Evaluation of Mood Changes AmongPeripartum Women at PKDAS Institute of Medical Science, Vaniyamkulam, Palakkad: A Prospective, Observational, Longitudinal Study

Background: The perinatal period is well established as an increased risk for development of serious mood disorders. Maternal mental health in developing countries gets less than its due attention. The present study was undertaken to evaluate mood changes in Peripartum period in our population and to identify demographic, obstetric, social and psychosocial risk factors associated with Peripartum depression using established scales.Material & Methods:A prospective, observational, longitudinal study conducted in PK das institute of medical science, vaniyamkulam, with 387 perinatal women for 12 months (February 2018– January 2019). Various scales EPDS (Edinburgh Postnatal Depression Scale), CMSS (Couple Marital Satisfaction Scale, IMS (Index of Marital Satisfaction), LES (Life Event Scale) were studied in Peripartum Period.Results:Among a total of 387 participants about half 189 (48.8%) were in 19-25 years of Age. Almost 30% and 40% had dissatisfied married life as per the CMS and IMS scales respectively. Just above 42% were screen positive for depression antenatally with EPDS & 39% (n = 151) in the immediate postpartum period. From these 151 screen positive cases in immediate postpartum period, 138 participants were followed up at 4-6 weeks (13 were lost to follow up) and up to 115 of 138 (83.3%) were screen positive for depression (N= 387, 29.7%), which was statistically significant (p<0.001). With EPDS during antenatal period there was no statistically significant relationship of depression with Education (p = 0.195), Occupation (p = 0.651) and pregnancy planned or unplanned (p = 0.223), whereas, Joint family, participants with dissatisfied marital relationship had increased risk of depression as evidenced by IMS and CMSS (p < 0.001). Participants with a previous male gender baby had less risk of developing depression (p< 0.001) & participants with previous 2 female children had increased risk of depression (p< 0.001).Conclusions:This study highlights importance of screening for maternal mental health problems during Peripartum period. Depression in immediate postpartum period is good predictor for increased risk of depression at 4-6 weeks postpartum.

Quarantine-related traumatic stress, views, and experiences during the first wave of Coronavirus pandemic: A mixed-methods study among adults in Saudi Arabia

Purpose Mental health is a significant problem following exposure to a traumatic event. This study aimed to examine quarantine-related experiences, traumatic stress, and coping strategies among adults quarantined in Saudi Arabia due to coronavirus disease 2019 (COVID-19) exposure or travel history. Methods Individuals aged ≥ 18 years who were quarantined in Saudi Arabia due to COVID-19 exposure or travel history were included. We used a sequential mixed methods design, using an online survey followed by in-depth individual telephonic interviews. The Impact of Event Scale-Revised (IES–R) was used to measure post-traumatic stress disorder (PTSD) symptoms after the quarantine. To identify factors associated with significant symptoms (IES–R score ≥ 33), prevalence ratios (PR) with 95% confidence intervals were computed using Poisson regression with robust error variance. In the next phase, a subset of the participants (n = 26) were interviewed to elicit their quarantine-related experiences and coping responses. Major themes and subthemes were identified. Results Of the 111 adults who completed the survey, 32 (28.8% [95% CI, 21.1–38.0%]) had significant PTSD symptoms (IES–R score ≥ 33) and 27 (24.3% [95% CI, 17.2–33.3%]) had severe symptoms (IES–R score > 37). Marital status was the only variable that was significantly associated with significant PTSD symptoms (P = 0.028). Significant symptoms were twice as prevalent in married adults than among other marital groups (PR 2.00, 95% CI, 1.08–3.72). Participants reported negative emotions such as overwhelming fear, helplessness, anxiety, and disgust. Participants utilized both problem-centered coping (e.g., use of social support) and emotion-centered coping (e.g., use of positive diversionary activities) during the quarantine period. Conclusion PTSD symptoms were present in one out of every four quarantined persons. The quarantine experience is viewed negatively. These findings highlight the need for increased awareness about stress-related disorders among quarantined individuals. Efforts are needed to detect and manage these symptoms early while making the quarantine experience more satisfying for the involved individuals and groups.

Post-traumatic stress symptoms in cancer patients during the COVID-19 pandemic: a one-year longitudinal study

Background: Cancer patients may be particularly vulnerable to psychological consequences of the COVID-19 pandemic and successive lockdowns. We studied the prevalence and evolution of post-traumatic stress disorder (PTSD) symptoms in cancer patients during the pandemic waves, and investigated factors associated with high symptoms. Methods: COVIPACT is a one-year longitudinal prospective study of French patients with solid/hematologic malignancy receiving treatment during the first nationwide lockdown. PTSD symptoms were measured every 3 months from April 2020 using the Impact of Event Scale-Revised. Patients also completed validated questionnaires on quality of life (QoL), cognitive complaints and insomnia, and a survey on their COVID-19 lockdown experience. Results: Longitudinal analyses involved 386 patients with at least one PTSD assessment after baseline (median age 63, 76% female). Among them, 21.5% had moderate/severe PTSD symptoms during the first lockdown. The rate of patients reporting PTSD symptoms decreased at lockdown release (13.6%), increased again at second lockdown (23.2%), and slightly declined from the second release period (22.7%) to the third lockdown (17.5%). Patients were grouped into three trajectories of evolution. Most patients had stable low symptoms throughout the period, 6% had high baseline symptoms slowly decreasing over time, and 17.6% had moderate symptoms worsening during second lockdown. Female sex, feeling socially isolated, worrying about COVID-19 infection, and using psychotropic drugs were associated with PTSD symptoms. PTSD symptoms were associated with impaired QoL, sleep and cognition. Conclusions: Around a quarter of cancer patients presented high and persistent PTSD symptoms over the first year of the COVID-19 pandemic and may benefit from psychological support.

Psychological Reactions of Hospital Workers to a Pandemic: A Comparison of SARS-CoV-2 in 2020 and SARS in 2003

Epidemic viral infections, including the outbreak of severe acute respiratory syndrome (SARS) in 2003 and SARS-CoV-2 in 2019, have brought tremendous loss to people across the nations. The aim of this study was to compare the psychological impact of the SARS-CoV-2 pandemic in 2020 and the SARS pandemic in 2003 on hospital workers. Hospital workers at a medical center in Southern Taiwan (n = 1816) were invited to complete questionnaires (SARS-CoV-2 Exposure Experience, the Impact of Event Scale, the Chinese Health Questionnaire, and the Distress Thermometer). The current data were compared to the data collected from hospital workers (n = 1257) at the same medical center during the SARS pandemic in 2003. We found the psychological impact on hospital workers during the SARS-CoV-2 pandemic was significantly lower than that during the previous SARS period. During the SARS-CoV-2 pandemic period, hospital workers with SARS experience were more accepting of the risk, felt a greater responsibility to take care of the SARS-CoV-2 patients, and were more likely to perceive the danger of becoming infected. The associated factors of psychiatric morbidity in hospital workers with SARS experience were being female, the degree of intrusion severity, and severity of psychological distress. Proper management strategies and lessons learned from the SARS experience might have led to low psychiatric morbidity during the SARS-CoV-2 pandemic.

Inter- and intra-event rainfall partitioning dynamics of two typical xerophytic shrubs in the Loess Plateau of China

Rainfall is known as the main water replenishment in dryland ecosystem, and rainfall partitioning by vegetation reshapes the spatial and temporal distribution patterns of rainwater entry into the soil. The dynamics of rainfall partitioning have been extensively studied at the inter-event scale, yet very few studies have explored its finer intra-event dynamics and the relating driving factors for shrubs. Here, we conducted a concurrent in-depth investigation of rainfall partitioning at inter- and intra-event scales for two typical xerophytic shrubs (Caragana korshinskii and Salix psammophila) in the Liudaogou catchment of the Loess Plateau, China. The event throughfall (TF), stemflow (SF), and interception loss (IC) and their temporal variations within the rainfall event as well as the meteorological factors and vegetation characteristics were systematically measured during the 2014–2015 rainy seasons. The C. korshinskii had significantly higher SF percentage (9.2 %) and lower IC percentage (21.4 %) compared to S. psammophila (3.8 % and 29.5 %, respectively) (p < 0.05), but their TF percentages were not significantly different (69.4 % vs. 66.7 %). At the intra-event scale, TF and SF of S. psammophila was initiated (0.1 vs. 0.3 h and 0.7 vs. 0.8 h) and peaked (1.8 vs. 2.0 h and 2.1 vs. 2.2 h) more quickly, and TF of S. psammophila lasted longer (5.2 vs. 4.8 h), delivered more intensely (4.3 vs. 3.8 mm∙h−1), whereas SF of C. korshinskii lasted longer (4.6 vs. 4.1 h), delivered more intensely (753.8 vs. 471.2 mm∙h−1). For both shrubs, rainfall amount was the most significant factor influencing inter-event rainfall partitioning, and rainfall intensity and duration controlled the intra-event TF and SF variables. The C. korshinskii with larger branch angle, more small branches and smaller canopy area, has an advantage to produce stemflow more efficiently over S. psammophila. The S. psammophila has lower canopy water storage capacity to generate and peak throughfall and stemflow earlier, and it has larger aboveground biomass and total canopy water storage of individual plant to produce higher interception loss compared to C. korshinskii. These findings contribute to the fine characterization of shrub-dominated eco-hydrological processes, and improve the accuracy of water balance estimation in dryland ecosystem.

Mental health status of COVID-19 survivors: a cross sectional study

Background Coronavirus disease-19 (COVID-19) is a communicable disease caused by a virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Pandemics are associated with the high level of mental stress. In many countries, general people reported the high level of depression, anxiety, psychological distress, post-traumatic stress disorder during recent a pandemic. This study aims to investigate the mental health status of people who survived through this alarming situation of COVID-19. Methods In this study, seventy individuals (either gender) between the age of 18–60 years, who contracted COVID-19 previously and then recovered as indicated by negative PCR results, were included. Data was collected by using three tools: impact of event scale (IES-R), patient health questionnaire-9(PHQ-9) and corona anxiety scale (CAS). People with other systemic/mental disorders, ongoing malignancies, upper/lower motor disorders and inability to give consent were excluded from the study. Results Mean age of participants was 26.29 + 11.79. All the 70 responders suffered from COVID-19. Among these 23 (32.9%) were asymptomatic and 47(67.1%) had common symptoms related to COVID-19 53 (75.7%) responders also had symptoms post-recovery. Most of the people who suffered COVID-19 had mild depression. Twenty-nine participants (41.4%) reported the highest impact of this traumatic event on their mental health. After suffering from COVID-19, 74.3% reported no anxiety as measured through corona anxiety scale (CAS). Conclusion High level of post-traumatic stress was seen among participants who recovered from COVID-19, especially those patients who were symptomatic. Mild depression and anxiety were also noted among them.

Increased psychological distress after the lifting of COVID-19 lockdown in the Saudi population: a cross-sectional study

Background Amid the ongoing COVID-19 pandemic and its global health and socioeconomic aftereffects, the enduring state of crisis is increasingly impacting the coping capacity of the populations. In this study, we aimed to characterize the levels of psychological distress after the lifting of COVID-19 lockdown. Results The Impact of Event Scale (IES-R) and Depression, Anxiety, and Stress Scales-21 items (DASS-21) were used to screen for post-traumatic stress syndrome (PTSD), depression, anxiety, and stress. The prevalence of PTSD was 41.6% and was associated with severe or extremely severe stress (27.8%), anxiety (31.4%), and depression (39.0%). All disorders were strongly correlated with one another. The risk of developing PTSD was independently associated with residence in high COVID-19 prevalence region (OR = 2.25, p = 0.004), poor (OR = 3.98, p = 0.002), or moderate (OR = 1.63, p = 0.048) self-assessed overall physical health, psychiatric comorbidity (OR = 1.87, p = 0.036), number of COVID-19-like symptoms (OR = 1.94, p = 0.039), and severe COVID-19 morbidity in the acquaintances (OR = 1.54, p = 0.026). Four theories were proposed to explain these high figures, with a discussion of their practical implications. Conclusions The lifting of lockdown measures was associated with a substantial increase in psychological distress among the Saudi population, referring to figures reported during the lockdown. This may indicate a decline in the overall population’s coping capacity with the enduring crisis.

Estimation of Prevalence and Comparing the Levels of Stress, Anxiety, Depression, and Psychological Impact Before and After COVID-19 Lockdown Among Front Line Health Care Workers

The main objective of the study is to estimate the prevalence and compare the levels of psychological impact, anxiety, depression, and stress experienced by the frontline health care workers (HCWs) during the lockdown and post lockdown periods at Apollo Institute of Medical Sciences and Research, Hyderabad, India. All participants involved in the study were evaluated by using depression, anxiety and stress scale 21, the impact of event scale revised scale for post-traumatic stress disorder (PTSD), and a standardized questionnaire. During the lockdown period, the score for depression was observed mean scores to be more in front desk people (2.70) followed by pharmacists and technicians (2.60) and security (2.28) in the lockdown period. During the lockdown, the highest levels of anxiety were seen in security staff (4.72) and housekeeping (4.8), with a considerable increase after the lockdown situation. During the lockdown period, the mean score of pharmacists and technicians (10.33) were more stressed than other HCWs, and the second-highest levels of stress were observed in security (10.11) and front desk workers (10.09), respectively. Our results show that there was a worsening of the psychological impact of the pandemic and an increase in PTSD, stress, anxiety, and depression among HCWs. Female gender, pharmacists, and technicians were the most vulnerable group to develop psychiatric comorbidities.

Personified program for correction of post-stress disorders in different categories of survivors (combatants and volunteers)

Combat stress has a significant impact on the individual. It is a major cause of combat mental trauma and stress disorders development. According to the World Health Organization, combat mental trauma is a direct cause of stress disorders in 80 % of survivors of hostilities, and in its long term are often observed: maladaptation, autoaggressive behavior, anxiety and depression, addiction. Against the background of use of the developed program, positive dynamics of mental state, decrease in levels of anxiety and depression, decrease in the level of groups of PTSD symptoms on the Impact of Event Scale were noted. Reducing level of maladaptation according to the method of K. Rogers and R. Diamond and level of social frustration. Thus, the developed personalized program for the correction of post-stress disorders contributes to the productive dynamics of psychopathological symptoms, reducing emotional tension, restoring a sense of psychological well-being, creating a new cognitive model of life.