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Assessing depression, anxiety, stress and psychological impact of Covid-19 on general population of Karachi; A web survey based cross-sectional study

Introduction: An outbreak of pneumonia was observed in December, 2019 China which was named as Covid-19 (Corona virus disease 19) by WHO. The first case of Covid-19 appeared in Pakistan on Feb 26, 2020. Pakistan has responded well to the cause and had taken timely decisions. During Covid-19 depression, anxiety, sleep disturbances have been revealed among population of various countries. This study was carried out to determine the mental health status of general population in Karachi during Covid-19 pandemic. Materials and Methods: This was a web survey based cross sectional study. The data was collected through a self-administrated questionnaire which was developed on Google forms. The questionnaire collected information regarding participants demographics, their knowledge about Covid-19, their attitude and practices towards it and the last part was used to assess psychological impact and mental health status of the participants using IES-R (Impact of event revised) score and DASS-21 (Depression, anxiety and stress score). Multivariate analysis of variance (MANOVA) and independent t-test were used as tests of significance. Results: Majority 229(76.3%) of the participants were aged between 15-25 years. Social media was the main medium through which people 124(41.3%) learned about Covid-19. Evaluation of knowledge regarding Covid-19 infection showed that majority correctly knew about transmission sources and sign/symptoms of Covid-19 infection. Analysis revealed that majority of the people 167(55.7%) had normal depression subscale score (0-9), 196(65.3%) had anxiety scores within normal range and 198(66%) did not report stress and had normal scores. While assessing the psychological impact of Covid-19 we found that 221(73.7%) had normal IES-R score and had mild impact of Covid-19. Conclusion: Our study showed that people of Karachi were well aware about Covid-19. Majority of respondents did not report depression, anxiety, stress and serious impact of Covid-19 on their lives showing their optimism and great will to fight against the pandemic. Keywords: COVID-19, Psychological impact; Mental health.

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Stress, Anxiety and Depression among Pregnant Women during the first wave of the COVID-19 Pandemic in Israel

Background: The new COVID-19 pandemic resulted in tremendous challenges to mankind in health, emotions and economy. A specifically vulnerable group are pregnant and postpartum women. We conducted a study that aimed to shed light on the effects of this pandemic on emotional state of pregnant and postpartum women. Objective and Study Design: A cross-sectional study in northern Israel based on web questionnaire for the assessment of general stress, anxiety and depression during the quarantine period of COVID-19 pandemics from April 20 until May 7, 2020. Participants were pregnant women and women up to a year after childbirth. Overall, 356 women of whom 251 pregnant and 101 post-partum filled the questionnaire. Results: Among 251 pregnant women, 199 (79.3 %) reported moderate-high stress, 145 (57.8 %) high anxiety. A hundred and three (41.0%) reported high level of depression (PH2>3). Among pregnant women, the following were the most prevalent stressors: fear that someone in their family will acquire the virus (80.1%), concern for the health of the baby (77.7%), fear that someone close will die from COVID-19 (72.9%) and worry of being infected within the hospital (71.7%). A univariate analysis of stress revealed that age (χ2=10.93, p<0.004) and income level (χ2=13.35, p<0.001) were associated with the level of stress. Stepwise logistic regression revealed that both age and income level below the mean were predictors of stress. Among the 165 multiparous pregnant women, age (25-34 vs. 35-44) was a predictor of stress (p<0.04). Conclusion: Our study clearly showed an enormous negative effect of the COVID-19 pandemic on emotional condition including stress, anxiety and depression on both pregnant and postpartum women. This provides an insight on the relation between economy and emotional state during uncertainty period. This effect adds a huge challenge to healthcare system and social support providers as well as the governments in providing means and solutions during pandemics and worldwide disaster. Keywords: COVID-19, Pregnant, Postpartum, Depression, Anxiety, Stress

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Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental Changes, and the “New Normal” During and After COVID-19

Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has rapidly swept across the world, inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, healthcare providers and people with underlying health conditions. Authorities around the world tried to prevent the virus spread by imposing social distancing measures, quarantining citizens and isolating infected persons. Apart from its physical impact, COVID-19 pandemic has brought numerous changes to people’s lives. It changed daily routines, caused worldwide economic crisis, increased unemployment, and placed people under emotional and financial pressures. It affected people psychologically and mentally especially in terms of emotions and cognition. During the acute crisis, everyone to varying degrees experienced fear of infection, somatic concerns, worries about the pandemic’s consequences, loneliness, depression, stress, as well as increased alcohol and drug use. As part of its public health response, the World Health Organization (WHO) has worked with partners to develop a set of new guidelines and messages that can be used to prevent, manage, and support mental and psychological well-being in different vulnerable target groups during the outbreak. Whether people like it or not, the psychological sequela of this pandemic will emerge and persist for months and years to come leading to long-term consequences. New lifestyles and “New Normals” will surely emerge. The main purpose of this review is to summarize the impact of coronavirus pandemic on the psychological and mental health of people around the world especially vulnerable groups. It also presents the relevant intervention actions and recommendations to cope efficiently and effectively with the psychological short-term and long-term outcomes, mental changes, and the “New Normal” during and after COVID-19. Keywords: COVID-19; Coronavirus, Psychological; Mental; New Normal

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Is there a connection between fecal and milk microbiota composition and function and perinatal depression? Rationale for future studies

Introduction: Coping with perinatal depression in healthcare systems worldwide has been so far more or less insufficient and there is a huge need of implementing new prevention and treatment options. Methods: Literature review has been done to assess state of current knowledge on microbiome changes in perinatal period and form potential clinical implementation of these information. Results: Intestinal microbiota can influence central nervous system functions and this relation seems bidirectional. The diversity of gut microbiota has emerged to play a significant role in the occurrence of mood and anxiety disorders, but this relationship is poorly understood in perinatal period. Studies have shown a reduced phylogenetic diversity and species richness of gut microbiota in depressed pregnant women, and a significant association between antibiotic exposure during the peripartum period and development of depressive symptoms. Even though breast milk is the fundamental source of microbes colonizing the infant’s gut, there is very little known about possible human milk microbiota changes in depressed women. Our microbiome may be modulated by numerous circumstances, especially diet but no current microbiome-specific dietary recommendations exist. Conclusions: Future research in the relationship between the gut microbiota, diet and PND holds tremendous potential to be integrated in clinical practice. The impact of breast milk microbiota on infant development and health could have important implications for early-life prevention of chronic conditions. Given that bacterial functions are conserved across taxonomic groups, incorporating microbial function biomarkers may be more productive than a purely taxonomic approach to understanding the microbiome in diseases. Keywords: Perinatal depression; Microbiota; Diet; Pregnancy; Breastfeeding

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Formation Prediction of Pre-Nosological Mental Disorders in Combatants

Clinically formed borderline mental disorders (BMD) in combatants have a lower prevalence in contrast to pre-clinical mental disorders. Blurred diagnostic criteria do not allow to classify short-term disorders of mental adaptation requiring therapy as BMD. In order to develop a model for predicting the formation of pre-clinical mental disorders (PMD) in combatants, the analysis of personal characteristics of 649 combatants was carried out. Among 311 people, in anamnesis, PMD with increased anxiety, dissomnia, instability of the emotional background were detected, in 338 people these states and other violations of mental adaptation were not recorded. Four years after participation in the fighting, according to Kotenev’s methodology and the Bass-Darky test, the combatants showed signs of maladaptation and a high level of physical aggression. On the basis of the obtained data, the model of forecasting the formation of PMD in combatants with the use of logistic regression by forced input of variables is calculated. It was found that the risk of PMD formation in combatants increases with a decrease in the indicator of the scale "symptoms of invasion" and with an increase in the parameters on the scales "symptoms of hyperactivity", "distress and maladaptation", "the presence of signs of post-traumatic stress disorder", "physical aggression" and "verbal aggression". This shows that PMD occurs more often in combatants with increased excitability in everyday life and a high level of physical aggression, while the symptoms of reliving a traumatic event are not a trigger factor for the formation of neurotic disorders. The use of this technique in medical and psychological combatant for the prevention of the formation of PMD is proposed. Formed borderline mental disorders (BMD) in combatants have a lower prevalence in contrast to disorders of the pre-nosological level [3]. The growth of adverse mental states, including pre-nosological mental disorders (PMD) in combatants is observed worldwide, which is probably associated with an increase in the number of local armed conflicts [8]. PMD have an uncertain prognosis, both in terms of recovery and in the formation of nosological forms [2]. This issue is often discussed in the medical literature, but vague diagnostic criteria do not allow to classify as formed BMD short-term disorders of mental adaptation that appear spontaneously - often against the background of the impact of trigger stimuli [4] At the same time, in the absence of therapy, they lead to a change in the personal structure and a violation of the quality of life of combatants [5, 6]. This puts before psychiatrists the task of developing new methodological and psycho-diagnostic approaches to both psycho-prophylactic examinations and treatment of this contingent [7]. Keywords: Combatants; Pre-nosological mental disorders; Prognosis model

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Comparison of the Prevalence of addiction internet in Brazilian University Students: Online cognition scale versus internet addiction test

Introduction: Some internet users lose the ability to control the duration and / or frequency of their use, leading to the phenomenon of internet addiction. In Brazil, there is no data about the prevalence of this phenomenon. Aim: To estimate and compare the prevalence of Internet addiction among university students in the health area. Method: A comparison of the prevalence was evaluated among undergraduate students from the health area of the University of Pernambuco, Brazil. Three instruments were applied: the Portuguese (Brazil) versions of the Internet Addiction Test, the Online Cognition Scale and a questionnaire characterizing socio-demographic and habits of use from Internet. The data were submitted to bivariate statistical tests, test of association for categorical variables and analysis of linear growth trend. Results: At the end of the study, 359 students participated in the study, 75.5% women with a mean age of 19.49 years (± 2.33 years). According to Internet Addiction Test, 44.28% of the sample had Internet Addiction, with a higher prevalence in males (51.1%). Concerning Online Cognition Scale, the prevalence of the disorder was 62.9%, higher in females (65.7%). This prevalence rates obtained were higher when compared to previous studies, which may be related to the variety of instruments. Conclusion: The prevalence of Internet Addiction in the sample studied varied according to the instrument used. There was also a significant linear trend between the weekly connection time and the severity of the addiction to the internet. Keywords: Internet; Addictive Behavior; Prevalence; Cross-Sectional Studies

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Open Access