Factors associated with anxiety and post-traumatic stress symptomatology during the COVID-19 pandemic in Turkey: A comparison of youths and adults

BackgroundIndividuals with psychosis and comorbid posttraumatic stress disorder (PTSD) typically present with more severe forms of illness. Subthreshold posttraumatic stress symptoms (PTSS) are also likely to cause significant distress. There is a need to enhance screening processes for distressing PTSS to encourage appropriate referral to specialized services. The PTSD checklist for DSM-5 (PCL-5) is a widely used self-report to assess PTSS, though there is concern regarding its validity for use in psychosis. If people scoring in the severe PTSS range on the PCL-5 also present with clinical profiles similar to those typically meeting diagnosis for PTSD, it will justify considering a broader range of PTSS and support the use of the PCL-5 as a brief screener. A severe range will arguably capture a wider array of individuals, including those with subthreshold PTSS who also likely require trauma-focused intervention.MethodsOne hundred and two individuals with psychosis completed the PCL-5 and a battery of clinical scales as part of an intake evaluation following referral for psychological follow-up at a clinic specializing in psychosocial interventions for psychosis. Prevalence and type of DSM-5 criterion A event were explored in conjunction with PTSS severity and referral-type. Pearson correlations identified clinical variables associated with PCL-5 total scores and were subsequently entered into a multivariate analysis of variance (MANOVA) with dichotomized PTSS severity categories (low, moderate, severe). Post hoc analyses explored significant interactions.ResultsOf the 102 participants, 21.6% reported no prior trauma and 14.7% reported non-valid events. Sixty-five participants were included in the analysis; 6.2% of which were referred for trauma. 81.5% reported criterion A events, 10.8% reported psychosis-related events, and 7.7% did not disclose an event. PCL-5 scores were dichotomized using the 33rd and 66th percentiles, translating into low (≤ 24), moderate (25–47), and severe (≥48) groups. Delusion severity and subjective stress, anxiety, depression, social anxiety, quality of life (QoL), and wellbeing were entered into a one-way MANOVA with PTSS severity groups. Significant main effects surviving Bonferroni correction emerged for all variables except delusion severity (F(2,40) = 3.06, p = .058) and wellbeing (F(2,56) = 1.50, p =.233). Stress (F(2,62) = 7.37, p = .001) was higher in the severe (M = 13.13, SD = 5.18) versus low group (M = 7.05, SD = 4.40, p = .001). Anxiety (F(2,62) = 8.02, p = .001) was also higher in the severe (M = 12.30, SD = 5.07) compared to low group (M = 5.85, SD = 5.06, p = .000), and depression (F(2,62) = 5.37, p = .007) was additionally higher in the severe (M = 12.61, SD = 5.73) compared to low group (M = 7.20, SD = 4.97, p = .005). Finally, social anxiety (F(2,58) = 4.25, p = .026.) was higher in the severe (M = 7.76, SD = 3.58) versus low group (M = 4.68, SD = 3.68, p = .029), while QoL (F(2,58) = 3.47, p = .038) was lower in the severe (M = 49.95, SD = 10.99) compared to low group (M = 58.95, SD = 13.76, p = .037).DiscussionDue to a relatively high number of invalid questionnaires (14.7%), service users should likely complete the PCL-5 in the presence of a health-care practitioner. Findings suggest inadequate referral rates for specialized services when they may indeed benefit the service-user. Severe PTSS was associated with increased symptoms of subjective anxiety, depression, stress, social anxiety, and decreased QoL, regardless of whether diagnostic criteria for PTSD was met. A severe PTSS category likely captures a broader range of individuals requiring specialized intervention and speaks to an important need to both facilitate and increase referral rate for trauma-focused therapy.

The American Cancer Society (ACS) estimates that 284,200 new cases of breast cancer will be diagnosed in 2021. According to the Texas Cancer Registry (TCR) an estimated 18,277 of those new diagnoses of female breast cancer will be made in the state of Texas. Studies have found that between 5% and 35% of breast cancer patients in the United States will develop diagnosable posttraumatic stress disorder (PTSD) or significantly impairing PTSD symptoms. The goal of the study was to gather data related to the presence of PTSD symptoms in a sample of West Texas female breast cancer patients. The proposed study aimed to:. (1)Determine the prevalence of PTSD in a sample of female, West Texas breast cancer patients(2)Identify elements of a breast cancer diagnosis and breast cancer treatment that may contribute to, or exacerbate these PTSD symptoms. Our sample consistent of 78 female breast cancer patients collected from a university medical center-affiliated cancer center in the West Texas region. The PTSD Checklist for DSM-5 (PCL5) was used to determine if a participant met diagnostic criteria for PTSD or fulfilled diagnostic criteria for any of the four symptom clusters – intrusive symptoms, avoidance symptoms, negative symptoms, and hyperarousal symptoms. PCL5 scores were then compared to a range of demographic variables including age, marital status, educational level, menopausal status, tobacco and alcohol use, time since diagnosis, as well as treatment modalities used. Further, PCL5 scores were compared to Her2, ER, and PR status of the tumor as well as clinical stage. Patients meeting criteria for PTSD and those with significant symptoms in distinct symptom clusters The only multi-group categorical variable that showed a significant relationship was lifetime tobacco use (F(2,75) = 4.97, p = 0.009) which showed a relationship such that current smokers were found to have higher PCL5 scores that either participants that were past smokers or those that had never smoked. Further, menopausal status (pre-menopausal versus post-menopausal) did was found to be related to PCL5 scores such that pre-menopausal women were found to have significantly higher PCL5 scores than post-menopausal women (t(71) = 2.558, p = 0.42). Living arrangement (alone or with others) was similarly, significantly related to PCL5 scores such that women living with others were found to have higher PCL5 scores than those living alone (t(74) = -1.904, p = .002). Receiving chemotherapy treatment or not was similarly related to PCL5 scores such that those that underwent chemotherapy treatment were found to have higher PCL5 scores (t(76), = -2.381, p = .008). HER2 positive status was also found to be related to PCL5 scores, such that HER2 positive patients were found to have higher PCL5 scores than HER2 negative patients (t(74) = -2.429, p = .001). While other samples identified larger percentages of diagnosable PTSD, our sample did find a percentage of patients with diagnosable PTSD consistent with the lower end of estimated rates. This. suggests that our sample is similar in some ways to that used in the existing body of literature. Future research could expand the scope of this study by including focusing on the significant variables identified in the current study, as well as by including more factors that may be particularly relevant to the patient population of the West Texas region, such as measures of religiosity, individualism, or self-reliance. nPercentage of total sampleNo significant symptoms4962.82%Significant symptoms in one symptom cluster1316.66%Significant symptoms in two symptom clusters67.69%Significant symptoms in three symptoms clusters33.85%Significant symptoms in all four symptom clusters (met criteria for PTSD diagnosis)78.97%Total78100% Citation Format: Evan Thomas Guidry, Nusrat Jahan, Catherine Jones. An investigation into the presence of posttraumatic stress disorder symptoms in breast cancer patients [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-09-06.

Background: COVID-19 has taken a huge toll on medical resources and the economy and will inevitably have an impact on public mental health. Post-traumatic stress disorder (PTSD), as the most common mental illness after an epidemic, must be seriously addressed. This study aimed to investigate the subjective fear of the Chinese general public during COVID-19 and to explore how it affected the development of PTSD.Methods: An online questionnaire survey was conducted among 1,009 people from January 30 to February 14, 2020 (about 1 month after the COVID-19 outbreak). The subjective fear was measured by a self-reported single-choice question. Four items from the Pittsburgh Sleep Quality Index (PSQI) were selected to measure the subjects' sleep quality. Their post-traumatic stress symptoms (PTSS) were measured by the PTSD Checklist for DSM-5 (PCL-5). Pearson correlation, hierarchical multivariate regression analysis, multiple mediator model, and bootstrapping were used in statistical analyses.Results: Different people showed different levels of subjective fear in response to the outbreak. There was a significant positive correlation between subjective fear and the total score of PCL-5 (R = 0.513, P < 0.01), meaning that the higher the degree of subjective fear, the more severe the symptoms of post-traumatic stress are. Subjective fear was an important predictor of PTSS, accounting for 24.3% of the variance. The total effect of subjective fear on PCL-5 scores was significant (total effect = 7.426, SE = 0.405, 95% CI = 6.631–8.221). The total indirect effect of subjective fear on PCL-5 scores through sleep quality was also significant (total indirect effect = 1.945, SE = 0.258, 95% CI = 1.436–2.470).Conclusions: Subjective fear has an important predictive effect on PTSS. In addition to the direct effect, our findings firstly demonstrate the mediating role of sleep quality in the relationship between subjective fear and PTSS.

Letter to the editor. Healthcare workers on the edge of sanity due to COVID-19: Rapid review of the results of systematic reviews and meta-analyzes

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected college students’ mental health and caused post-traumatic stress symptoms (PTSS). Event centrality is thought to play a key role in the development of PTSS, but it is not yet clear by what mechanism. Theoretically, event centrality may affect the retrieval of traumatic memories and further prompt post-traumatic cognitions to understand events, and so may in turn be associated with PTSS in college students. However, few empirical studies have examined the mediating role of post-traumatic cognitions in the relationship between event centrality and PTSS, especially among college students during the COVID-19 pandemic. Objectives: The objective of this study was to examine the mediating roles of post-traumatic cognitive factors (e.g. attention to negative information, catastrophizing, and rumination) in the relationship between event centrality and PTSS among college students during the COVID-19 pandemic. Methods: We recruited 1153 college students who completed the pandemic experiences scale, the centrality of event scale, the attention to positive and negative information scale, the cognitive emotion regulation questionnaire, and the PTSD Checklist for DSM-5 during the COVID-19 pandemic in May 2020. Results: In this sample of college students, event centrality directly predicted PTSS, and PTSS was also indirectly predicted by event centrality through attention to negative information, catastrophizing, and rumination. Conclusions: These findings support the existing literature on the relationship between event centrality, proposed cognitive variables, and PTSS, and shed light on the mechanisms underlying PTSS. Our findings also highlight the importance and applicability of targeted cognitive interventions for PTSS in college students during the COVID-19 pandemic. HIGHLIGHTS The COVID-19 pandemic has caused post-traumatic stress symptoms among college students. Event centrality is a risk factor of post-traumatic stress symptoms among college students during the COVID-19 pandemic. Attention to negative information, catastrophizing and rumination mediate the relationship between event centrality and post-traumatic stress symptoms.

Previous coronavirus pandemics were associated elevated post-traumatic stress symptoms (PTSS), but the self-report and neurological basis of PTSS in patients who survived coronavirus disease 2019 (COVID-19) are largely unknown. We conducted a two-session study to record PTSS in the COVID-19 survivors discharged from hospitals for a short (i.e., about 3 months, Session 1) to a medium period (i.e., about 6 months, Session 2), as well as brain imaging data in Session 2. The control groups were non-COVID-19 locals. Session 1 was completed for 126 COVID-19 survivors and 126 controls. Session 2 was completed for 47 COVID-19 survivors and 43 controls. The total score of post-traumatic stress disorder (PTSD) checklist for DSM-5 (PCL-5) score was significantly higher in COVID-19 survivors compared with controls in both sessions. The PCL-5 score in COVID-19 survivors was positively correlated with the duration after discharge (r = 0.27, p = 0.003 for Session 1), and increased by 20% from Session 1 to Session 2 for the survivors who participated both sessions. The increase was positively correlated with individual’s test-retest duration (r = 0.46, p = 0.03). Brain structural volume and functional activity in bilateral hippocampus and amygdala were significantly larger in COVID-19 survivors compared with controls. However, the volumes of the left hippocampus and amygdala were negatively correlated with the PCL-5 score for the COVID-19 survivors. Our study suggests that COVID-19 survivors might face possible PTSS deteriorations, and highlights the importance of monitoring mental wellness of COVID-19 survivors.

IntroductionTo study the level and predictors of posttraumatic stress, anxiety and depression symptoms in medical, surgical and trauma patients during the first year post intensive care unit (ICU) discharge.MethodsOf 255 patients included, 194 participated at 12 months. Patients completed the Impact of Event Scale (IES), Hospital Anxiety and Depression Scale (HADS), Life Orientation Test (LOT) at 4 to 6 weeks, 3 and 12 months and ICU memory tool at the first assessment (baseline). Case level for posttraumatic stress symptoms with high probability of a posttraumatic stress disorder (PTSD) was ≥ 35. Case level of HADS-Anxiety or Depression was ≥ 11. Memory of pain during ICU stay was measured at baseline on a five-point Likert-scale (0-low to 4-high). Patient demographics and clinical variables were controlled for in logistic regression analyses.ResultsMean IES score one year after ICU treatment was 22.5 (95%CI 20.0 to 25.1) and 27% (48/180) were above case level, IES ≥ 35. No significant differences in the IES mean scores across the three time points were found (P = 0.388). In a subgroup, 27/170 (16%), patients IES score increased from 11 to 32, P < 0.001. No differences in posttraumatic stress, anxiety or depression between medical, surgical and trauma patients were found. High educational level (OR 0.4, 95%CI 0.2 to 1.0), personality trait (optimism) OR 0.9, 95%CI 0.8 to 1.0), factual recall (OR 6.6, 95%CI 1.4 to 31.0) and memory of pain (OR 1.5, 95%CI 1.1 to 2.0) were independent predictors of posttraumatic stress symptoms at one year. Optimism was a strong predictor for less anxiety (OR 0.8, 0.8 to 0.9) and depression symptoms (OR 0.8, 0.8 to 0.9) after one year.ConclusionsThe mean level of posttraumatic stress symptoms in patients one year following ICU treatment was high and one of four were above case level Predictors of posttraumatic stress symptoms were mainly demographics and experiences during hospital stay whereas clinical injury related variables were insignificant. Pessimism was a predictor of posttraumatic stress, anxiety and depression symptoms. A subgroup of patients developed clinically significant distress symptoms during the follow-up period.

Effect of agreement between clinician-rated and patient-reported PTSD symptoms on intensive outpatient treatment outcomes

Background: The mental status of patients with Corona Virus Disease 2019 (COVID-19) (PCs), health care workers (HCWs) exposed to the COVID-19, and general population (GP) has be reported. However, no studies comprehensively investigated their mental status. Thus, this study investigated the prevalence, comparisons and risk factors of mental problems among three groups during the COVID-19 pandemic. Methods: 1300 participants including 137 PCs, 159 HCWs and 1003 GP were enrolled. The anxiety, depression and post-traumatic stress symptom (PTSS) were assessed by the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C). Findings: During the COVID-19 pandemic, the prevalence of anxiety, depression and PTSS were 21.7%, 76.1% and 19.5% in PCs, 9.3%, 25.3% and 9.5% in HCWs, and 12.7%, 25.8% and 6.9% in GP, respectively. The SAS, SDS and PCL-C total scores differed among three groups after controlling for covariates (all, pInterpretation: Our data revealed the high prevalence of mental problems among PCs, HCWs and GP, and more serious mental problems in PCs than HCWs and GP as well as the significant effects of having friend or relative infected, married and age 30-40 years on mental problems in the different population during the COVID-19 pandemic. Thus, these findings further suggested that mental problems in the different population should adopt the different psychological interventions to reduce their mental distress caused by the COVID-19.Funding Statement: This work was supported by the National Natural Science Foundation of China (81771439), Jiangsu Provincial Key Research and Development Program (BE2018662), Jiangsu Provincial Health Commission Science Research Program (QNRC2016228, H2019056 and LGY2018010), Jiangsu Provincial Six Talent Peaks Project (WSN-165), Suzhou Municipal Sci-Tech Bureau Program (SS2019009), and CAS Key Laboratory of Mental Health, Institute of Psychology (KLMH2019K03).Declaration of Interests: The authors declared no conflict of interest.Ethics Approval Statement: The protocol, questionnaire and informed consent of this study were approved by the Institutional Review Board at the Affiliated Guangji Hospital of Soochow University.

Effects of intranasal (S)-ketamine on Veterans with co-morbid treatment-resistant depression and PTSD: A retrospective case series

Event centrality, defined as the extent to which a traumatic event becomes a core component of a person's identity (Berntsen & Rubin, 2006), is both a correlate and predictor of posttraumatic stress disorder (PTSD) symptoms, over and above event severity. These findings suggest that decreasing the perceived centrality of a traumatic event to one's identity might result in decreases in PTSD symptom severity. To date, few studies have examined how centrality is affected by PTSD treatment. The present study tested the hypotheses that change in centrality would be associated with both change in PTSD symptom severity and discharge PTSD symptom severity in an exposure-based PTSD partial hospitalization program (N = 132; 86.0% White; 85.2% female; M age = 36 years). At discharge (i.e., after approximately 6 weeks of treatment), both PTSD symptoms and centrality had significantly decreased, ds = .70 and .98, respectively, with large effect sizes. Decreases in Centrality of Events Scale (CES) scores at posttreatment, baseline CES scores, and baseline PTSD Checklist for DSM-5 (PCL-5) scores were associated with change (i.e., decrease) in PCL-5 scores, p < .001, as well as with posttreatment PCL-5 scores, p < .001. Decreases in CES scores over time, baseline CES scores, and baseline PCL-5 scores explained 31% of the variance in PCL-5 change and 34% of the variance in posttreatment PCL-5 scores. The results indicate the potential importance of decreasing the centrality of a traumatic event in PTSD treatment and recovery.

Background: The severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic led to several needed containment measures that conditioned the onset of depressive, anxiety, and post-traumatic stress symptoms in the population. These symptoms, especially if not diagnosed and treated, can also occur in patients undergoing medical care or surgery, with a high impact on people's lives and causing low adherence to treatment. The study evaluates whether the spread of the coronavirus disease 2019 (COVID-19) worsened the onset of post-surgical distress and symptoms of anxiety and depression in a population undergoing hysterectomy for benign disease during the pandemic era, comparing it with a population with the same characteristics but recruited before COVID-19. Methods: The sample was evaluated before surgery (T1), post-operatively (T2), and 3 months after surgery (T3) through a sociodemographic questionnaire and through the HADS (Hospital Anxiety and Depression Scale) to evaluate anxious-depressive symptoms and the PCL-5 (Post-traumatic Stress Disorder Checklist for DSM-5) to assess the onset of post-surgical distress. Results: Patients treated after the COVID-19 pandemic showed a higher depressive symptoms rate compared with those treated before (p-value = 0.02); conversely, pre-COVID-19 patients were more prone to develop post-traumatic stress disorder (PTSD) (p-value = 0.04). A significant association between the occurrence of PTSD and anxiety-depressive symptoms registered at T2 (p-value = 0.007) and T3 (p-value < 0.0001) emerged. In the end, the COVID-19 pandemic has exerted a detrimental influence on the mental well-being of the patients under investigation, with a notable exacerbation of their mood disturbances. Conclusions: The findings advocate for the implementation of psychometric and psychodiagnostic assessments to promptly detect high-risk scenarios that could lead to PTSD, compromising treatment compliance and exacerbating the overall outcome, resulting in substantial direct and indirect burdens.

Post-traumatic stress disorder (PTSD) is a multifaceted psychiatric disorder arising from exposure to traumatic events, characterized by intrusion symptoms, avoidance behaviors, heightened arousal, and negative cognitive and mood alterations. Military personnel are particularly vulnerable to PTSD because of frequent exposure to life-threatening situations during deployments. In France, studies have reported PTSD prevalence rates of 1.7% and 4.8% among military personnel. Early detection and intervention through regular psychological assessments are essential, as chronic PTSD offers limited therapeutic options. The PTSD Checklist for DSM-5 (PCL-5) is widely used for screening, with demonstrated validity in various settings, including the military. However, its application among non-native French speakers in the French Foreign Legion requires validation as a result of potential comprehension issues. This study assessed the psychometric properties of the French version of the PCL-5 in a cohort of French Foreign Legion soldiers deployed in Mali during Operation Barkhane in early 2022. The PCL-5 was administered approximately 1 month postdeployment. Two commonly accepted PCL-5 cutoff scores, 31 and 33, and 4 subscores were used based on recommendations. French proficiency levels were categorized into 5 levels based on validated oral and written examinations. Descriptive statistics, Spearman's correlation coefficients, analysis of variance, and the Kruskal-Wallis test were utilized to analyze the data. The final sample comprised 250 legionnaires. The mean PCL-5 score was 21.24 (SD=5.23). Six individuals scored above the cutoff; however, after clinical examination, only one was diagnosed with PTSD (prevalence rate of 0.40%), while the others had anxiety or interpersonal issues. The PCL-5 demonstrated excellent internal consistency (Cronbach's alpha=0.96). Subscale internal consistency ranged from 0.60 to 0.93. No significant correlation was found between PCL-5 scores and French proficiency levels. This study confirms the reliability of the PCL-5 as a PTSD screening tool within the French Foreign Legion, demonstrating strong internal consistency and applicability across diverse linguistic backgrounds. The high sensitivity of the PCL-5 resulted in false positives, underscoring the necessity of follow-up clinical evaluations to confirm PTSD diagnoses and provide appropriate care. The lack of significant correlations between PCL-5 scores and French proficiency suggests the tool effectively screens individuals regardless of language proficiency. Future research should aim to enhance item comprehension among non-native speakers and explore additional screening instruments to complement the PCL-5 in this unique linguistic population. 20230928_C2EDFRI_4.

Posttraumatic Stress Disorder (PTSD) is a heterogeneous mental health disorder that can develop following a traumatic experience. Understanding its neurobiological basis is crucial to advance early diagnosis and treatment. Electroencephalography (EEG) can be used to explore the neurobiological basis of PTSD. However, only limited research has explored mobile EEG, which is important for scalability. This proof-of-concept study delves into mobile EEG-derived biomarkers for posttraumatic stress (PTS) symptom severity and their potential implications. Participants with partial PTSD, defined as meeting for at least three out of four symptom clusters, including hyperarousal symptoms, were enrolled in the study. Over four weeks, we measured PTS symptom severity using the PTSD checklist for DSM-5 (PCL-5) at multiple timepoints, and we recorded multiple EEG sessions from 21 individuals using a mobile EEG device. In total, we captured 38 EEG sessions, each comprising two recordings (“Recording A” and “Recording B”) that lasted approximately 180 s, to evaluate reproducibility. Next, we extracted Shannon entropy, as a measure of the brain flexibility and complexity of the signal and spectral power for the fronto-temporal regions of interest, including electrodes at AF3, AF4, T7, and T8 for each EEG recording session. We calculated the partial correlation between the EEG variables and PCL- 5 measured closest to the EEG session, using age, sex, and the grouping variable ‘batch’ as covariates. We observed a significant negative correlation between Shannon entropy in fronto- temporal regions and PCL-5 scores. Specifically, this association was evident in the AF3 (r = -0.456, FDR-corrected p = 0.01), AF4 (r = -0.362, FDR-corrected p = 0.04), and T7 (r = -0.472, FDR-corrected p = 0.01) regions. Additionally, we found a significant negative association between the alpha power estimated from AF4 and PCL-5 (r = -0.429, FDR-corrected p = 0.04). Our findings suggest that EEG markers acquired using a mobile EEG device are associated with PTS symptom severity, offering valuable insights into the neurobiological mechanisms underlying PTSD and highlighting the potential benefits of this innovative technology in assessing and monitoring PTSD.

Background: By investigating the incidence of post-traumatic stress disorder (PTSD) among residents during a period of low transmission, this study reflects the long-term impact of coronavirus disease 2019 (COVID-19) and identify which categories of residents are more likely to develop PTSD due to an acute infectious disease crisis, facilitating the development of targeted strategies to protect mental health after outbreaks of similar acute infectious diseases in the future.Methods: A cross-sectional survey was conducted in China from 4 to 26 February 2021. A convenience sampling strategy was adopted to recruit participants. Participants were asked to complete the PTSD Checklist for DSM-5 (PCL-5). A multivariable linear stepwise regression analysis model was used to identify which factors were associated with PTSD in residents of China.Results: A total of 2,361 Chinese residents completed the questionnaire. The mean PCL-5 score for the respondents was 13.65 (SD = 8.66), with 219 (9.28%) patients having probable PTSD symptoms. Respondents who were female (β = 0.038), had a relative or friend who had contracted COVID-19 (β = 0.041), and had poor health (β = 0.184) had higher PCL-5 scores, while the population aged over 60 years (β = −0.063), who agreed that COVID-19 information was released in a timely manner (β = −0.347), who had experienced a relatively limited impact of COVID-19 on their life (β = −0.069), and who agreed that the local prevention initiatives were sophisticated (β = −0.165) had lower PTSD scores.Conclusions: Outbreaks of acute infectious diseases can have long-term psychological health effects in the general population. In addition, health policy makers need to be concerned about and implement measures to support the mental health of vulnerable groups.