Mental Health Status of Late-Middle-Aged Adults in China During the Coronavirus Disease 2019 Pandemic

Background: The novel coronavirus 2019 (COVID-19) pandemic and related compulsory measures have triggered a wide range of psychological issues. However, the effect of COVID-19 on mental health in late-middle-aged adults remains unclear.Methods: This cross-sectional, web-based survey recruited 3,730 participants (≥ 50 years old) between February 28 and March 11 of 2020. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale were used to evaluate depression, anxiety, insomnia, and acute stress symptoms. Multivariate logistic regression analysis was fitted to explore risk factors that were associated with the selected outcomes.Results: The mean age of the participants was 54.44 ± 5.99 years, and 2,026 (54.3%) of the participants were female. The prevalence of depression, anxiety, insomnia, and acute stress symptoms among late-middle-aged adults in China during the COVID-19 pandemic was 20.4, 27.1, 27.5, and 21.2%, respectively. Multivariable logistic regression analyses showed that participants who were quarantined had increased odds ratios for the four mental health symptoms, and those with a good understanding of the COVID-19 pandemic displayed a decreased risk for all mental health symptoms among late-middle-aged adults. In addition, participants with a low income and with a risk of COVID-19 exposure at work had a remarkably high risk of depression, anxiety, and acute stress symptoms.Conclusions: Mental health symptoms in late-middle-aged adults in China during the COVID-19 pandemic are prevalent. Population-specific mental health interventions should be developed to improve mental health outcomes in late-middle-aged adults during this public health emergency.

Acute Stress Symptoms After Forcible and Substance-Involved Rapes

In the early aftermath of a sexual assault, survivors often experience symptoms of distress including reexperiencing, avoidance, and hyperarousal symptoms. However, less is known about associations between rape characteristics and the nature of early reactions. We designed the current study to examine the unique and combined associations between use of force and substances during rape on acute stress symptoms. Participants were 56 women (ages 18–58) who completed a sexual assault medical forensic exam in the emergency department within 120 hours of the rape and then completed a follow-up clinical phone screening within 30 days of the forensic exam. Follow-up assessments included characteristics of the recent rape (force, substances), history of prior sexual assault, demographics, and symptoms of acute stress. Multivariate regression analyses revealed that, after controlling for prior sexual assault, sexual orientation, and race/ethnicity, there were no significant differences on any symptom cluster by rape type. However, this study involved a small, difficult-to-reach sample and, therefore, was only powered to detect large effect sizes. We encourage more research examining potentially unique, early symptom presentations for substance-involved rapes.

Assessing acute psychological distress in the immediate aftermath of stroke

Background and purpose: High acute stress may presage the development of subsequent cardiovascular ailments. Understanding how best to assess acute stress may inform early interventions seeking to prevent long-term morbidity/mortality following stroke. A mixed methods approach examined early post-stroke acute stress symptoms using the post-traumatic stress disorder checklist-5 (PCL-5) and the acute stress disorder scale (ASDS). Methods: A focus group of stroke survivors and/or their caregivers ( N=8) evaluated PCL-5/ASDS feasibility, and 20 patients hospitalized for acute stroke were interviewed 2–10 days post-stroke onset, using either the PCL-5 or the ASDS. Results: Acute stress symptoms were present and measurable during acute stroke recovery. Assessment of acute stress in hospitalized patients with stroke is feasible; a briefer modified ASDS has advantages over the PCL-5. Conclusions: The ASDS is a viable and useful measure for assessing psychological distress during the acute post-stroke aftermath. Findings suggest that acute stress symptoms are present among patients with stroke, warranting greater attention to psychological responses in the early post-stroke period. Given that acute stress has serious potential long-term health consequences, additional research on stroke-related acute stress may prove useful for understanding post-stroke morbidity/mortality.