Sociodemographic and Academic Burden Factors Associated with Anxiety and Depression Among Final-Year Health Sciences Undergraduates in Malaysia

Effects of contact with COVID-19 patients on the mental health of workers in a psychiatric hospital.

Free Papers Compiled

Health and social care workers (HSCWs) are at risk of experiencing adverse mental health outcomes (e.g. higher levels of anxiety and depression) because of the COVID-19 pandemic. This can have a detrimental effect on quality of care, the national response to the pandemic and its aftermath. A longitudinal design provided follow-up evidence on the mental health (changes in prevalence of disease over time) of NHS staff working at a remote health board in Scotland during the COVID-19 pandemic, and investigated the determinants of mental health outcomes over time. A two-wave longitudinal study was conducted from July to September 2020. Participants self-reported levels of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7) and mental well-being (Warwick-Edinburgh Mental Well-being Scale) at baseline and 1.5 months later. The analytic sample of 169 participants, working in community (43%) and hospital (44%) settings, reported substantial levels of depression and anxiety, and low mental well-being at baseline (depression, 30.8%; anxiety, 20.1%; well-being, 31.9%). Although mental health remained mostly constant over time, the proportion of participants meeting the threshold for anxiety increased to 27.2% at follow-up. Multivariable modelling indicated that working with, and disruption because of, COVID-19 were associated with adverse mental health changes over time. HSCWs working in a remote area with low COVID-19 prevalence reported substantial levels of anxiety and depression, similar to those working in areas with high COVID-19 prevalence. Efforts to support HSCW mental health must remain a priority, and should minimise the adverse effects of working with, and disruption caused by, the COVID-19 pandemic.

Background and objectivesCyber-victimization is closely linked with mental health problems such as anxiety, depression, etc., and has become a growing concern among university students in Bangladesh. In the era of globalization, smart gadgets, the internet, and other online resources are readily available, and these tools and devices have now become the primary method for cyberbullying. The authors aim to explore the impacts of cyber-victimization and other factors on anxiety and depression among university students in Bangladesh.MethodsThe primary data for this cross-sectional study were collected using a well-structured questionnaire. This study employs three widely used scales such as cyberbullying inventory, general anxiety disorder-7 (GAD-7), and patient health questionnaire-9 (PHQ-9). Descriptive statistics and multivariable logistic regression analyses are carried out to identify the factors associated with depression and anxiety among university students in Bangladesh.ResultsFindings depict that the prevalence of depression and anxiety among university students was 52.5% and 44.0%, respectively. Depressed respondents were considerably more likely to have difficulty sleeping (p < 0.001), spend more time on social media (p = 0.002), have suicidal thoughts (p < 0.001), and have a high cyber-victimization score (p < 0.001) compared to non-depressed respondents. In comparison with non-anxious respondents, anxious respondents were significantly more likely to: have sleeping difficulties (p < 0.001); spend more time on social media (p = 0.031); have suicidal thinking (p < 0.001); and have a comparatively high cyber-victimization score (p < 0.001). Multivariable logistic regression analysis identified that a one-unit increase in the cyber-victimization score results in a 1.24 times higher chance of experiencing depression (AOR: 1.24, 95% CI 1.17–1.31, p < 0.001), and a one-unit increase in the cyber-victimization score results in a 1.23 times higher chance of experiencing anxiety (AOR: 1.23, 95% CI 1.17–1.30, p < 0.001).ConclusionUniversity students are struggling with cyberbullying, which can lead to depression and anxiety levels. Promoting more cyberbullying awareness is necessary since failing to do so could result in a sustained or increased prevalence of anxiety and depression levels among students, which could have disastrous repercussions.

BackgroundDepression and anxiety disorders among the global population have worsened during the COVID-19 pandemic. Yet, current methods for screening these two issues rely on in-person interviews, which can be expensive, time-consuming, and blocked by social stigma and quarantines. Meanwhile, how individuals engage with online platforms such as Google Search and YouTube has undergone drastic shifts due to COVID-19 and subsequent lockdowns. Such ubiquitous daily behaviors on online platforms have the potential to capture and correlate with clinically alarming deteriorations in depression and anxiety profiles of users in a noninvasive manner.ObjectiveThe goal of this study is to examine, among college students in the United States, the relationships of deteriorating depression and anxiety conditions with the changes in user behaviors when engaging with Google Search and YouTube during COVID-19.MethodsThis study recruited a cohort of undergraduate students (N=49) from a US college campus during January 2020 (prior to the pandemic) and measured the anxiety and depression levels of each participant. The anxiety level was assessed via the General Anxiety Disorder-7 (GAD-7). The depression level was assessed via the Patient Health Questionnaire-9 (PHQ-9). This study followed up with the same cohort during May 2020 (during the pandemic), and the anxiety and depression levels were assessed again. The longitudinal Google Search and YouTube history data of all participants were anonymized and collected. From individual-level Google Search and YouTube histories, we developed 5 features that can quantify shifts in online behaviors during the pandemic. We then assessed the correlations of deteriorating depression and anxiety profiles with each of these features. We finally demonstrated the feasibility of using the proposed features to build predictive machine learning models.ResultsOf the 49 participants, 49% (n=24) of them reported an increase in the PHQ-9 depression scores; 53% (n=26) of them reported an increase in the GAD-7 anxiety scores. The results showed that a number of online behavior features were significantly correlated with deteriorations in the PHQ-9 scores (r ranging between –0.37 and 0.75, all P values less than or equal to .03) and the GAD-7 scores (r ranging between –0.47 and 0.74, all P values less than or equal to .03). Simple machine learning models were shown to be useful in predicting the change in anxiety and depression scores (mean squared error ranging between 2.37 and 4.22, R2 ranging between 0.68 and 0.84) with the proposed features.ConclusionsThe results suggested that deteriorating depression and anxiety conditions have strong correlations with behavioral changes in Google Search and YouTube use during the COVID-19 pandemic. Though further studies are required, our results demonstrate the feasibility of using pervasive online data to establish noninvasive surveillance systems for mental health conditions that bypasses many disadvantages of existing screening methods.

Background:During the COVID-19 pandemic, the Albanian authorities declared mandatory stay-at-home measures, closing businesses, schools, and public places. This study aims to investigate the impact of these immediate changes on the mental well-being of the population.Methodology:Respondents (N = 1678) aged 18–60 years were selected through a convenient sampling method. A questionnaire was administered online for 26 days, where respondents reported the time spent daily in the COVID-19 topic and filled in their generalities, the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7.Results:Findings suggest a significant negative correlation between age and anxiety scoring (r(n = 1678) = −0.121, P ≤ 0.001) and between age and depression scoring (r(n = 1678) = −0.232, P ≤ 0.001), shown also on the ANOVA test for age and anxiety (F = 6.019, P ≤ 0.05), where younger populations had higher anxiety levels, as well as age and depression (F = 20.326, P ≤ 0.05), where older populations had higher levels of depression. Differences on the level of education resulted in a lower score of anxiety and depression (F = 3.524, P ≤ 0.05; F = 7.739, P ≤ 0.05, respectively) on respondents with higher education. Those who found themselves jobless from the pandemic scored higher on anxiety and depression (F = 9.760, P ≤ 0.05; M = 6.21, ds = 4.686 and F = 16.051, P ≤ 0.05; M = 8.18, ds = 5.791, respectively) compared with those who are still working. Significant differences were found on the ANOVA test related to different amounts of time spent daily on the COVID-19 topic for anxiety and depression (F = 25.736, P ≤ 0.001; F = 5.936, P ≤ 0.003, respectively), with people who spend <1 h scoring higher on depression (M = 7.57, ds = 5.849) and those who spent >3 h scoring higher on anxiety (M = 6.76, ds = 5.60). On the t-test, people on a romantic relationship scored lower levels of depression (t = −4.053, P ≤ 0.0001) compared to single individuals, and females scored higher levels of anxiety (t = 12.344, P ≤ 0.001) compared to males.Conclusions:Younger participants score higher levels of anxiety and depression. Higher education individuals show lower levels of anxiety and depression. Having a job translates into lower levels of anxiety and depression. People who spent more time on the COVID-19 topic daily have higher levels of anxiety, whereas those who spent less time have higher levels of depression. Being in a romantic relationship relates to lower levels of depression. Females report higher levels of anxiety compared to males.

IntroductionMultiple sclerosis (MS) is often associated with depression and anxiety, with no clear prevalence, and the relationship between them is not fully understood.MethodsIn a cross-sectional study of 365 multiple sclerosis patients selected through a random sampling method from the MS society of Riyadh, Saudi Arabia, we collected data by self-administered questionnaires - the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) questionnaire - and analyzed by descriptive and analytical statistics.ResultsApproximately 51.1% of participants had moderate or severe anxiety and 64% of them had depression among community-based multiple sclerosis patients according to Generalized Anxiety Disorder (GAD-7) questionnaire, and according to the PHQ-9 Arabic version about 28.85% showed mild to moderate depression.The MS patients aged 53 to over 60 years showed higher levels of mild anxiety (76.32%) and higher levels of depression ranging from mild to moderate (53.61%) (P = 0.001). While the MS patients younger than 53 years showed moderate to severe anxiety (60.71%) and depression levels (62.32%). In different age group bad health status (37.6%) was associated with a higher prevalence of depression levels (P =< 0.001) and people who were widowed (22.38%), divorced (26%), and separated (37.82%) had significant depression levels (P = 0.017). In terms of anxiety, 54.58% of females had anxiety (P = 0.005), more older people showed anxiety (43.17%) (P = 0.026), and people with a bad general health state (26.38%) had anxiety (P = <0.001).ConclusionAmong different types of MS patients, anxiety is more prevalent in the elder group (76%) of people and depression is more prevalent in young patients (62%).

Impact of COVID-19 pandemic on mental health, risk perception and coping strategies among health care workers in Albania - evidence that needs attention

There are limited studies regarding physical activity, anxiety, and depression levels among patients with postacute myocardial infarction (AMI). This is a need for more research on physical activity, anxiety, and depression levels based on the type of AMI following hospitalization to develop interventions to improve these outcomes. To compare physical activity behavior, anxiety, and depression levels among patients with post-ST-elevation myocardial infarction (STEMI) and post-non-ST-elevation myocardial infarction (NSTEMI) not involved in cardiac rehabilitation program following hospitalization. A descriptive cross-sectional study design was employed with a convenience sample of 254 patients with post-AMI, 4 weeks after hospitalization. Participants, recruited from three hospitals in Jordan. The sample characteristics included the following: 140 males (54.3%), 120 married (47.2%), diagnosed with STEMI (n = 137, 53.1%) or NSTEMI (n = 117, 45.3%). And 41.3% of participants had moderate-to-severe anxiety level (General Anxiety Disorder-7 [GAD-7] > 10), while 22.0% had moderate to severe depression levels (Patient Health Questionnaire-9 [PHQ-9] > 10). Post-STEMI and post-NSTEMI participants had moderate levels of anxiety, with 14.39 (3.45) versus 13.37 (3.51); and depression levels of 12.66 (3.28) versus 12.22 (3.54), respectively. There was no significant difference in depression level between patients with post-STEMI and post-NSTEMI, but the former had statistically significant higher anxiety level than the latter. The mean self-reported exercise duration and exercise frequency of patients with post-STEMI were significantly higher than for their post-NSTEMI counterparts: 151.7 (76.33) versus 87.78 (37.62) minutes per week, and 2.92 (1.44) versus 1.97 (0.88) times per week (respectively). Furthermore, patients with post-STEMI had less mean sedentary time: 582.92 (128.92) and 641.54 (147. 27) minutes per day (p > .05) (respectively). Healthcare providers have to consider the differences in physical activity behavior, anxiety, depression levels based on types of AMI when developing interventions and establishing cardiac rehabilitation program to improve physical activity behavior and reducing sedentary time.

Young adults report increased rates of anxiety and depression than other age groups. Furthermore, young adult athletes experience additional stressors that may negatively impact their mental health. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among Division I collegiate athletes and the influences of sex, sport type, and distance from home. It was hypothesized that self-reported levels of anxiety and depression would increase among this population during this timeframe. Cross-sectional. Level 3. Participants included 792 incoming Division I collegiate athletes. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scores were completed by all incoming student athletes at a single institution as part of their preparticipation examination over 5 years. Both survey scores were categorized into different levels of severity and separately compared with chi-square tests. Continuous scores were modeled separately using negative binomial regression models including year, sex, sport type, and home location as covariates. Results showed consistent levels of anxiety and depression over time. Female athletes reported higher levels of both anxiety and depression than male athletes, and individual sport athletes reported higher levels of depression than team sport athletes. Distance from home was not associated with anxiety or depression levels. Overall, levels of anxiety and depression did not change in this population over this time period. However, differences in anxiety and depression were seen between sexes and depression between sport types. Understanding anxiety and depression risk factors among collegiate athletes can enhance early identification and intervention to improve mental health and allow for better allocation of resources to at-risk groups among Division I collegiate athletes.

Objective: The aim of the present study was to investigate the psychiatric distress, including stress, anxiety, and depression levels, among COVID-19 positive patients who were admitted between 01 July 2020 to 31 August 2020 to the COVID-19 isolation ward of the Uttar Pradesh University of Medical Sciences, Saifai, Etawah India. Participants included 100 patients, with 55 males and 45 females. The majority of admitted patients (81%) were illiterate. Out of 100 patients, 83 were married, 16 were unmarried, and only 1 was a widow. Methods: Levels of anxiety, depression, and stress level were noted in admitted patients using Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9) depression assessment, and Perceived Stress Scale 4 (PSS-4) assessment techniques, respectively. Results: Patient Health Questionnaire (PHQ-9) depression assessment results showed minimal, mild, and moderate depression in 9, 25, and 66 patients, respectively, with a 10.6 median score of PHQ-9. Mild, moderate, and severe anxiety (GAD-7 score) was present in 22, 28, and 50 of the patients surveyed. The mean Perceived Stress Scale 4 (PSS-4) was also analyzed, and it reported 6.1 values. The results of the study demonstrated that the patients had a high label of psychiatric distress, but still, admitted patients believe that they will come out from this pandemic condition. Conclusion: Although patients claimed psychiatric distress and mental health illness, they still denied the requirement of any mental health professionals to minimize stress levels and were satisfied with the medical facilities available in a hospital located in a rural area.

BackgroundThis study aimed to explore the levels of anxiety and depression in a sample of home-quarantined college students to identify the risk factors for psychological distress during the COVID-19 lockdown.MethodsA total of 1156 college students studying in Jiangsu, China, participated from August 5 to August 14. A structured questionnaire was used to collect data anonymously, including demographic characteristics, the generalized anxiety disorder-7 (GAD-7) questionnaire, the patient health questionnaire-9 (PHQ-9), a physical activity scale, and items related to COVID-19. The chi-square test and Fisher’s exact test were employed to establish the differences in levels of anxiety and depression across sociodemographic characteristics. Binary logistic regression was applied to measure the predictors of levels of anxiety and depression, and associations were considered significant at p <0.05.ResultsThe estimates of anxiety and depression were 48.1% and 57.6%, respectively. The univariate analysis indicated a significant difference in anxiety levels across student grades, whether the student was an only child, the distance from the worst-hit areas, and physical activity/exercise intensity. Physical activity intensity and living in communities with infected people were statistically correlated with the level of depression. Binary logistic regression results indicated that the predictive factors for anxiety were living within a short distance from the worst-hit areas (10~20 km), engaging in higher education (graduate students), and low-intensity daily exercise. Factors statistically predicting depression symptoms were having siblings, a COVID-19 diagnosis in the community and low-intensity daily exercise.ConclusionDuring outbreaks, students in an extremely stressful state are more likely to develop anxiety and depression, particularly postgraduates. Psychological interventions to reduce fears and encourage exercise should be available to home-quarantined college students. Students who live in the worst-hit areas and are not the only child in the family should be prioritized.

The COVID-19 pandemic is profoundly impacting mental health worldwide1-3. Wuhan, China has been the first city to experience the emergency of COVID-19 and its high hospitalization and casualty rates, as well as the mandatory curfews that were strictly enforced for infection control, with their significant mental health implications4. Although a large number of hospitalized COVID-19 patients recovered and met the clinical criteria for discharge, we hypothesized that mental health problems would occur as major sequelae among COVID-19 survivors. A total of 4,328 hospitalized COVID-19 patients who met relevant clinical criteria5 were discharged between January 18 and March 29, 2020 from five hospitals in Wuhan, China (Wuhan No.1 Hospital, Wuhan Wuchang Hospital, Hubei Provincial Hospital of Traditional Chinese Medicine, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, and Wuhan Pulmonary Hospital). All these COVID-19 survivors (median age: 59 years, interquartile range, IQR: 47-68 years; 54.1% female) were followed up and assessed by mental health care specialists. The evaluation period started on the date of hospital discharge and continued through July 28, 2020. Among the survivors, 156 (3.6%) dropped out at some point of the follow-up. The validated Chinese versions of the Patient Health Questionnaire-9 (PHQ-9)6 and the Generalized Anxiety Disorder-7 (GAD-7)7 were administered to evaluate post-discharge depression and anxiety. As a reference group, 1,500 randomly selected individuals from the general population of Hubei province were assessed using the same instruments during the same time frame. Chi-square tests were used to compare the prevalence of mild-to-severe mental health problems in the two samples. Among COVID-19 survivors with depression or anxiety, logistic regression analysis was applied to test whether several variables (including age, gender, education, income level, comorbid chronic physical diseases, and retesting positive for SARS-CoV-2) influenced the severity of the mental health condition. The study was approved by the institutional ethics board of Tongji Medical College, Huazhong University of Science and Technology. All participants provided their informed consent. The median duration of the follow-up period was 144.0 days (IQR: 135-157). During this period, 615 COVID-19 survivors (14.2%) were found to have clinically defined depression (i.e., a score of at least 5 on the PHQ-9) and 528 (12.2%) to have clinically defined anxiety (i.e., a score of at least 5 on the GAD-7). Four survivors attempted suicide. Compared to the reference group, the risk of both depression and anxiety in COVID-19 survivors was significantly higher (relative risk, RR=1.2, 95% CI: 1.1-1.4, p=0.002; and RR=1.4, 95% CI: 1.2-1.7, p=0.001, respectively). Among the 615 survivors with depression, the risk for a severe condition (i.e., a score of at least 10 on the PHQ-9) was significantly higher in individuals living alone (odds ratio, OR=5.2, 95% CI: 3.6-7.1, p<0.001), in females (OR=3.4, 95% CI: 2.8-5.3, p<0.001), in those with a low income level (OR=2.4, 95% CI: 1.8-3.5, p=0.012), in those with a comorbid chronic physical disease (OR=2.8, 95% CI: 2.1-3.7, p=0.032), and in those who retested positive for SARS-CoV-2 (OR=10.4, 95% CI: 8.3-12.5, p<0.001). Age did not significantly influence the severity of depression. Among the 528 COVID-19 survivors with anxiety, the risk for a severe condition (i.e., a score of at least 10 on the GAD-7) was significantly higher in individuals with a low educational level (OR=3.5, 95% CI: 3.1-4.2, p<0.001), in unmarried subjects (OR=1.7, 95% CI: 1.2-2.8, p=0.025), and in those who retested positive for SARS-CoV-2 (OR=4.7, 95% CI: 3.7-5.8, p<0.001). Age, gender and other social status indices did not influence the severity of anxiety. All the four COVID-19 survivors who attempted suicide were elderly, had retested positive for SARS-CoV-2, and had experienced severe levels of depression and anxiety. In summary, this follow-up study documents that mental health problems among COVID-19 survivors in Wuhan are significantly more common than in the general population of the Hubei province. Risk factors for more severe mental health problems include retesting positive for SARS-CoV-2, living alone, female gender, comorbid chronic physical diseases, and low education and income levels. Clinicians and policy makers should be aware of the risk of mental health sequelae in COVID-19 survivors and implement appropriate preventive and treatment measures.

The Butterfly Hug Method is a non-pharmacological therapeutic intervention that is used to return the hyperaroused mind into a relaxed state. However, a small number of studies have been conducted to examine the effects of the butterfly hug method to the mental health status of senior citizens. This study aimed to determine the Effects of the Butterfly Hug Method on the Mental Health Status of Senior Citizens. The study employed quantitative true-experimental research design. The study was conducted in a selected healthcare facility located in Caloocan City, Philippines. Simple random sampling was utilized to select and divide the participants into two groups, experimental group and control group. The sample was composed of 10 participants. Data were collected using the adopted tools, Patient Health Questionnaire - 9 (PHQ-9) and Generalized Anxiety Disorder - 7 (GAD-7). Data collected were analyzed using descriptive statistics, particularly mean and standard deviation. Inferential statistics was utilized, particularly using paired t-test and independent sample t-test. There is no significant difference between the post test results of the control group and the experimental group. Both interventions, Standard of Care (Physical Activity) and Butterfly Hug Method, were effective in reducing the levels of anxiety and depression in senior citizens. Both interventions were able to reduce the level of anxiety and depression in senior citizens. Regardless that there is no significant difference between the effectiveness of the standard of care in the control group and the butterfly hug method in the experimental group, it has been established that the score and level of depression and anxiety of the participants in the experimental group was reduced. Thus, the Butterfly Hug Method is beneficial to senior citizens in improving the levels of their mental health status.

This study aimed at comparing the depression and anxiety levels, and health self-perception during the coronavirus disease 2019 pandemic among subjects who practice aerobic, strength, and mixed (aerobic and strength) exercises and nonsports participants. We included 304 Brazilians of both sexes in this cross-sectional study. All participants were recruited through online advertisement and completed a self-administered questionnaire regarding the personal information, level of restriction adopted, physical activity, and mood state screening (Patient Health Questionnaire-9 and General Anxiety Disorder-7). We divided the participants into four groups: strength sports group (CrossFit or strength training), aerobic/endurance sports groups (running, cycling, triathlon, or swimming), mixed sports groups (individuals who practice endurance and strength sports), and nonsports group. The Kruskal-Wallis test showed a significant effect of the group on the depression and anxiety levels. Meanwhile, the post-hoc comparisons showed a significantly lower depression level in the mixed and aerobic sports groups than in the strength sports and nonsports groups, and a significantly lower anxiety level in the mixed and aerobic sports groups than in the nonsports group. Furthermore, participants in the mixed, strength, and aerobic sports groups presented a better level of health self-assessment than the nonsports group, and those in the mixed sports group had a better level of health self-assessment than the strength or aerobic sports groups. Individuals practicing aerobic exercises present lower depression and anxiety levels than those practicing strength training and are inactive. However, individuals who practice strength exercises and aerobics have the best levels of health perception.