Anxiety, Depression and Functional impairment during the COVID-19 Pandemic among Health Care Workers

Abstract BackgroundCOVID-19 is an infectious disease caused by a newly discovered coronavirus that is pandemic, with more than 338 thousand cases worldwide. Geometrically increasing numbers of cases and deaths from COVID 19 in the world, both medical staff and the public have been experiencing psychological problems, including anxiety, depression, and stress, which can cause disability and functional impairment of the individual. One of the most stressful situations is the unpredictability of the situation and the uncertainty of when to control the disease and the seriousness of the risk. These challenges and stress can trigger a common mental disorder. This study aimed to determine the burden of stress anxiety and depression among all employees of Eye and ENT hospitals.MethodologyA hospital-based cross-sectional study was carried out among all the employees of Hospital for Children Eye ENT and Rehabilitation Services Bhaktapur during the COVID-19 pandemic lockdown using an online self-administered questionnaire through Google forms. The tools were adopted from Hospital Anxiety and Depression scale (HADS) Nepali version on a Likert's scale of 0 to 3 validated by Risal A. et al. and WHO Disability Assessment Schedule (WHODAS S2.0) on a Likert's scale of 1 to 5 to assess functional impairment.ResultsThe mean age (SD) of the participants (n=86) was 32.53 (7.92) years. Male and female participants was equal in number. The point prevalence of anxiety and depression was 25.6% and 14.0%, respectively. Females had a higher prevalence of both anxiety (39.5% vs 11.6%, p<0.01) and depression (18.6% vs 9.3%, p=0.351). The mean (SD) anxiety, depression and functional impairment scores were 7.27 (4.621), 5.13 (4.023) and 19.47 (6.228), respectively. Females had a very strong association with both anxiety (AOR=5.008 (95% CI; 1.593-15.741)) and depression (AOR=2.173 (95% CI; 0.599-7.882)). Married participants had a positive association with anxiety (AOR 4.379 (95% CI; 1.121-17.106)) and depression (AOR 1.542 (95% CI; 0.379-6.276)). Clinical and supporting staff both had a higher prevalence of both anxiety (31.0% and 20.5%, p=0.265) and depression (16.7% and 11.4%, p=0.478). The mean 12-item WHO disability assessment schedule score (WHODAS 2.0) among all participants and participants with anxiety and depression was 19.47 (95% CI: 18.13-20.80), 21.27 (95% CI: 18.08-24.46) and 19.92 (15.28-24.56), respectively. The life activities domain of WHODAS 2.0 was significantly higher in participants with anxiety (1.91 vs 1.56, p<0.01) and depression (1.75 vs 1.63, p<0.001) than in those without anxiety.ConclusionAnxiety and depression during COVID-19 pandemic lockdown were highly prevalent both in clinical and non-clinical employees, causing mild to moderate functional impairment.

Download Full-text

Anxiety–Depression of Dialysis Patients and Their Caregivers

Medicina ◽

10.3390/medicina55050168 ◽

2019 ◽

Vol 55 (5) ◽

pp. 168 ◽

Cited By ~ 3

Author(s):

Georgia Gerogianni ◽

Maria Polikandrioti ◽

Fotoula Babatsikou ◽

Sofia Zyga ◽

Victoria Alikari ◽

...

Keyword(s):

Statistical Significance ◽

Depression Scale ◽

Total Sample ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Dialysis Patients ◽

Cross Sectional ◽

Significance Level ◽

The Mean ◽

Anxiety Depression

Background and Objectives: Anxiety–depression of patients undergoing hemodialysis has a strong relation with the levels of anxiety–depression of their caregivers. The aim of this study was to evaluate anxiety–depression of dialysis patients and their caregivers. Materials and Methods: In this cross-sectional study, 414 pairs of patients and caregivers from 24 hemodialysis centers of Greece completed the Hospital Anxiety and Depression Scale (HADS). The statistical analysis of the data was performed through the Statistical Program SPSS version 20.0. The statistical significance level was set up at 5%. Results: The mean age of patients was 64 (54.06–72.41) years old and the mean duration of hemodialysis was 36 (16–72) months. The mean age of caregivers was 54 (44–66) years old. Of the total sample, 17.1% (n = 71) of patients had high levels of anxiety and 12.3% (n = 51) had high levels of depression. Additionally, 27.8% (n = 115) of caregivers had high levels of anxiety and 11.4% (n = 47) had high levels of depression. Caregivers had higher levels of anxiety when their patients had high levels of anxiety as well (42.3%). Additionally, they had higher levels of depression when their patients had high levels of depression as well (17.6%). Conclusions: The results of this study showed a significant association between the levels of anxiety and depression among patients and caregivers. There is a necessity for individualized assessment of dialysis patients and their caregivers and the implementation of specific interventions for reducing the levels of anxiety and depression among them.

Download Full-text

Anxiety and Depression among Hypertensive Outpatients in Afghanistan: A Cross-Sectional Study in Andkhoy City

International Journal of Hypertension ◽

10.1155/2018/8560835 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Mohammad Shoaib Hamrah ◽

Mohammad Hassan Hamrah ◽

Hideki Ishii ◽

Susumu Suzuki ◽

Mohammad Hussain Hamrah ◽

...

Keyword(s):

Diabetes Mellitus ◽

Chronic Diseases ◽

National Level ◽

Depression Scale ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Cross Sectional ◽

Hypertensive Patients ◽

Comorbid Anxiety ◽

Anxiety Depression

There is a relationship between mental and physical health. Depression and anxiety are linked with the development of several chronic diseases. The purpose of the present study was to determine the prevalence and factors associated with anxiety and depression among adult hypertensive outpatients in Afghanistan. Methods. Two hundred thirty-four consecutive hypertensive patients from December 2015 to August 2016 were recruited to complete the Hospital Anxiety and Depression Scale (HADS) questionnaire, which has scores for classifying the participants having anxiety and depression symptoms. Results. Of the total 234 patients, 81 (34.6%) were males and 153 (65.4%) were females. The mean age was 54.6±12.7 for the hypertensive patients with anxiety and 63.8±15.0 for the hypertensive patients with depression while this figure was 49.5±10.2 for the adult participants in general population in Kabul city (Saeed, 2013). The prevalence of anxiety and depression (42.3% vs. 58.1%) among hypertensive persons is compared with the same mental disorders among Afghan refugees (39.3% vs. 22.1%) in Dalakee Refugee Camp (in Iran) (Hosseini Divkolaye and Burkle, 2017). Of the total participants, 99 had anxiety (42.3%), 136 had depression (58.1%), and 66 had (28.2%) comorbid anxiety-depression. Multivariate analysis was used. For anxiety age, female gender, smoking, diabetes mellitus, and 2 or more chronic diseases had a significant association. For depression, age and diabetes mellitus had a significant association, and for comorbid anxiety, depression, age, diabetes mellitus, and 2 or more chronic diseases had a significant association. Conclusion. This study shows that anxiety and depression are highly prevalent among hypertensive patients in an outpatient clinic in Afghanistan. There was an association between some sociodemographic and clinical characteristics and anxiety and depression. More studies are needed on a national level to inform the development of strategies for the prevention and control of psychological distress among patients with chronic diseases in Afghanistan.

Download Full-text

An Investigation of Associations and Incidence of Anxiety, Depression, Perceived Vulnerability to Diseases, and Fear of COVID-19 Among Nigerian Health Care Workers

Archives of Pediatric Infectious Diseases ◽

10.5812/pedinfect.114746 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Joy Osagiator Ariyo ◽

Ebenezer Olutope Akinnawo ◽

Bede Chinonye Akpunne ◽

Daniel Oluwasanmi Kumuyi ◽

Deborah Foluke Onisile

Keyword(s):

Health Care ◽

Health Care Workers ◽

Depression Scale ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Cross Sectional ◽

Perceived Vulnerability ◽

Care Workers ◽

Mental Wellness ◽

Anxiety Depression

Background: Health care workers (HCWs) are the frontline of coping COVID-19 pandemic, which indicates the importance of improving their mental wellness to better cope with the situation. Objectives: The current study aimed to firstly assess the severity of anxiety and depression and perceived vulnerability to diseases, and secondly to investigate their association with the fear of COVID-19 among Nigerian HCWs. Methods: For this cross-sectional study, a purposefully selected sample of 413 HCWs from two tertiary healthcare institutions in Benin City, Edo State, South-South Nigeria, responded to the Fear of COVID-19 Scale, Hospital Anxiety and Depression Scale, and Perceived Vulnerability to Disease Scale. Data was collected between October 2020 and February 2021. Descriptive statistics were used to summarize socio-demographic variables, while inferential statistics (t-test for independent samples, one-way ANOVA, and linear regression) were used to test hypotheses. Results: A high prevalence of anxiety, depression, and perceived vulnerability to diseases (PVD) was observed. Perceived infectability (β = 0.244, P = 0.000), germ aversion (β = 0.166, P = 0.000), and composite PVD (β = 0.96, P = 0.000) were identified as independent and significant predictors of fear of COVID-19, accounting for 7.5; 3.3, and 9.9% variance in the severities of Fear of COVID-19, respectively. Anxiety and depression showed a significant joint prediction of Fear of COVID-19 severity, accounting for a 4.0% variance in the severity. Fear of COVID-19 was not found to be influenced by sex or job type differences among the HCWs. Conclusions: This study demonstrated a high incidence of anxiety, depression, and perceived vulnerability to COVID-19 among Nigerian HCWs. These reported symptoms of psychopathology are also strong independent and joint predictors of fear of COVID-19.

Download Full-text

Cost-effectiveness of WHO Problem Management Plus for adults with mood and anxiety disorders in a post-conflict area of Pakistan: randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.2020.138 ◽

2020 ◽

Vol 217 (5) ◽

pp. 623-629 ◽

Cited By ~ 2

Author(s):

Syed Usman Hamdani ◽

Zill-e- Huma ◽

Atif Rahman ◽

Duolao Wang ◽

Tao Chen ◽

...

Keyword(s):

Cost Effectiveness ◽

Depression Scale ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Problem Management ◽

Post Conflict ◽

Intervention Cost ◽

The Mean ◽

The Cost ◽

Anxiety Depression

BackgroundWith the development of evidence-based interventions for treatment of priority mental health conditions in humanitarian settings, it is important to establish the cost-effectiveness of such interventions to enable their scale-up.AimsTo evaluate the cost-effectiveness of the Problem Management Plus (PM+) intervention compared with enhanced usual care (EUC) for common mental disorders in primary healthcare in Peshawar, Pakistan. Trial registration ACTRN12614001235695 (anzctr.org.au).MethodWe randomly allocated 346 participants to either PM+ (n = 172) or EUC (n = 174). Effectiveness was measured using the Hospital Anxiety and Depression Scale (HADS) at 3 months post-intervention. Cost-effectiveness analysis was performed as incremental costs (measured in Pakistani rupees, PKR) per unit change in anxiety, depression and functioning scores.ResultsThe total cost of delivering PM+ per participant was estimated at PKR 16 967 (US$163.14) using an international trainer and supervisor, and PKR 3645 (US$35.04) employing a local trainer. The mean cost per unit score improvement in anxiety and depression symptoms on the HADS was PKR 2957 (95% CI 2262–4029) (US$28) with an international trainer/supervisor and PKR 588 (95% CI 434–820) (US$6) with a local trainer/supervisor. The mean incremental cost-effectiveness ratio (ICER) to successfully treat a case of depression (PHQ-9 ≥ 10) using an international supervisor was PKR 53 770 (95% CI 39 394–77 399) (US$517), compared with PKR 10 705 (95% CI 7731–15 627) (US$102.93) using a local supervisor.ConclusionsThe PM+ intervention was more effective but also more costly than EUC in reducing symptoms of anxiety, depression and improving functioning in adults impaired by psychological distress in a post-conflict setting of Pakistan.

Download Full-text

Psychiatric Disorders in an Arctic Community

The Canadian Journal of Psychiatry ◽

10.1177/070674370004500404 ◽

2000 ◽

Vol 45 (4) ◽

pp. 357-362 ◽

Cited By ~ 17

Author(s):

Jack Haggarty ◽

Zack Cernovsky ◽

Patricia Kermeen ◽

Harold Merskey

Keyword(s):

Alcohol Abuse ◽

Psychiatric Disorders ◽

Depression Scale ◽

Self Report ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Hospital Anxiety ◽

Cross Sectional ◽

The Past ◽

Anxiety Depression

Objective: To determine the rates of depression, anxiety, and alcohol abuse, using modern nosology, in a random sample of residents aged 14 to 85 years living in an Arctic community. Method: A cross-sectional 2-step survey of randomly selected households was undertaken, using a self-report questionnaire to screen for anxiety, depression, and alcohol abuse. The survey included the Hospital Anxiety and Depression Scale (HADS) and Ewing and Roose's 4-question alcohol screening instrument (the CAGE questionnaire). Cut-off scores for the HADS and CAGE were found by comparing HADS and CAGE scores with scores on the Structured Clinical Interview for the DSM-III-R (SCID) in a stratified subs ample. Results: Estimated rates of depression and anxiety were 26.5% and 19.0% respectively within the past week, and estimated rates of lifetime alcohol abuse were 30.5%. Conclusions: The estimated prevalence of psychiatric disorders in this Arctic community is higher than that indicated in previous findings on Native mental health.

Download Full-text

Fatigue, Anxiety, and Depression in Long-Term Survivors of Testicular Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2003.08.163 ◽

2003 ◽

Vol 21 (7) ◽

pp. 1249-1254 ◽

Cited By ~ 162

Author(s):

Sophie D. Fosså ◽

Alv A. Dahl ◽

Jon H. Loge

Keyword(s):

Testicular Cancer ◽

Depression Scale ◽

Chronic Fatigue ◽

Anxiety And Depression ◽

Male Survivors ◽

Psychiatric Intervention ◽

The Mean ◽

Anxiety Depression ◽

Long Term Survivors

Purpose: To investigate the prevalence of chronic fatigue (CF), the levels of anxiety and depression, and the correlation between these conditions in long-term survivors of testicular cancer (TCSs). Occurrence of CF in TCSs is compared with findings in male survivors of Hodgkin’s disease (HDSs) and in males from the general population (GenPop). Methods: TCSs, HDSs, and two cohorts of the GenPop completed the Fatigue Questionnaire (FQ) and the Hospital Anxiety and Depression Scale (HADS) as part of a questionnaire survey. Cases of CF were identified according to published cut-offs, and the levels of anxiety (HADS-A) and depression (HADS-D) were calculated. Results: Among 791 TCSs, 16% displayed CF (HDSs, 24%; GenPop, 10%). In the age group younger than 30 years, the prevalence of CF was higher in TCSs than in the GenPop (P <.01). In TCSs, age, anxiety, depression, and comorbidity were independent predictors of CF. The mean HADS-A score in TCSs was significantly above the comparable figure of the GenPop and similar to that of HDSs. The mean HADS-D score in TCSs was below that of the GenPop. The highest and lowest mean scores of HADS-A and HADS-D were observed in the youngest TCSs. Conclusion: The prevalence of CF is less in TCSs than in HDSs but exceeds that of the GenPop. Together with comorbidity and age, anxiety and depression predict CF in TCSs, warranting psychiatric intervention for cases of CF among TCSs. Anxiety is a larger problem in TCSs than depression, particularly among the youngest TCSs.

Download Full-text

Relação do Tabagismo com Ansiedade e Depressão nos Cuidados de Saúde Primários

Acta Médica Portuguesa ◽

10.20344/amp.278 ◽

2013 ◽

Vol 26 (5) ◽

pp. 523

Author(s):

Helder Farinha ◽

Joana Raposo de Almeida ◽

Ana Rita Aleixo ◽

Hugo Oliveira ◽

Filomena Xavier ◽

...

Keyword(s):

Nicotine Dependence ◽

Treatment Options ◽

Depression Scale ◽

Tobacco Consumption ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Cross Sectional ◽

History Of ◽

Anxiety Depression ◽

History Of Depression

Introduction: Smoking prevalence in Portugal is estimated to be 19.7% (2005). Smoking is prevalent in anxiety disorders. Studies report that 60% of smokers have a history of depression. The Fagerström scale can be used to assess smoke dependence. The Hospital Anxiety and Depression Scale allows an estimate of anxiety and depression. Our goal was to find whether there is a relationship between smoking and anxiety / depression in eight clinics within primary care practice.Material and Methods: We designed an observational, descriptive, cross-sectional, analytical study. Anonymous survey. We considered as inclusion criteria the over 18 years of age and literate clinic users and as exclusion criteria the under 18 years old users or incomplete surveys. We defined as variables: Fagerström, Hospital Anxiety and Depression Scale, age, marital status, gender, profession, schooling.Results: We obtained a total of 608 valid surveys of which there were 64% women and 21% smokers. We found no differences in the prevalence of anxiety or depression when comparing non-smokers, ex-smokers and smokers. We found that the degree of nicotine addiction varies directly with anxiety and depression, however, the only statistically significant relationship observed was in women, even after correcting the effect of age.Discussion: There is a relationship between nicotine dependence and the severity of symptoms of anxiety and depression, most relevant in women. Limitation: selection bias.Conclusion: This study supplies information regarding psychological factors associated with tobacco consumption, allowing for its inclusion in treatment options for nicotine dependence.

Download Full-text

Anxiety and Depression among new entrants in a Medical College

Indian Journal of Community Health ◽

10.47203/ijch.2020.v32i01.012 ◽

2020 ◽

Vol 32 (1) ◽

pp. 57-61

Author(s):

Vikrant Prabhakar ◽

Amrit Virk ◽

Parmal Saini

Keyword(s):

Depression Scale ◽

Severe Depression ◽

Well Being ◽

Cross Sectional Study ◽

North India ◽

Anxiety And Depression ◽

Cross Sectional ◽

Medical College ◽

High Prevalence ◽

Anxiety Depression

Background: Depression is commonly reported by university students due to change in environment, academic demands, developing new relations and more financial freedom. If that professional course happens to be medical education, the transition is even more drastic. Studies have also shown that Quality of Life (QOL) is negatively affected by the presence of anxiety and depression. Aim: Present study aims to find the prevalence of anxiety, depression and stress among students who have recently joined medical college. Materials & Method: This cross-sectional study was undertaken at Private medical college in north India. Depression, Anxiety and Stress Scale (DASS) was used for the data collection. MBBS students who have joined the institution in August 2019 were included in the study. Statistical Analysis Used: Data was entered in excel and analysed using Statistical Package for Social Science (SPSS) Version 21. Result: We found that almost half of the students who participated in the study had scores above 10 (meaning thereby depressed) on the depression scale, with 23.5% of respondents showing moderate or severe depression. Two-third students experienced anxiety, with 20% students having severe to very severe anxiety. Stress levels amongst the students were also high, with 47% of the students reporting stress. 3.4% students experienced severe or very severe stress. Conclusion: Medical students have high prevalence of stress, anxiety and depression. It is recommended that medical colleges should implement appropriate and timely measures to address students’ well-being and offer comprehensive intervention and preventive programs to help students cope with this transition phase.

Download Full-text

Prevalence and Measurement of Anxiety and Depression in Working Nurses in Nepal: A Reflection of Professional Hazard in Low Income Nation

10.21203/rs.2.16888/v1 ◽

2019 ◽

Author(s):

Pramila Karki ◽

George W. B. J. Katwal ◽

Ayush Chandra ◽

Avinash Chandra

Keyword(s):

Low Income ◽

Rating Scale ◽

Mental Health Problems ◽

Strong Association ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Cross Sectional ◽

General Anxiety Disorder ◽

Validated Questionnaire ◽

Anxiety Depression

Abstract Background Anxiety, Depression is one of the under reported, underdiagnosed in Nepal though it is the leading cause of incapacitation and is the leading healthcare burden worldwide. The prevalence of anxiety, depression among health personnel is not reported. In this study we attempted to assess the incidence and impact of depression and anxiety in nurses who are working upfront in different hospitals.Method A cross-sectional study was carried out and the sample was collected from nurses working in different hospitals who had spent 6 months or more time as a working nurse in those hospitals. Prevalence of anxiety and depression was assessed using a structured validated questionnaire, The Hamilton Anxiety Scale (HAM-A) with a cut-off score for various levels of anxiety. Similarly, General Anxiety Disorder Questionnaires (GAD), Hamilton Depression Rating Scale (HAM-D) was used to assess depression and anxiety.Result The analysis of these different scales revealed that disabling anxiety prevailed at highest (43.6%) in nursing staff according to HAM-A scale. Moderate anxiety also seemed to be higher (>20%) in GAD questionnaire. The moderate to severe anxiety prevailed in majority of our study participants in all these scales (HAM-A, HAM-D, GAD). Interestingly, there seemed a strong association between HAM-A to GAD (p=0.008).Conclusions This is probably the first study of its kind that reports on the prevalence of anxiety, depression in the nurses who work in different hospitals in Nepal. We hope this study also depicts the mental health problems that the medical professionals are suffering in other nations as well.

Download Full-text

Anxiety and depression among caregivers of hemodialysis patients at the Indonesian national referral hospital

Medical Journal of Indonesia ◽

10.13181/mji.v27i4.2999 ◽

2018 ◽

Vol 27 (4) ◽

pp. 271-8

Author(s):

Lucky A. Bawazier ◽

Ignatius Stanley ◽

Wicensius Sianipar ◽

Suhardjono Suhardjono

Keyword(s):

Strong Predictor ◽

Total Duration ◽

Depression Scale ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Cross Sectional ◽

Hospital Anxiety Depression Scale ◽

Anxiety Depression ◽

National Referral Hospital ◽

Rule Out

Background: In Indonesia, chronic kidney disease (CKD) is primarily managed by hemodialysis (HD) because limited resources rule out the possibility of renal transplantation. HD patients are commonly accompanied by caregivers. However, most studies have neglected the health of caregivers, who play an important role in the survival of HD patients. This study aimed to determine the proportion of caregivers who suffer from anxiety and depression and the factors involved.Methods: This was a cross-sectional study involving 100 caregivers in the HD unit of Cipto Mangunkusumo Hospital, Jakarta. This study used the hospital anxiety depression scale (HADS) to determine the extent of anxiety and depression among caregivers. All caregivers were asked to fill out the questionnaire without assistance.Results: A total of 28% and 18% of caregivers were found to be anxious and depressed respectively. The caregiver’s relationship with the patient, whether the caregiver was being paid or unpaid, the total duration of care, and income were not associated with levels of anxiety and depression. However, the proportion of each 24-hour period spent on care was significantly associated with anxiety (p=0.037) and depression (p=0.015). The time spent on care every 24 hours was also a significant predictor of anxiety (p=<0.001) and depression (p=0.021).Conclusion: One-third of caregivers were found to be anxious and/or depressed. The time spent on care every 24 hours was a strong predictor of both anxiety and depression.

Download Full-text