhelmed public health systems across the world, imposing increased working hours and workloads for health care workers. Here, we have evaluated the prevalence of health outcomes and associated factors of interns and resident physicians in Panama.MethodsA cross-sectional study was undertaken during July 23, 2020, to August 13, 2020, to evaluate the prevalence of health outcomes and associated factors in interns and residents across Panama. Snowball sampling was used to recruit participants. Then an electronic questionnaire with scales to evaluate anxiety disorders (GAD-7), depression (PHQ-9) and post-traumatic stress (IES-R) was evaluated. In addition, socio-demographic variables, clinical history of mental disorders and COVID-19 exposure were evaluated. Independent analyses for each mental health outcome were undertaken using a logistic regression analysis.ResultsA total of 517/1205 (42.9%) interns and residents were nationwide recruited. Of these 274 (53.0%) were interns and 243 (47.0%) residents. The overall prevalence of depression symptoms was 25.3%, 13.7% anxiety and 12.2% post-traumatic stress. At least, 9.3% participants reported having suicidal ideation.The most parsimonious model showed females had a higher prevalence of mental health disorders, in all results and the married participants were more likely to present depression (OR, 1.73; 95% CI, 1.03-2.91; P = 0.039) or at least one alteration to mental health (OR, 1.66; 95% CI, 1.03-2.68; P = 0.039). Resident physicians in surgical specialties were less likely to have post-traumatic stress (OR, 0.20; 95% CI, 0.06-0.63; P = 0.006) or at least one mental health disturbance (OR, 0.46; 95% CI, 0.26-0.83; P = 0.010). A history of psychological trauma and psychiatric pathology were risk factors for most of the disorders investigated.ConclusionsA high prevalence of mental health disorders was found, showing the need to mitigate this emotional burden among healthcare workers in the current context of the COVID-19 pandemic.


2020 ◽  
Author(s):  
Maria Malliarou ◽  
Dimitra Tsapakidi ◽  
Mairi Gouva ◽  
Evaggelia Kotrotsiou ◽  
Athanasios Nikolentzos ◽  
...  

Abstract Background The number of refugees and displaced people who have been forced to migrate due to war, mass violence and political instability has reached unprecedented levels. The objective of this study was to assess the degree of depression, resilience and post-traumatic stress disorder (PTSD) in asylum-seeker war refugees, temporally stationed in Larisa, Central Greece, through self-administered questionnaire. Simple regression, Pearson’s correlation coefficient and one-way Anova was used.Methods A cross-sectional study carried out with asylum-seeker war refugees residing in Larisa at a number of apartments rented and ran by the UNHCR and the municipality of Larisa. For the data collection PHQ-9 questionnaire, CD-RISC questionnaire and Harvard Trauma questionnaire (HTQ) were used. Descriptive statistics were applied, as well as Cronbach’s alpha coefficient.Results A total of 64 immigrants (40 males and 23 females, 1-mssing value) agreed to participate in the research. The mean age was 35.72 (SD 7.45), 35 respondents were classified as increased PTSD (scores > 2.5). The results showed a physically and exhausted sample, with marginal mental strength (Mean = 59.38%), fluctuating between moderate (N% = 28.10%) and severe depression (N% = 28.10%). About one in two participants (N% = 54.70%) showed signs of post-traumatic stress disorder PTSD, reporting traumatic experiences that mainly involved immediate events of violence, i.e. beating, while there were very few cases of sexual abuse or violence. A key factor in the formulation of PTSD, depression and Mental Stress Indicators was found to be age but limited to 43 years.Conclusion This study revealed that the refugees of the sample are tired, after being absent and idle for about 2 years from their homeland, in a marginal state of collapse. The most important event-hope that sustains its moderate resilience is the grant of asylum and the hope of arrival in the country of destination.


2021 ◽  
Vol 15 (6) ◽  
pp. 1225-1226
Author(s):  
T. Iqbal ◽  
F. Naseem ◽  
A. A. Baig ◽  
F. Liaquat

Aim: To gauge the physiological sequelae of covid-19 pandemic on medical personnel in Pakistan. Place & duration: An online cross sectional study was conducted from May, 2020 to August, 2020 in Lahore. Methodology: 17 score PTSD check list civilian version was used to assess the symptoms of post-traumatic stress disorder in medical personnel. Results: Mean post-traumatic stress score (PTSS) was 39±15 with a range of 18-89. 66% (n=240) of the participants experienced moderate to extreme stress level. Chi Square test was used to determine an association between higher stress level and age, gender and staff category. Higher stress scores were associated with females (p<0.01). Conclusion: Rewarding the health personnel with gratitude, acknowledgement, financial compensations and provision of personal protective equipments (PPEs) can halt the psychological sequelae and is a promise to win this battle. Keywords: SARS coV2, Covid 19, PTSD, Health personnel


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