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.

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.

PTSD and Depression in Healthcare Workers in the Italian Epicenter of the COVID-19 Outbreak

Background: Increasing evidence highlights the susceptibility of Healthcare Workers to develop psychopathological sequelae, including Post-Traumatic Stress Disorder (PTSD) and depression, in the current COronaVIrus Disease-19 (COVID-19) pandemic, but little data have been reported in the acute phase of the pandemic. Objective: To explore Healthcare Workers’ mental health reactions in the acute phase of the COVID-19 pandemic in the first European epicenter (Lodi/Codogno, Italy), with particular attention to post-traumatic stress and depressive symptoms and their interplay with other psychological outcomes. Methods: 74 Healthcare Workers employed at the Azienda Socio Sanitaria Territoriale of Lodi (Lombardy, Italy) were recruited and assessed by means of the Impact of Event Scale- Revised, the Professional Quality of Life Scale-5, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 item, the Resilience Scale and the Work and Social Adjustment Scale. Socio-demographic and clinical variables were compared across three subgroups of the sample (No PTSD, PTSD only, PTSD and depression). Results: A total of 31% of subjects endorsed a diagnosis of PTSD and 28.4% reported PTSD comorbid with major depression. Females were more prone to develop post-traumatic stress and depressive symptoms. Subjects with PTSD and depression groups showed high levels of PTSD, depression, burnout and impairment in functioning. Anxiety symptoms were higher in both PTSD and depression and PTSD groups rather than in the No PTSD group. Conclusion: Our results showed high rates of PTSD and depression among Healthcare Workers and their comorbidity overall being associated with worse outcomes. Current findings suggest that interventions to prevent and treat psychological implications among Healthcare Workers facing infectious outbreaks are needed.

Impact of Event Scale-6 (IES-6) for U.S. Adults Who Experienced the COVID-19 Pandemic

Background: Post-traumatic stress disorder (PTSD) is a mental illness caused by traumatic events, such as the COVID-19 pandemic. Accurate diagnosis of this disorder is critical to establish effective intervention approaches. The Impact of Event Scale-6 (IES-6) is widely used for PTSD screening, but there has been no research on its psychometric properties with individuals who experienced the COVID-19 pandemic.Methods: A random sample of 600 participants were randomly selected from a COVID-19 survey database (n = 6,391). Rasch analysis was conducted to examine item fit, rating scale structure, construct validity, differential item functioning (DIF), and precision of the IES-6. Results: The principal component analysis of Rasch residuals (54.1% of the raw variance explained) and the average of residual correlations (average r = .19) supported the unidimensionality structure in the IES-6. The rating scale was suitable, and the item difficulty hierarchy was logical. The item fit and the DIF contrast were acceptable, except for item 5. The IES-6’s person reliability was .76, which was also an acceptable level.Conclusions: This study showed that the IES-6 has acceptable item-level psychometrics for screening PTSD in adults in the United States for individuals who have experienced the COVID-19 pandemic. The findings suggested that the IES-6 would be useful for the rapid identification of PTSD and allow clinicians to quickly provide interventions for people with the disorder and their families.

The NICU during COVID-19 pandemic: impact on maternal pediatric medical traumatic stress (PMTS)

Objective: to assess how hospital and outpatient clinic policy changes due to COVID-19 pandemic impact on pediatric medical traumatic stress (PMTS) symptoms in mothers of newborns admitted in a NICU. Study design: observational case control study enrolling mothers of infants admitted in the NICU at birth during Covid-19 pandemic compared with mothers of infants admitted in the NICU before the COVID pandemic. Control group was selected matching 1:1 with study group for following infants’ clinical variables: gender, type of pathology, gestational age, weight at birth, day of recovery, ventilator time days, associated malformations. Italian version of the Impact of Event Scale—Revised (IES-R) was used as a measure of PMTS. Result: Mothers of study group (50) scored significantly higher than mothers of control group on three of four scales of IES-R (respectively, “IES-R Total”: F= 6.70; p= .011; IES-R subscale “Intrusion”: F= 7.45; p= .008; IES-R subscale “Avoidance”: F= 8.15; p= .005). A significantly higher number of mothers in study group scored above the IES-R total clinical cut-off compared to mothers of control group (72% vs 48%; Chi2=6.00; p=.012). Conclusion: The COVID-19 pandemic acted as a superimposed stress in mothers of newborn admitted in the neonatal intensive care unit at birth determining high levels of PMTS. Clinicians and researchers should identify and implement novel strategies to provide family-centered care during Covid-19 pandemic and beyond.

Evaluation of the Changes in Mental Health State at the Beginning of COVID-19 in Hospital Personnel

Objective: In the present study, it was aimed to determine the changes in the mental states of hospital personnel at the beginning of COVID-19 pandemic, and the factors affecting these changes. Methods: The research sample consisted of 299 hospital personnel in Turkey, who could be reached with the online method. The data were collected using the “Information Form”, which was prepared in line with the literature and the pandemic process, “The Impact of Event Scale (IES)” and the “Depression-Anxiety-Stress Scale (DAS-21)”. Results: It was found that the sociodemographic characteristics, medical history, and the characteristics related to COVID-19 were effective on the participants in terms of their mental states and the way they perceived traumatic experiences. According to the multiple linear regression analyses, it was found that hyper arousal and reexperiencing predicted stress, anxiety, and depression with a rate of 58.5%, 59.0% and 60.6%, respectively. Conclusion: At the beginning of the pandemic, it was observed that the responses of frontline hospital employees to traumatic experiences affected their mental states. Psychiatric nurses should take an active role in the development and implementation of psychosocial support programs for hospital personnel. Bangladesh J Medicine July 2022; 33(1) : 19-26

Personal experience, posttraumatic symptomatology, and meaning in life during the first months of the COVID-19 pandemic

Background The traumatic subjective distress and personal meaning in life were examined in the context of the first months of the COVID-19 pandemic sanitary crisis and home lockdown. Method: A total of 543 participants answered an online survey that included questions about the individual characteristics of the pandemic experience, the Impact of Event Scale-Revised, and the Personal Meaning Profile-Brief. Results: Nearly all of life impaired areas, having the suspicion of being ill with COVID-19, having lost a close person to this virus, and having been accompanied during the lockdown were experiences associated with higher PTSD symptoms. Posttraumatic symptomatology was inversely correlated with areas of meaning in life. Lastly, a higher number of affected areas and a negative subjective lockdown circumstance explained greater total PTSD symptoms. Conclusion: Specific pandemic experiences and lockdown circumstances affected the presence of posttraumatic symptoms. The personal meaning of life seems to be involved in the process of less adverse traumatic consequences.