Elevated depression and anxiety among pregnant individuals during the COVID-19 pandemic

Mental health problems are common in pregnancy, typically affecting between 10-25% of pregnant individuals. Elevated symptoms of depression and anxiety can negatively impact both the pregnant individual and developing fetus. The current COVID-19 pandemic is a unique stressor with potentially wide-ranging consequences for pregnancy and beyond. We assessed symptoms of anxiety and depression among pregnant individuals during the current COVID-19 pandemic and determined factors that were associated with psychological distress. 1987 pregnant participants were surveyed across Canada in April 2020. The assessment included questions about COVID-19-related stress and standardized measures of depression, anxiety, pregnancy-related anxiety, sleep and social support. We found substantially elevated psychological distress compared to similar pre-pandemic pregnancy cohorts, with 37% reporting clinically relevant symptoms of depression, 57% reporting clinically relevant symptoms of anxiety, and 68% reporting elevated pregnancy-related anxiety. Higher levels of social support and longer sleep duration were associated with lower psychological symptoms across domains. This study shows concerningly elevated levels of psychological distress among pregnant individuals during the COVID-19 pandemic, that may have long-term impacts on their children. Potential intervention targets are needed in addition to improving protective factors related to increased social support and sleep -- these should be urgently considered to mitigate long-term negative outcomes.

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Prevalent, Incident, and Persistent Insomnia in a Population-Based Cohort Tested Before (2018) and During the First-Wave of COVID-19 Pandemic (2020)

SLEEP ◽

10.1093/sleep/zsab258 ◽

2021 ◽

Author(s):

Charles M Morin ◽

Lydi-Anne Vézina-Im ◽

Hans Ivers ◽

Jean-Arthur Micoulaud-Franchi ◽

Pierre Philip ◽

...

Keyword(s):

Mental Health ◽

Social Support ◽

Sleep Quality ◽

Large Scale ◽

Mental Health Problems ◽

Psychological Symptoms ◽

Population Based ◽

Lifestyle Changes ◽

Anxiety And Depression ◽

Lower Social Support

Abstract Study Objectives High rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018). Methods Data were derived from a longitudinal, population-based study of insomnia in Canada. When the first lockdown started in the province of Quebec, a subsample of participants who had completed the latest 2018 follow-up were surveyed (April-May 2020) about their sleep, insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence, incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive symptoms were estimated, as well as their associations with confinement, loneliness, social support, use of electronics, and other lifestyle changes occurring during the pandemic. A sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue, anxiety, and depression were administered at both assessments. Results The sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women). Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19% (syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rates. Of those classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence rate was 76.5% two years later. There was a significant worsening of sleep quality, fatigue, anxiety and depression (all ps < 0.005) during the COVID-19 pandemic compared to 2018. Significant associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced physical exercise, and higher financial stress. Conclusions The COVID-19 pandemic is associated with significant increases in insomnia and psychological symptoms compared to the pre-pandemic period. Large scale public sleep and mental health intervention programs should be prioritized during and after a pandemic such as the the COVID-19.

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Emotion regulation difficulties and interpersonal problems during the COVID-19 Pandemic: Predicting anxiety and depression

10.31234/osf.io/g5d8r ◽

2021 ◽

Author(s):

Ole Andre Solbakken ◽

Omid V. Ebrahimi ◽

Asle Hoffart ◽

Jon T. Monsen ◽

Sverre Urnes Johnson

Keyword(s):

Mental Health ◽

Emotion Regulation ◽

Mental Health Problems ◽

Interpersonal Problems ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Social Distancing ◽

Symptoms Of Depression ◽

Interpersonal Difficulties ◽

The Impact

Background: Central components of psychological functioning, such as difficulties in emotion regulation and interpersonal problems are likely to have been substantially impacted by COVID-19 and the amelioration measures of societal lock-down and social distancing. In turn, these factors are likely to predict mental health outcomes, such as symptoms of depression and anxiety throughout the pandemic and beyond. Methods: To investigate this issue, we conducted an internet-based survey with 10,061 responders at the height of lock-down (T1). After social distancing measures had been eased (T2), 4,936 responders (49.1%) completed the survey again. Results: Emotion regulation difficulties, interpersonal problems, and symptoms of depression and anxiety decreased from T1 to T2, but changes were minor. After controlling for age and gender, emotion regulation- and interpersonal difficulties were associated with anxiety and depression throughout the study period, and changes in all domains occurred in concert. More extensive problems with emotion regulation at T1 predicted greater reductions in both symptom domains as amelioration measures were eased, while the converse was true for interpersonal problems. Furthermore, the impact of initial emotion regulation difficulties on subsequent changes in both anxiety- and depressive symptoms was dependent on the level of interpersonal difficulties, so that high interpersonal problem load at T1 reversed the effect of emotion regulation difficulties on symptom development. Conclusions: The results suggest that emotion regulation- and interpersonal difficulties are highly central to mental health during the pandemic, and may be important targets for remediation to reduce mental health problems throughout the course of the pandemic and beyond.

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Impact of Longitudinal Social Support and Loneliness Trajectories on Mental Health during the COVID-19 Pandemic in France

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312677 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12677

Author(s):

Sandy Laham ◽

Leticia Bertuzzi ◽

Séverine Deguen ◽

Irwin Hecker ◽

Maria Melchior ◽

...

Keyword(s):

Mental Health ◽

Social Support ◽

Mental Health Problems ◽

Health Problems ◽

Health Study ◽

Depression And Anxiety ◽

Linear Regression Models ◽

Symptoms Of Depression ◽

Common Mental Health Problems ◽

Mental Health Study

(1) Background: Little is known about how the COVID-19 pandemic has impacted social support and loneliness over time and how this may predict subsequent mental health problems. This study aims to determine longitudinal trajectories of social support and loneliness in the French general population during the first year of the COVID-19 pandemic and study whether variations in these trajectories are associated with symptoms of depression and anxiety; (2) Methods: Analyses were based on data from 681 French participants in the international COVID-19 Mental Health Study (COMET) study, collected at four periods of time between May 2020 and April 2021. Group-based trajectory modelling (GBTM) was used to determine social support and loneliness trajectories. Associations between the identified trajectories and symptoms of depression and anxiety, measured with the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7), were tested through multivariate linear regression models; (3) Results: Social support trajectories revealed four stable groups: ‘poor’ (17.0%), ‘moderate’ (42.4%), ‘strong’ (35.4%) and ‘very strong’ (5.1%). Loneliness trajectories also identified four groups: ‘low stable’ (17.8%), ‘low rising’ (40.2%), ‘moderate stable’ (37.6%) and ‘high rising’ (5.0%). Elevated symptoms of depression were associated with poor social support as well as all identified loneliness trajectories, while high levels of anxiety were associated with moderate stable and high rising loneliness trajectories; (4) Conclusions: High and increasing levels of loneliness are associated with increased symptoms of depression and anxiety during the pandemic. Interventions to address loneliness are essential to prevent common mental health problems during the pandemic and afterwards.

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The Moderating Impact of Social Support Following Childhood Sexual Abuse

Violence and Victims ◽

10.1891/0886-6708.7.2.173 ◽

1992 ◽

Vol 7 (2) ◽

pp. 173-186 ◽

Cited By ~ 58

Author(s):

Maria Testa ◽

Brenda A. Miller ◽

William R. Downs ◽

Denise Panek

Keyword(s):

Social Support ◽

Sexual Abuse ◽

Treatment Group ◽

Childhood Sexual Abuse ◽

Mental Health Problems ◽

Comparison Group ◽

Psychological Symptoms ◽

Self Esteem ◽

The Impact

The role of social support in moderating the impact of childhood sexual abuse on adult psychological adjustment was examined. Subjects included 475 women, age 18-45, some of whom were currently receiving treatment, others who were not. Women in the treatment group were receiving therapy for either alcoholism, for being battered, or for mental health problems. The comparison group was drawn from two sources: a random household sample and a sample of women attending drinking driver classes. Among both groups, women who had been sexually abused exhibited more psychological symptoms and lower self-esteem compared to those who were not abused. Latency of disclosure of childhood sexual abuse had no impact on long-term consequences of the abuse for either the treatment or the comparison group. However, among women in the comparison group, those who experienced supportive reactions following disclosure of sexual abuse had fewer psychological symptoms and somewhat higher self-esteem relative to those who did not receive support. Social support had no apparent effect on the long-term adjustment of women in the treatment group. Possible explanations for this pattern and directions for future research are discussed.

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The effectiveness of telephone-delivered psychological therapies for depression and anxiety: A systematic review

Journal of Telemedicine and Telecare ◽

10.1177/1357633x16686547 ◽

2016 ◽

Vol 24 (2) ◽

pp. 65-74 ◽

Cited By ~ 11

Author(s):

Anna E Coughtrey ◽

Nancy Pistrang

Keyword(s):

Mental Health Problems ◽

Assessment Tool ◽

Psychological Symptoms ◽

Public Health Practice ◽

Depression And Anxiety ◽

Symptoms Of Depression ◽

Psychological Therapies ◽

Quasi Experimental ◽

Common Mental Health Problems ◽

Randomised Controlled

Objectives The telephone is increasingly used to deliver psychological therapies for common mental health problems. This review addressed the following question: are evidence-based psychological therapies for adults with depression and/or anxiety effective in reducing psychological symptoms when delivered over the telephone? Method A systematic search for articles published over a 25-year period (January 1991–May 2016) was performed using the databases PsycINFO, PubMed and Web of Science. Citation searches, manual searches of bibliographies of relevant papers, and hand searches of key journals were also conducted. The quality of the studies included for review was assessed using the Effective Public Health Practice Project Quality Assessment Tool. Results Fourteen studies met inclusion criteria for the review. Ten reported findings from telephone treatment for depression and four for anxiety. Nine studies used randomised controlled designs, two used quasi-experimental designs and three used uncontrolled designs. Thirteen studies reported reductions in symptoms of depression or anxiety. Cohen’s d ranged from 0.25–1.98 (median = 0.61) for controlled studies and from 1.13–1.90 (median = 1.26) for uncontrolled studies. Only four studies reported clinically significant change. Conclusions The findings indicate that telephone-delivered interventions show promise in reducing symptoms of depression and anxiety. Further research is required to establish the types of interventions that are most effective and the characteristics of clients who find them beneficial.

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The effect of psychological distress on IVF outcomes: Reality or speculations?

PLoS ONE ◽

10.1371/journal.pone.0242024 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0242024

Author(s):

Gulzhanat Aimagambetova ◽

Alpamys Issanov ◽

Sanja Terzic ◽

Gauri Bapayeva ◽

Talshyn Ukybassova ◽

...

Keyword(s):

Psychological Distress ◽

Pregnant Women ◽

Success Rate ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Stress Scale ◽

Ivf Outcomes ◽

Global Stress ◽

Related Stress ◽

Simple Logistic

Introduction Infertility is a problem that affects millions of people worldwide. The aim of this study was to assess the effect of stress, depression and anxiety on the IVF outcomes in Kazakhstan. Methods The prospective cohort study was performed using questionnaires to assess psychological distress in 304 infertile female in three different cities in Kazakhstan. Results The average age of participants was 33.7 years with infertility duration of 5.9 years. Regarding stress, depression and anxiety we found that more than 80% of all respondents had CES-D score higher than 16, indicating that they are at risk of developing clinical depression. On average, FPI subscales’ scores, global stress score and anxiety scale (STAI-S and STAI-T) scores were statistically significantly higher among not pregnant women than pregnant women. Similarly, in simple logistic regression analysis all FPI subscales scores, global stress scale score and anxiety scales’ scores were negatively associated with clinical pregnancy. Conclusion Rates of stress, anxiety and depression among IVF patients are higher than in general population. If the level of infertility-related stress is higher, IVF success rate is lower. Findings of our study indicate the need for the specific psychological interventions for all infertility women, to improve IVF success rate.

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Moderating Roles of Resilience and Social Support on Psychiatric and Practice Outcomes in Nurses Working During the COVID-19 Pandemic

SAGE Open Nursing ◽

10.1177/23779608211024213 ◽

2021 ◽

Vol 7 ◽

pp. 237796082110242

Author(s):

Anna E. Schierberl Scherr ◽

Brian J. Ayotte ◽

Marni B. Kellogg

Keyword(s):

Mental Health ◽

Social Support ◽

Online Survey ◽

Psychological Symptoms ◽

The United States ◽

Direct Care ◽

Behavioral Measure ◽

Hierarchical Regression ◽

Research Reporting ◽

Symptoms Of Depression

Introduction Staff and equipment shortages and an easily transmissible virus make working in the COVID-19 pandemic demanding physically and psychologically. Nurses on the frontlines are particularly vulnerable to the adversity of working under these conditions, particularly with regard to mental health. Thus, understanding risk and protective factors for this vulnerable and essential group is critical for identifying potential targets of interventions. We had two aims for the current study: (a) to examine work functioning and symptoms of depression, anxiety, and posttraumatic stress (PTSD) among nurses who did and did not care for patients with COVID-19; and (b) to determine if resilience and social support moderate these relationships. Methods For three weeks in July 2020, nurses across the United States were invited to participate in an online survey collecting data on demographics, resilience, social support, and screening measures of depression, PTSD, anxiety, and distracted practice. Data were analyzed using descriptive statistics and hierarchical regression for each outcome measure. Conclusions Our findings support a growing body of research reporting that nurses are experiencing mental health sequelae during the COVID-19 pandemic, especially those providing direct care to patients with the virus. We found that compared to nurses who did not care for patients with COVID-19, those who did reported increased symptoms of PTSD, depression, and anxiety. A novel contribution is our finding that nurses providing direct COVID-19 care also experienced increased levels of distracted practice, a behavioral measure of distraction linking to a potential impact on patient care. We also found that resilience and social support acted as moderators of some of these relationships. Fostering resilience and social support may help buffer the effects of providing care to patients with COVID-19 and could potentially decrease nurse vulnerability to developing psychological symptoms and impairment on the job.

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COVID-19 pandemic related long-term chronic stress on the prevalence of depression and anxiety in the general population

BMC Psychiatry ◽

10.1186/s12888-021-03385-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tian Qi ◽

Ting Hu ◽

Qi-Qi Ge ◽

Xiao-Na Zhou ◽

Jia-Mei Li ◽

...

Keyword(s):

Mental Health ◽

General Population ◽

Chronic Stress ◽

Protective Factor ◽

Mental Health Problems ◽

Anxiety Symptoms ◽

Binary Logistic Regression Analysis ◽

Depression And Anxiety ◽

Factors Associated

Abstract Background The COVID-19 pandemic has lasted for more than 1 year, causing far-reaching and unprecedented changes in almost all aspects of society. This study aimed to evaluate the long-term consequences of the COVID-19 pandemic on depression and anxiety, and explore the factors associated with it. Methods A cross-sectional study using an online survey was conducted to assess mental health problems from February 2 to February 9, 2021 by using patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7). The insomnia severity index (ISI), demographic data and COVID-19 related variables were measured by a self-designed questionnaire. The factors associated with depressive and anxiety symptoms were identified by Pearson chi-square test and binary logistic regression analysis. Results In the study that 1171 participants enrolled, the overall prevalence of depressive and anxiety symptoms among general people was 22.6 and 21.4% respectively in the present study. Living alone was a potential risk factor for depressive symptoms, while regular exercises was a potential protective factor. The prevalence of depressive and anxiety symptoms was significantly associated with the severity of insomnia symptoms and the negative feelings about pandemic. Conclusion COVID-19 pandemic- related chronic stress has brought about profound impacts on long-term mental health in the general population. The level of insomnia and a negative attitude towards the pandemic are significantly correlated with unfavorable mental health. However, we failed to found a significant association of age and gender with the mental health symptoms, although they were recognized as well-established risk factors during the outbreak by some other studies. This discrepancy may be because the acute and chronic effects of the pandemic are influenced by different factors, which reminds that more attention should be paid to the intrinsic psychological factors and physical reactions towards COVID-19.

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Sleep patterns and symptoms of anxiety and depression in patients with chronic pain

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000100007 ◽

2009 ◽

Vol 67 (1) ◽

pp. 25-28 ◽

Cited By ~ 28

Author(s):

Martha M.C. Castro ◽

Carla Daltro

Keyword(s):

Chronic Pain ◽

Sleep Disturbances ◽

Myofascial Pain ◽

Depression Scale ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Sleep Patterns ◽

Symptoms Of Depression ◽

High Prevalence ◽

The Mean

BACKGROUND: Sleep disturbances and symptoms of anxiety and depression have been shown to be involved in the genesis and perpetuation of chronic pain. OBJECTIVE: To evaluate sleep patterns and the prevalence of symptoms of anxiety and depression in patients with chronic pain. METHOD: Four hundred consecutive patients referred to a chronic pain outpatient clinic were investigated using patient charts, the numerical Visual Analogue Scale for the evaluation of pain, the Hospital Anxiety and Depression scale and the Mini-Sleep Questionnaire. RESULTS: The mean age of patients was 45.6±11.4 years. The most frequent medical diagnosis was myofascial pain followed by neuropathic pain. The prevalence of symptoms of anxiety was 72.8%, depression 93% and altered sleep patterns 93%. CONCLUSION: This study revealed a high prevalence of symptoms of depression and anxiety and alterations in sleep patterns in patients with chronic pain, justifying investigation into these disturbances in this group of patients.

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Depression and anxiety at time of implantable cardioverter defibrillator implantation and the biological link with cardiovascular disease

EP Europace ◽

10.1093/europace/euab116.331 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

ACJ Van Der Lingen ◽

MT Rijnierse ◽

AM Hooghiemstra ◽

S Elshout ◽

VP Van Halm ◽

...

Keyword(s):

Psychological Distress ◽

Autonomic Function ◽

Nyha Class ◽

Functional Class ◽

Depression And Anxiety ◽

Icd Implantation ◽

Symptoms Of Depression ◽

Nyha Functional Class ◽

Inflammatory Status ◽

Cardiac Status

Abstract Funding Acknowledgements Type of funding sources: None. Background Psychological distress, such as symptoms of anxiety and depression, are frequently present in patients receiving an implantable cardioverter defibrillator (ICD) and they are associated with adverse outcomes. Multiple pathophysiological mechanisms may explain the link between psychological distress and cardiovascular disease, such as autonomic dysfunction, neuro-endocrine alterations and chronic inflammation. Purpose The present study aims to examine the prevalence of psychological distress at time of ICD implantation and evaluates the complex interplay between psychological distress, autonomic function, neuro-endocrine alterations and inflammatory status in ICD patients. Methods We conducted a prospective study that included ICD patients receiving an ICD for primary and secondary prevention of sudden cardiac death. Prior to implantation, patients underwent extensive psychological evaluation, including validated questionnaires for depression, anxiety and personality traits. Cardiac status was evaluated by left ventricular ejection fraction (LVEF) assessment, New York Heart Association (NYHA) functional class evaluation, 6-minute walk test (6MWT), and 24-hour Holter monitoring for heart rate variability (HRV). Thyroid function, catecholamine levels and inflammatory status were also evaluated. Results Of 178 patients included (age 64 ± 12, 79% male, LVEF 35 ± 13%), 35% had symptoms of depression and 32% had symptoms of anxiety. Symptoms of depression and anxiety increased significantly with higher NYHA functional class (P < 0.001). Depressive symptoms were associated with a reduced 6MWT (411 ± 128 m versus 488 ± 89 m, P < 0.001), lower LVEF (29 ± 9% versus 36 ± 13%, P = 0.03), higher heart rate (74 ± 13 bpm versus 70 ± 13 bpm, P = 0.02), higher thyroid stimulating hormone levels (1.8 [1.3-2.8] mU/L versus 1.5 [1.0-2.2] mU/L, P = 0.04) and multiple HRV parameters, indicating reduced HRV. Anxiety symptoms were only associated with a reduced 6MWT (433 ± 112 m versus 477 ± 102, P = 0.02). Symptoms of depression or anxiety were not correlated with c-reactive protein, NT-proBNP or catecholamine levels. Conclusion A substantial part of ICD patients has symptoms of depression and anxiety at time of ICD implantation. Depression was correlated with a higher NYHA class, reduced exercise capacity, reduced LV-function and alterations in autonomic function, suggesting a biological link between depression and cardiac status. Whether depression and anxiety leads to an increase in ventricular arrhythmias will be determined during further follow-up. Abstract Figure. NYHA class and psychological distress

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