COVID-19 Fear Association with Depression, Anxiety, and Insomnia: A National Web-Based Survey on the General Population

Objective: COVID-19 pandemic has influenced almost every country worldwide. Being in a pandemic situation can cause psychological distress to people, which can lead to sleep disorders. The present study aimed to assess prevalence of depression, anxiety, and insomnia among Iranian people and their relations with COVID-19 fear in the early stages of COVID-19 pandemic. Method: A cross-sectional and population-based online study was designed. We created an online form and used Fear of COVID-19 scale (FCV-19), Generalized Anxiety Disorder 2 scale (GAD-2), Patient Health Questionnaire-2 (PHQ-2), and Insomnia Severity Index (ISI), to assess fear of COVID-19, anxiety, depression, and insomnia, respectively. We sent the link to the online survey to Iranians interested in participating in the study via social media, and 1223 Iranian completed the form. Results: A total of 1223 individuals with a mean age of 39.82 ± 10.75 years participated in the study. Prevalence of insomnia, depression and anxiety among our participants were 55.2%, 61.5%, and 50.9%, respectively. The mean FCV-19 score among the participants was 19.70 ± 5.08. Insomnia was more common among those who were 50 years or older. Fear of COVID-19 was related to a more risk of progression toward depression, anxiety, and insomnia. Conclusion: Fear of COVID-19 has a considerable association with depression, anxiety, and insomnia in the pandemic, and strategies to reasonably decrease people’s fears can help to reduce incidence of psychological issues during the pandemic.

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COVID-19 Lockdown 2020 Changed Patterns of Alcohol and Cannabis Use in Swiss Elite Athletes and Bodybuilders: Results From an Online Survey

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.759335 ◽

2021 ◽

Vol 3 ◽

Author(s):

Christian Imboden ◽

Malte Christian Claussen ◽

Samuel Iff ◽

Boris B. Quednow ◽

Erich Seifritz ◽

...

Keyword(s):

Alcohol Consumption ◽

Trait Anxiety ◽

Online Survey ◽

Elite Athletes ◽

National Level ◽

Severity Index ◽

Cannabis Use ◽

Cross Sectional ◽

Patient Health ◽

Daily Training

Objectives: During the COVID-19 pandemic, increased patterns of substance use have been reported in the general population. However, whether this also applies to athletes is not yet clear. This study aimed to detect changes in alcohol consumption and cannabis use in elite athletes and bodybuilders during the first COVID-19 lockdown in Switzerland.Methods: Between April 25 and May 25, 2020, a cross-sectional online survey was conducted among bodybuilders and Swiss elite athletes who were active in Olympic sports and disciplines approved by the International Olympic Committee (IOC) on at least the national level. The collected data included information on alcohol and cannabis use during the last month (lockdown) and in the year before COVID-19 lockdown (pre-lockdown), daily training times, existential fears on a scale from 1 to 100, Patient Health Questionnaire-9 for depression (PHQ-9), Insomnia Severity Index (ISI), and State-Trait Anxiety Inventory (STAI).Results:N = 275 athletes (elite athletes: n = 193; bodybuilders: n = 82) was included in this study. Both pre-lockdown and during lockdown, more bodybuilders used cannabis (both time points: p < 0.001) than elite athletes, and more elite athletes drank alcohol (pre-lockdown: p = 0.005, lockdown: p = 0.002) compared to bodybuilders. During lockdown, fewer athletes drank alcohol compared to before, but those who continued drinking did so on more days per week (p < 0.001, Eta2 = 0.13). Elite athletes were more likely to increase their drinking with 17.7 vs. 8.2% in bodybuilders. When compared to pre-lockdown measures, the number of athletes using cannabis did not change during lockdown. Only three of 203 elite athletes reported using cannabis during lockdown; this contrasts with 16 of 85 bodybuilders. In a multivariate regression model, existential fears and a lower ISI score were significant predictors for increased alcohol consumption during the lockdown in the entire sample. In a model based on elite athletes only, male sex and a lower ISI score predicted increased alcohol consumption. In a bodybuilder-based model, predictors of increased alcohol consumption were existential fears and trait anxiety.Conclusion: We suggest identifying athletes who are at risk for increased alcohol and cannabis use; we suggest this to be able to professionally support them during stressful times, such as the COVID-19 pandemic.

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Impact of Insomnia Symptoms on the Clinical Presentation of Depressive Symptoms: A Cross-Sectional Population Study

Frontiers in Neurology ◽

10.3389/fneur.2021.716097 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yun Ho Choi ◽

Kwang Ik Yang ◽

Chang-Ho Yun ◽

Won-Joo Kim ◽

Kyoung Heo ◽

...

Keyword(s):

Depressive Symptoms ◽

Clinical Presentation ◽

Severity Index ◽

Population Based ◽

Cross Sectional ◽

Sleep Study ◽

Patient Health ◽

Clinically Significant ◽

The Impact ◽

Insomnia Symptoms

Objective: Insomnia and depression are prevalent disorders that often co-occur. This study aimed to investigate the impact of clinically significant insomnia symptoms on the prevalence and clinical presentation of clinically significant depressive symptoms and vice versa.Methods: This study used data from the Korean Headache-Sleep Study (KHSS), a nationwide cross-sectional population-based survey regarding headache and sleep. Clinically significant insomnia symptoms were defined as Insomnia Severity Index (ISI) scores ≥ 10 and clinically significant depressive symptoms were defined as Patient Health Questionnaire-9 (PHQ-9) scores ≥ 10, respectively. We referred clinically significant insomnia symptoms and clinically significant depressive symptoms as insomnia symptoms and depressive symptoms, respectively.Results: Of 2,695 participants, 290 (10.8%) and 116 (4.3%) were classified as having insomnia and depressive symptoms, respectively. The prevalence of depressive symptoms was higher among participants with insomnia symptoms than in those without insomnia symptoms (25.9 vs. 1.7%, respectively, P < 0.001). Among participants with depressive symptoms, the PHQ-9 scores were not significantly different between participants with and without insomnia symptoms (P = 0.124). The prevalence of insomnia symptoms was significantly higher among participants with depressive symptoms than in those without depressive symptoms (64.7 vs. 8.3%, respectively, P < 0.001). The ISI scores were significantly higher among participants with insomnia and depressive symptoms than in participants with insomnia symptoms alone (P < 0.001).Conclusions: Participants with depressive symptoms had a higher risk of insomnia symptoms than did those without depressive symptoms. The severity of depressive symptoms did not significantly differ based on insomnia symptoms among participants with depressive symptoms; however, the severity of insomnia symptoms was significantly higher in participants with depressive symptoms than in those without depressive symptoms.

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The Prevalence of Depression and Anxiety Disorders Among Postgraduate Students in an Arabic Sample: A Cross-sectional Study

10.21203/rs.3.rs-143732/v2 ◽

2021 ◽

Author(s):

Asem A. Alageel ◽

Rayyan A. Alyahya ◽

Raed A Alghamdi ◽

Ban A. Alzaid ◽

Aryaf. S Alsubaie ◽

...

Keyword(s):

Mental Health ◽

Anxiety Disorders ◽

Online Survey ◽

Cross Sectional Study ◽

Depression And Anxiety ◽

Cross Sectional ◽

Postgraduate Students ◽

High Prevalence ◽

Prevalence Of Depression ◽

Patient Health

Abstract Background: Depression and anxiety are indicators of mental health and quality of life. Studies found a high prevalence of depression and anxiety disorders among specific populations, such as medical students, residents and fellows. However, postgraduate students unarguably suffer from many private and career life stressors. Unfortunately, research about the prevalence of depression and anxiety among postgraduate students are greatly lacking.Methods: A cross-sectional online survey; a self-questionnaire divided into five sections. Socio-demographic characteristics, the Patient Health Questionnaire for Depression (PHQ9), Generalized Anxiety Disorder 7 item (GAD7), insomnia and suicide. Results: The number of participants was 1,005, The prevalence of depression and GAD that warrant treatments are 27.4% and 23.6%, respectively. Most of the participants who screened positive for depression and GAD were not aware of having these disorders. Females were at a higher risk of depression (OR: 1.5, 95% CL: 1.10 to 2.15) and GAD (OR:1.49, 95% CL 1.07 to 2.07). Insomnia is associated significantly with depression (P<0.001) and GAD (P<0.001). Depression increases the risk for active suicide thoughts (OR= 7.453) (P<0.001). Limitations: Due to the nature of cross-sectional studies, causal relationships cannot be identified.Conclusion: We have identified a higher prevalence of depression and GAD among postgraduate students compared with the general population. However, they appear to be underrepresented in mental health literature, so further research is necessary.

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The Prevalence of Depression and Anxiety Disorders Among Postgraduate Students in an Arabic Sample: a Cross-sectional Study

10.21203/rs.3.rs-143732/v1 ◽

2021 ◽

Author(s):

Asem Alageel ◽

Rayyan Abdullah Alyahya ◽

Raed A. Alghamdi ◽

Ban A. Alzaid ◽

Aryaf S Alsubaie ◽

...

Keyword(s):

Mental Health ◽

Anxiety Disorders ◽

Online Survey ◽

Cross Sectional Study ◽

Depression And Anxiety ◽

Cross Sectional ◽

Postgraduate Students ◽

High Prevalence ◽

Prevalence Of Depression ◽

Patient Health

Abstract Background: Depression and anxiety are indicators of mental health and quality of life. Studies found a high prevalence of depression and anxiety disorders among specific populations, such as medical students, residents and fellows. However, postgraduate students unarguably suffer from many private and career life stressors. Unfortunately, research about the prevalence of depression and anxiety among postgraduate students are greatly lacking.Methods: A cross-sectional online survey; a self-questionnaire divided into five sections. Socio-demographic characteristics, the Patient Health Questionnaire for Depression (PHQ9), Generalized Anxiety Disorder 7 item (GAD7), insomnia and suicide.Results: The number of participants was 1,005, The prevalence of depression and GAD that warrant treatments are 27.4% and 23.6%, respectively. Most of the participants who screened positive for depression and GAD were not aware of having these disorders. Females were at a higher risk of depression (OR: 1.5, 95% CL: 1.10 to 2.15) and GAD (OR:1.49, 95% CL 1.07 to 2.07). Insomnia is associated significantly with depression (P<0.001) and GAD (P<0.001). Depression increases the risk for active suicide thoughts (OR= 7.453) (P<0.001). Conclusion: We have identified a higher prevalence of depression and GAD among postgraduate students compared with the general population. However, they appear to be underrepresented in mental health literature, so further research is necessary. The limitations of this study were centered on the nature of cross-sectional studies, causal relationships cannot be identified.

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Depression and its associated factors among pregnant women in central Vietnam

Health Psychology Open ◽

10.1177/2055102920988445 ◽

2021 ◽

Vol 8 (1) ◽

pp. 205510292098844

Author(s):

Bao-Yen Luong-Thanh ◽

Lan Hoang Nguyen ◽

Linda Murray ◽

Manuel Eisner ◽

Sara Valdebenito ◽

...

Keyword(s):

Pregnant Women ◽

Associated Factors ◽

Mental Health Problems ◽

Cross Sectional Study ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Prevalence Of Depression ◽

Patient Health ◽

Quota Sampling

To date, little attention has been given to prenatal depression, especially in low and middle-income countries. The aim of this research was to assess the prevalence of depression and its associated factors amongst pregnant women in a central Vietnamese city. This cross-sectional study included 150 pregnant women from 29 to 40 weeks of gestation, from eight wards of Hue city, via quota sampling from February to May 2019. We employed the Patient Health Questionnaire (PHQ-9) to assess depression. Findings suggest the need to provide routine screening of pregnant women in primary care for depressive symptoms and other mental health problems.

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Public Concerns during the COVID-19 Lockdown: A Multicultural Cross-Sectional Study among Internet Survey Respondents in Three Countries

Journal of Clinical Medicine ◽

10.3390/jcm10081577 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1577

Author(s):

Alona Emodi-Perlman ◽

Ilana Eli ◽

Nir Uziel ◽

Joanna Smardz ◽

Anahat Khehra ◽

...

Keyword(s):

Mental Health ◽

Online Survey ◽

Middle Eastern ◽

Well Being ◽

Cross Sectional Study ◽

Internet Survey ◽

Physical And Mental Health ◽

Cross Sectional ◽

Culturally Different ◽

Patient Health

(1) Background: this study aimed to evaluate the worries, anxiety, and depression in the public during the initial coronavirus disease 2019 (COVID-19) pandemic lockdown in three culturally different groups of internet survey respondents: Middle Eastern (Israel), European (Poland), and North American (Canada). (2) Methods: a cross-sectional online survey was conducted in the mentioned countries during the lockdown periods. The survey included a demographic questionnaire, a questionnaire on personal concerns, and the Patient Health Questionnaire-4 (PHQ-4). A total of 2207 people successfully completed the survey. (3) Results: Polish respondents were the most concerned about being infected. Canadian respondents worried the most about their finances, relations with relatives and friends, and both physical and mental health. Polish respondents worried the least about their physical health, and Israeli respondents worried the least about their mental health and relations with relatives and friends. Canadian respondents obtained the highest score in the PHQ-4, while the scores of Israeli respondents were the lowest. (4) Conclusions: various factors should be considered while formulating appropriate solutions in emergency circumstances such as a pandemic. Understanding these factors will aid in the development of strategies to mitigate the adverse effects of stress, social isolation, and uncertainty on the well-being and mental health of culturally different societies.

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Concerns in the Norwegian Population during the Initial Lockdown Due to the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116119 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6119

Author(s):

Inger Schou-Bredal ◽

Laila Skogstad ◽

Tine K. Grimholt ◽

Tore Bonsaksen ◽

Øivind Ekeberg ◽

...

Keyword(s):

Online Survey ◽

Female Gender ◽

Population Based ◽

Snowball Sampling ◽

Financial Loss ◽

Next Of Kin ◽

Cross Sectional ◽

Norwegian Population ◽

Gender And Age ◽

Response Alternatives

Although concern affects one’s welfare or happiness, few studies to date have focused on peoples’ concerns during the initial COVID-19 lockdown. The aim of the study was to explore concerns in the Norwegian populations according to gender and age, and identify which concerns were most prominent during the lockdown. A population-based cross-sectional online survey using snowball-sampling strategies was conducted, to which 4527 adults (≥18 years) responded. Questions related to concerns had response alternatives yes or no. In addition, they were asked which concern was most prominent. Nearly all the 4527 respondents (92%) reported that they were concerned: 60.9% were generally concerned about the pandemic, 83.9% were concerned about family and friends, 21.8% had financial concerns, and 25.3% expected financial loss. More women were concerned about family and friends than males, (85.2% vs. 76.2%, p < 0.001), whereas more men expected financial loss (30.4% vs. 24.4%y, p = 0.001). Younger adults (<50 years) had more financial concerns than older adults (25.9% vs. 10.5%, p < 0.001). Being concerned about family and friends was the most prominent concern and was associated with; lower age (OR 0.79), female gender (OR 1.59), and being next of kin (2.42). The most prominent concern for adults 70 years or older was being infected by COVID-19. In conclusion, women and younger individuals were most concerned. While adults under 70 years of age were most concerned about family and friends and adults 70 years or older were most concerned about being infected by COVID-19.

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AB1192 THE UNDERWORLD OF DEPRESSIVE SYMPTOMS IN RHEUMATIC DISEASES: OVERLOOKED, UNRECOGNIZED OR UNPERCEIVED?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1998 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1886.2-1887

Author(s):

F. Ingegnoli ◽

T. Schioppo ◽

T. Ubiali ◽

V. Bollati ◽

S. Ostuzzi ◽

...

Keyword(s):

Depressive Symptoms ◽

Rheumatic Diseases ◽

Real Life ◽

Severe Depression ◽

Mild Depression ◽

Cross Sectional ◽

Online Study ◽

Social Burden ◽

Patient Health ◽

The University

Background:The concomitant presence of depressive symptoms and rheumatic diseases (RDs) impose a considerable economic and social burden on the communities as they are associated with numerous deleterious outcomes such as increased mortality, work disability, higher disease activity and worsening physical function, higher pain levels and fatigue. Despite growing interest on depressive symptoms burden in RDs, current patient perception on this topic is unknown.Objectives:Italian patients with RDs were invited to participate in an online study gauging the presence and the perception of depressive symptoms using the Patient Health Questionnaire (PHQ-9).Methods:This was a cross-sectional no-profit online study to screen the presence and the perception of depressive symptoms in RDs patients. All participants gave their consent to complete the PHQ-9 and they were not remunerated. Completion was voluntary and anonymous. The PHQ-9 rates the frequency of symptoms over the past 2 weeks on a 0-3 Likert-type scale. It contains the following items: anhedonia, depressed mood, trouble sleeping, feeling tired, change inappetite, guilt or worthlessness, trouble concentrating, feeling slowed down or restless, and suicidal thoughts. Patients were stratified as: <4 not depressed, 5-9 sub-clinical or mild depression, 10-14 moderate depression, 15-19 moderately severe depression and 20-27 severe depression. The survey was disseminated by ALOMAR (Lombard Association for Rheumatic Diseases) between June and October 2019.Results:192 patients took part in the study: 170 female with median age 50 years. Among respondents only 35 (18.2%) were not depressed. Depression was sub-clinical or mild in 68 (35.4%), moderate in 42 (21.9%), moderately severe in 30 (15.6%), and severe in 17 (8.9%). 16 (8.3%) of respondents declared to have depressive symptoms and 7 of 16 were under psychiatric therapy.Moreover, patients were grouped according to diagnosis.124 respondents had inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis). 23 (18.5%) were not depressed. Depression was sub-clinical or mild in 41 (33%), moderate in 26 (21%), moderately severe in 21 (17%), and severe in 13 (10.5%). Among them, 8 (6.5%) declared to have depressive symptoms depressed and 3 of 8 were under psychiatric therapy.49 respondents had a connective tissue disease or vasculitis. 11 (22.5%) were not depressed. Depression was sub-clinical or mild in 19 (38.8%), moderate in 13 (26.5%), moderately severe in 2 (4%), and severe in 4 (8.2%). Among them, 3 (6%) declared to have depressive symptoms and 1 of 6 were under psychiatric therapy.19 respondents had other rheumatic diseases. 1 (5.3%) was not depressed. Depression was sub-clinical or mild in 8 (42.1%), moderate in 3 (15.8%), moderately severe in 7 (36.8%). Among them, 5 (26.3%) declared to be depressed and 3 of 5 were under psychiatric therapy.Conclusion:Our study confirmed that the overall real-life burden of depressive symptoms is relevant in all RDs. At the same time, these results highlighted that depressive symptoms are overlook by physicians and unperceived by patients since fewer that half of respondents (46.4%) had a clinical depression (PHQ-9>10). These results suggested that screening for depression should form part of the routine clinical assessment of RD patients.Acknowledgments:We thank the Lombard Association of Rheumatic Diseases (ALOMAR) for its contribution to design and disseminate the survey, the group that sustain systemic sclerosis (GILS), and the IT service of the University of Milan.Disclosure of Interests:Francesca Ingegnoli: None declared, Tommaso Schioppo: None declared, Tania Ubiali: None declared, Valentina Bollati: None declared, Silvia Ostuzzi: None declared, Massimiliano Buoli: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB

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Development of a health literacy scale for preconception care: a study of the reproductive age population in Japan

BMC Public Health ◽

10.1186/s12889-021-12081-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maiko Suto ◽

Haruhiko Mitsunaga ◽

Yuka Honda ◽

Eri Maeda ◽

Erika Ota ◽

...

Keyword(s):

Health Literacy ◽

Online Survey ◽

Preconception Care ◽

Population Based ◽

Living Environment ◽

Reproductive Age ◽

Self Report ◽

Healthy Weight ◽

Cross Sectional ◽

Behavioral Skills

Abstract Background Preconception care aims to improve both maternal and child health in the short as well as long term, along with providing health benefits to adolescents, women, and men, whether or not they plan to become parents. However, there is limited evidence regarding the effectiveness of interventions for improving preconception health in population-based settings. To accumulate evidence in this field, this study focused on the concept of health literacy, and aimed to develop a self-report health literacy scale in Japanese, focusing on preconception care. Methods We conducted a cross-sectional online survey. Participants were recruited from December 2019 to February 2020 from the registered members of a web-based research company. Participants were Japanese men and women aged 16–49 (n = 2000). A factor analysis was conducted to select both factors and items for health-related behavior and skills (33 initial items were generated), along with an item response theory analysis to examine how the 16 items were related to people’s knowledge of preconception care. Results We developed a 6-factor (including “appropriate medical examinations,” “appropriate diet,” “stress coping,” “healthy weight,” “safe living environment,” and “vaccinations”), 25-item behavior and skills scale, as well as a 13-item knowledge scale, to evaluate participants’ health literacy around preconception care. A shortened version, consisting of 17 items, was also prepared from the 25 items. The reliability coefficients of total scores and each factor of the behavior and skills scale were comparatively high, with weak-to-moderate correlation between behavior and skills and knowledge. Conclusions The new scale will, ideally, provide information on the current state of preconception care health literacy of the general population. In addition, this scale, which consists of both behavioral/skills and knowledge dimensions, should help support the effective implementation of risk assessment programs and interventions aimed at promoting behavioral changes using a population-based approach. Future studies using different question/administration formats for diverse populations, and considering respondents’ opinions on health literacy scales should be effective in improving this scale.

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Factors that influence mothers’ prenatal decision to breastfeed in Spain

International Breastfeeding Journal ◽

10.1186/s13006-020-00341-5 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Ana Ballesta-Castillejos ◽

Juan Gómez-Salgado ◽

Julián Rodríguez-Almagro ◽

Inmaculada Ortiz-Esquinas ◽

Antonio Hernández-Martínez

Keyword(s):

Online Survey ◽

Maternal Education ◽

Binary Logistic Regression ◽

Ethics Committee ◽

Cross Sectional ◽

Factors Associated ◽

Online Study ◽

Multiple Factors ◽

Intention To Breastfeed ◽

Significant Factors

Abstract Background Parents’ decisions about how to feed their newborns are influenced by multiple factors. Our objective was to identify the factors that can influence the decision to breastfeed. Methods Cross-sectional observational online study was conducted in Spain on women who gave birth between 2013 and 2018. The total number of participants was 5671. Data collection was after approval by the ethics committee in 2019. The data were collected retrospectively because the information was obtained from women who were mothers during the years 2013–2018. An online survey was distributed to breastfeeding associations and postpartum groups. Multivariate analysis with binary logistic regression was done to calculate the Adjusted Odds Ratios (aOR). The main result variable was “intention to breastfeed”. Results Ninety-seven percent (n = 5531) of women made the decision to breastfeed prior to giving birth. The internet played a role in deciding to breastfeed in 33.7% (n = 2047) of women, while 20.1% (n = 1110) said the same thing about their midwife. We identified five significant factors associated with the mother’s prenatal decision to breastfeed: attending maternal education (aOR 2.10; 95% CI 1.32, 3.34), having two (aOR 0.52; 95% CI 0.28, 0.99) and three children (aOR 0.24; 95% CI 0.10, 0.59), previous breastfeeding experience (aOR 6.99; 95% CI 3.46, 14.10), support from partner (aOR 1.58; 95% CI 1.09,2.28) and having a condition during pregnancy (aOR 0.62; 95% CI 0.43, 0.91). Conclusions Factors related with previous breastfeeding experience and education for mothers are decisive when it comes to making the decision to breastfeed. Given the proven influence that partners have in decision-making, it is important for them to be fully involved in the process.

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