Impact Of Event Scale-Revised Scores Research Articles

Predictors of "brain fog" 1year after COVID-19 disease.

IntroductionBrain fog has been described up to 1 year after SARS-CoV-2 infection, notwithstanding the underlying mechanisms are still poorly investigated. In this study, we aimed to evaluate the prevalence of cognitive complaints at 1-year follow-up and to identify the factors related to persistent brain fog in COVID-19 patients.MethodsOut of 246 COVID patients, hospitalized from March 1st to May 31st, a sample of 137 patients accepted to be evaluated at 1 year from discharge, through a full clinical, neurological, and psychological examination, including the Montreal Cognitive Assessment (MoCA), impact of event scale-revised (IES-R), Zung self-rating depression scale (SDS), Zung self-rating anxiety scale (SAS), and fatigue severity scale (FSS). Subjects with prior cognitive impairment and/or psychiatric disorders were excluded.ResultsPatients with cognitive disorders exhibited lower MoCA score (22.9 ± 4.3 vs. 26.3 ± 3.1, p = 0.002) and higher IES-R score (33.7 ± 18.5 vs. 26.4 ± 16.3, p = 0.050), SDS score (40.9 ± 6.5 vs. 35.5 ± 8.6, p = 0.004), and fatigue severity scale score (33.6 ± 16.1 vs. 23.7 ± 12.5, p = 0.001), compared to patients without cognitive complaints. Logistic regression showed a significant correlation between brain fog and the self-rating depression scale values (p = 0.020), adjusted for age (p = 0.445), sex (p = 0.178), premorbid Cumulative Illness Rating Scale (CIRS) (p = 0.288), COVID-19 severity (BCRSS) (p = 0.964), education level (p = 0.784) and MoCA score (p = 0.909).ConclusionsOur study showed depression as the strongest predictor of persistent brain fog, adjusting for demographic and clinical variables. Wider longitudinal studies are warranted to better explain cognitive difficulties after COVID-19.

A machine-learning model to predict suicide risk in Japan based on national survey data.

ObjectiveSeveral prognostic models of suicide risk have been published; however, few have been implemented in Japan using longitudinal cohort data. The aim of this study was to identify suicide risk factors for suicidal ideation in the Japanese population and to develop a machine-learning model to predict suicide risk in Japan.Materials and MethodsData was obtained from Wave1 Time 1 (November 2016) and Time 2 (March 2017) of the National Survey for Stress and Health in Japan, were incorporated into a suicide risk prediction machine-learning model, trained using 65 items related to trauma and stress. The study included 3,090 and 2,163 survey respondents >18 years old at Time 1 and Time 2, respectively. The mean (standard deviation, SD) age was 44.9 (10.9) years at Time 1 and 46.0 (10.7) years at Time 2. We analyzed the participants with increased suicide risk at Time 2 survey. Model performance, including the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity, were also analyzed.ResultsThe model showed a good performance (AUC = 0.830, 95% confidence interval = 0.795–0.866). Overall, the model achieved an accuracy of 78.8%, sensitivity of 75.4%, specificity of 80.4%, positive predictive value of 63.4%, and negative predictive value of 87.9%. The most important risk factor for suicide risk was the participants' Suicidal Ideation Attributes Scale score, followed by the Sheehan Disability Scale score, Patient Health Questionnaire-9 scores, Cross-Cutting Symptom Measure (CCSM-suicidal ideation domain, Dissociation Experience Scale score, history of self-harm, Generalized Anxiety Disorder-7 score, Post-Traumatic Stress Disorder check list-5 score, CCSM-dissociation domain, and Impact of Event Scale-Revised scores at Time 1.ConclusionsThis prognostic study suggests the ability to identify patients at a high risk of suicide using an online survey method. In addition to confirming several well-known risk factors of suicide, new risk measures related to trauma and trauma-related experiences were also identified, which may help guide future clinical assessments and early intervention approaches.

Psychological impacts of COVID-19 pandemic in cancer patients on active treatment

IntroductionAlthough cancer patients have a high risk of exposing COVID-19 and developing severe complications, they have to receive active treatment. We aimed to determine the psychological conditions of cancer patients and shed light on the establishment of early psychological intervention and intervention policies by making specific recommendations. MethodWe consecutively evaluated 385 cancer patients under treatment. Post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, stress, and associated sociodemographic/clinical characteristics were investigated. In addition, we applied depression-anxiety-stress-scale-21 (DASS-21) for the mental states of patients and Impact of Event-Scale-Revised (IES-R) for the psychological effects of Covid-19. ResultsThe mean age was 58 (18–88). 47.2% were psychologically distressful per DASS-21, and 39.3% were traumatic per IES-R scores. 71.9% stated the risk of getting COVID-19 was high since they had cancer, and 82% stated serious complications would develop if they had COVID-19 infection. Patients diagnosed for more than one year were more stressed, anxious, and depressive (p–value = 0.001,0.003,0.049, respectively). Singles were more stressed, depressed, and traumatized than couples (p-value = 0.001, 0.011, 0.001). In multivariate analysis, a significant correlation with being under psychiatric treatment before the pandemic was found for depression (OR: 3.743, 95 %CI: 1.790–7.827) anxiety (OR: 3.776–95 %CI: 1.945–7.332) and stress levels (OR: 4.129, 95 %CI: 1.728–9.866). Having relatives who died or received treatment for COVID-19(OR: 0.515,0.296–0.895) and being unmarried (OR: 2.445–95% CI: 1.260–4.747) predicts PTSD development. ConclusionsWhen the psychological effects of the COVID-19 pandemic are manifesting strongly, cancer patients' anxiety and exposure levels are high. It is of great importance that clinicians understand needs, recognize psychological distress, and direct them to relevant departments for supportive care.

North-African doctors as second victims of medical errors: a cross sectional survey

IntroductionPhysicians involved in medical errors (MEs) can experience loss of self-esteem and negative psychological experiences. They are called “second victims” of the ME.AimsTo i) describe the profile, the types and the severity of MEs, and ii) explore the psychological impact on “second victims” to better understand how they cope.MethodsIt was a cross sectional retrospective study conducted from March to August 2018. All physicians working at Farhat Hached and Sahloul University hospitals were asked to complete a questionnaire about their possible MEs. The impact of MEs was evaluated using the Impact of Event Scale-Revised (IES-R) (scoring, 0–88) (subscales ranges; intrusion, (0–32); avoidance, (0–32); hyperarousal, (0–24)). The diagnosis of post-traumatic stress disorder (PTSD) was made when the total IES-R score exceeded 33. The coping strategies were evaluated using Ways of Coping Checklist Revised (WCC-R) scale (scoring, problem-focused, (10–40); emotion focused, (9–36); seeking social support, (8–32)).ResultsAmong 393 responders, 268(68.2%) reported MEs. Wrong diagnosis (40.5%), faulty treatment (34.6%), preventive errors (13.5%) and faulty communication (6.4%) were the main frequent types of MEs. The most common related causes of MEs were inexperience (47.3%) and job overload (40.2%). The physicians’ median (range) score of the IES-R was 19(0–69). According to the IES-R score, the most frequent psychological impacts were median (range): intrusion, 7(0–28) and avoidance symptoms, 7(0–24). PTSD symptoms affected 23.5% of physicians. Female sex and serious MEs were identified as predictors of PTSD. On the WCC-R check list, coping was balanced between the three coping strategies median (range), problem focused, 28.5(10–40); emotion-focused, 24(9–36) and seeking social support 21(8–32).ConclusionThere is a relatively high impact of ME within these North-African university hospital physicians. Coping was balanced within different three strategies as reported worldwide. Physicians adopted more likely constructive changes than defensive ones.

Post-traumatic Stress, Work Performance and Employee Satisfaction Among Health Care Workers during the COVID-19 Pandemic

Aim: This cross-sectional study was carried out to investigate post-traumatic stress, work performance and employee satisfaction of healthcare workers (HCWs) (nurses and physicians) during the COVID-19 pandemic. Methods: A face-to-face questionnaire was administered to 169 HCWs working in inpatient clinics of two public hospitals in İstanbul, Türkiye. The questionnaire comprised four parts, including a socio-demographic form, the Impact of Event Scale-Revised (IES-R), the Employee Performance Scale and the Employee Satisfaction Scale (ESS). Results: IES-R scores showed that 14.2% and 47.9% of participants experienced mild and severe post-traumatic stress (PTSD), respectively. IES-R total and all sub-dimensions scores (intrusion, avoidance, and hyperarousal) were significantly higher in participants who worked ≥48 hours a week and in those who were exposed to verbal/physical violence. EPS scores showed weak inverse correlations with the overall IES-R score (r=-.300; p=.000) and with all sub-dimension scores, while ESS scores (r=,528; p=,000) showed moderate correlations with the overall EPS score and strong correlations with all sub-dimension scores. Conclusions: The remarkably higher incidence of PTSD showed a close relationship with both satisfaction and performance levels among HCWs. As PTSD has long-term effects on the lives of HCWs as well as on quality of life, preventive interventions directed to the sources of PTSD in the work environment are of utmost importance and should encompass attempts to promote both satisfaction and work performance, and to establish safe working conditions. Keywords: Post-traumatic stress, work performance, employee satisfaction, health care worker, COVID-19.

Mental health and psychosocial support for the war-wounded: A retrospective cohort study from the Democratic Republic of Congo, Mali and Nigeria.

BackgroundFor more than 150 years, war surgery has been at the heart of the humanitarian assistance offered by the International Committee of the Red Cross (ICRC) in conflict zones around the world. Mental health and psychosocial support (MHPSS) is increasingly recognized as an integral part of the medical care offered to this highly vulnerable group of patients. This study seeks to identify patient characteristics associated with high distress prior to MHPSS and predictors of improvement following it.MethodsBetween October 2018 and April 2020, 2,008 weapon-wounded patients received MHPSS in ICRC-supported hospitals in the Democratic Republic of Congo (DRC), Mali and Nigeria. The 21-item Depression and Anxiety Scale (DASS21), the Impact of Events Scale Revised (IES-R) and the ICRC functionality scale for Africa were administered before and after the MHPSS response. Logistic regression models were used to measure associations between outcome and exposure variables. Data was initially collected for monitoring purposes and analyzed retrospectively for the sake of this study.ResultsThe main reasons for surgery were firearms (65%), other weapons (13%) and mines (5%). Linear trends were found between increasing number of days between violence and first consultation and decreased likelihood of presenting high levels of anxiety (aOR 0.75, p = 0.014), and stress (aOR 0.78, p = 0.032). Violence committed by military/armed group was associated with increased likelihood of reporting high levels of anxiety (aOR 2.47, p = 0.047). On the IES-R, high scores at baseline were more likely to be found among illiterate patients (aOR 0.08, p = 0.042) and having been wounded by firearms considerably increased the likelihood of reporting high levels of PTSD (aOR 21.34, p = 0.035). Following MHPSS, 92.28% of the patients showed a reduction in symptoms on the DASS21, 93.00% showed a reduction in symptoms on the IES-R and 83.04% showed an improvement on the ICRC Africa functioning scale. On the DASS21, factors negatively associated with improved anxiety included lack of social support (aOR 0.17, p = 0.047) and suffering from a chronic medical/physical condition (aOR 0.40, p = 0.013). Patients with reduced IES-R scores were more likely to have a high level of education (aOR 8.95, p = 0.029) and to have received MHPSS that lasted between 22 and 30 days (aOR 8.73, p = 0.008). Predictors of improved functioning included being 35–44 years of age (aOR 3.74, p = 0.004) and suffering from a severe or chronic medical condition (aOR 1.66, p = 0.044).ConclusionsClinical implications of this study include the increased involvement of family and other caregivers in the MHPSS and longer-term follow-up of patients with severe and/or chronic medical conditions. Further research is needed with regard to joint psychological and physical outcomes, the role of the patient’s education level and the personal styles and techniques used by the counsellors.

Daily Written Care Summaries for Families of Critically Ill Patients: A Randomized Controlled Trial*

To determine the effect of daily written updates on the satisfaction and psychologic symptoms of families of ICU patients. Randomized controlled trial. Single, urban academic medical center. Surrogates of nondecisional, critically ill adults with high risk of mortality ( n = 252) enrolled from June 2019 to January 2021. Usual communication with the medical team with or without written communication detailing the suspected cause and management approach of each ICU problem, updated each day. Participants completed surveys at three time points during the ICU stay: enrollment ( n = 252), 1 week ( n = 229), and 2 weeks ( n = 109) after enrollment. Satisfaction with care was measured using the Critical Care Family Needs Inventory (CCFNI). The presence of anxiety, depression, and acute stress were assessed using the Hospital Anxiety and Depression Scale (HADS) and Impact of Events Scale Revised (IES-R). CCFNI, HADS, and IES-R scores were similar among participants assigned to the intervention group and control group upon enrollment and during the first week after enrollment ( p > 0.05). From enrollment to the second week after enrollment, there was an improvement in CCFNI and HADS scores among participants assigned to the intervention group versus the control group. At week 2, CCFNI scores were significantly lower among participants in the intervention group versus the control group, indicating greater satisfaction with care: 15.1 (95% CI, 14.2-16.0) versus 16.4, (95% CI, 15.5-17.3); p = 0.04. In addition, 2 weeks after enrollment, the odds of symptoms of anxiety, depression, and acute stress among participants assigned to the intervention versus control group were 0.16 (95% CI, 0.03-0.82; p = 0.03); 0.15 (95% CI, 0.01-1.87; p = 0.14); and 0.27 (95% CI, 0.06-1.27; p = 0.10), respectively. Written communication improved satisfaction and the emotional well-being of families of critically ill patients, supporting its use as a supplement to traditional communication approaches.

Infra-Low Frequency Neurofeedback in the Treatment of Patients With Chronic Eating Disorder and Comorbid Post-Traumatic Stress Disorder.

The treatment of patients suffering from an eating disorder and a comorbid post-traumatic stress disorder is challenging and often leads to poor outcomes. In a randomized control trial, we evaluated to what extent adding Infra-Low Frequency (ILF) neurofeedback could improve symptom reduction within an established inpatient treatment program. In a randomized two-group design, patients suffering from an eating disorder (anorexia nervosa, bulimia nervosa, or binge eating disorder) and comorbid post-traumatic stress disorder (N = 36) were examined while attending an inpatient treatment program in a clinic for psychosomatic disorders. The intervention group received ILF neurofeedback in addition to regular therapy, while the control group received “media-supported relaxation” as a placebo intervention. At the beginning and at the end of their treatment, all participants completed the Eating Disorder Examination-Questionnaire (EDE-Q) as a measure of eating disorder psychopathology and the Impact of Event Scale-Revised (IES-R) in order to assess symptoms of post-traumatic stress. Changes in EDE-Q and IES-R scores over time served as primary outcomes as well as an increase in body mass index in underweight patients. Secondary outcomes were the perceived benefit of the received intervention, global assessment of psychological treatment success, and complications in the course of treatment. Statistical evaluation was carried out with repeated measurement analysis of variance for the primary outcomes and with t-tests and Fisher’s exact test for the secondary outcomes. Our results indicate better treatment outcomes in the ILF neurofeedback group with regard to trauma-associated avoidance as well as with regard to restraint eating and increase in body weight. Furthermore, patients who had received ILF neurofeedback rated the intervention they received and, in tendency, their overall treatment more positively and they experienced fewer complications in the course of treatment. ILF neurofeedback is very well accepted by patients and seems to provide a relevant additional benefit in some aspects of symptom reduction. Findings confirm the feasibility of embedding this treatment approach in an inpatient setting and support the case for a larger study for greater statistical power.Clinical Trial Registration: “Infra-Low Frequency Neurofeedback training in the treatment of patients with eating disorder and comorbid post-traumatic stress disorder”; German Clinical Trials Registry (https://www.drks.de; Identifier: DRKS00027826).

The Impact of the COVID-19 Pandemic on the Psychological Well-being of Healthcare Workers in Obstetrics and Gynaecology: An Observational Study at an Apex Institute.

Background and objectiveThe coronavirus disease 2019 (COVID-19) pandemic has affected the health, social, and economic sectors all over the world. With a view to assessing the impact of COVID-19 on the mental health of healthcare workers (HCWs), we conducted a study to find out the incidence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among HCWs.Material and methodsThis was an observational cross-sectional study conducted in the Department of Obstetrics and Gynaecology in collaboration with the Department of Psychiatry at AIIMS, New Delhi from March 2021 to June 2021. One hundred HCWs working in the Department of Obstetrics and Gynaecology were surveyed using a set of semi-structured interview schedules and structured questionnaires distributed via email or manually. The structured questionnaire included the demographic profile; other baseline information; the 42-item Depression, Anxiety, and Stress Scale (DASS-42); and the Impact of Event Scale-Revised (IES-R) instrument. Data analysis was carried out using the statistical package STATA version 14.0 (StataCorp LLC, College Station, TX).ResultsA total of 100 HCWs participated in the study, out of which 39 (39%), 45 (45%), and 16 (16%) were doctors, nursing staff, and supporting staff, respectively. Overall, 92 (92%) of the participants were women, and the mean age of the participants was 29.87 ±4.85 years. Out of the 100 participants, 17 (17%), 25 (25%), 13 (13%), and two (2%) participants had depression, anxiety, stress, and PTSD, respectively. Occupation-wise, among the nursing staff, doctors, and supporting staff, the incidence of depression was 24.4%, 15.4%, 0.0%, respectively; the anxiety rate was 33.3%, 25.6%, and 0.0%, respectively; and the rate of stress was 17.8%, 12.8%, and 0.0%, respectively. The IES-R score was significantly higher among unmarried as compared to married participants (2.70 ±7.935 vs. 1.60 ±3.583, p=0.000). Participants living in joint families had a higher DASS-42 score (DASS-D: 4.00 ±5.299 vs. 3.77 ±7.727, p=0.889; DASS-A: 4.31 ±4.398 vs. 4.12 ±7.496, p=0.905; DASS-S: 4.08 ±4.816 vs. 3.88 ±7.567, p=0.016) and lower IES-R score (1.31 ±4.922 vs. 2.66 ±9.947, p=0.752) as compared to those living in nuclear families. Depression (4.86 ±8.165 vs. 2.00 ±4.388, p=0.054), anxiety (5.31 ±7.538 vs. 2.14 ±4.704, p=0.024), stress (5.20 ±7.651 vs. 1.67 ±4.733, p=0.014) and PTSD (3.61 ±10.900 vs. 1.44 ±2.634, p=0.245) were all higher among HCWs having exposure to COVID-19 more than 10 hours per week compared to participants with an exposure of less than 10 hours per week. The participants having psychiatric illness in the family showed significantly higher mean values for DASS-42 (DASS-D: 20.00 ±26.870 vs. 3.50 ±6.264, p=0.001; DASS-A: 18.50 ±20.506 vs. 3.88 ±6.215, p=0.002; DASS-S: 18.00 ±21.213 vs. 3.64 ±6.346, p=0.003) as compared to those without any psychiatric illness in the family.ConclusionBased on our findings, occupational and environmental factors at the workplace play a key role in mental health outcomes, and COVID-19 has had a significant impact on the mental health of HCWs. Furthermore, we have also observed that effective planning can significantly reduce mental stress.

The effect of the Covid-19 pandemic stressor on the state-trait anxiety level.

To evaluate the effect that the coronavirus diseases-2019 pandemic will likely have on public and its impact on the state-trait anxiety level of the masses. The cross-sectional study was conducted from May 28 to June 5, 2020, in Turkey, with Kayseri province being the first ring of the chain, and comprised adult citizens of either gender living in Turkey during the pandemic period who could use online technologies. The Impact of Event Scale-Revised was used to determine the effects of the pandemic on the public, and the State Anxiety Inventory and the Trait Anxiety Inventory were used to determine the anxiety level of the public. Data was analysed using SPSS 25 and Stata 14. Of the 1507 subjects, 862(57.2%) were females and 645(42.8%) were males. The largest age group was 18-29 years with 573(38%) sucjects, while the smallest group was aged >60 years with 53(3.5%) subjects. The mean score of State Anxiety Inventory was 39.3±11.3 and mean Trait Anxiety Inventory score was 42.8±8.7, while the Impact of Event Scale-Revised mean score was 27.4±14.5. Each one unit increase in the Impact of Event Scale-Revised total score increased state anxiety score 1.10 times and trait anxiety score 1.07 times. Increasing age had a protective effect on state-trait anxiety. Consequently, an increase in Impact of Event Scale-Revised score led to an increase in the anxiety level.

The Elephant in the Room: A Cross-Sectional Study on the Stressful Psychological Effects of the COVID-19 Pandemic in Mental Healthcare Workers.

Despite extensive research on COVID-19’s impact on healthcare workers, few studies have targeted mental health workers (MHWs) and none have investigated previous traumatic events. We investigated psychological distress in MHWs after the first lockdown in Italy to understand which COVID-19, sociodemographic, and professional variables represented greater effects, and the role of previous trauma. The survey included sociodemographic and professional questions, COVID-19 variables, and the questionnaires Life Events Checklist for DSM-5 (LEC-5), Impact of Event Scale—Revised (IES-R), and Depression Anxiety Stress Scales 21 (DASS-21). On the 271 MHWs who completed the survey (73.1% female; mean age 45.37), we obtained significant effects for contagion fear, experience of patients’ death, increased workload, and worse team relationship during the first wave. Nurses were more affected and showed more post-traumatic stress symptoms, assessed by IES-R, and more depressive, anxiety, and stress symptoms, assessed by DASS-21. The strongest risk factors for distress were greater age, professional role, increased workload, worse team relationship, and separation from family members. Previous experience of severe human suffering and unwanted sexual experiences negatively impacted IES-R and DASS-21 scores. Being a psychiatrist or psychologist/psychotherapist and good team relationships were protective factors. Recent but also previous severe stressful events might represent relevant risk factors for distress, reducing resilience skills. Identifying vulnerable factors and professional categories may help in the development of dedicated measures to prevent emotional burden and support psychological health. Highlights: Psychological distress in mental health workers in the COVID-19 pandemic is more frequent in nurses, who experience more depression, anxiety, and post-traumatic stress symptoms. Previous and recent stressful events are risk factors for distress and should guide intervention strategies.

Measurement of risk and stressors of post-traumatic stress disorder during the first lockdown period of COVID-19 among Industrial workers, Hyderabad, India

Introduction: Post-traumatic stress disorder usually occurs after a traumatic event and this COVID-19 pandemic has affected mental health to a great extent. While there is extensive research being conducted about this aspect among the general population, the most neglected are the Industrial workers during the first lockdown period. The aim of the study was to assess the risk of post-traumatic stress disorder symptoms using the impact of event scale-revised (IES-R), their main stressors and coping measurements among the industrial workers of Hyderabad. Methods: A telephonic interview schedule was adopted to fill the online questionnaire among Industrial workers of age group 20-55 years during the lockdown period. Hundred and seventy-four participants were included in our study and data was collected using standardized tools IES-R and brief resilient coping scale. Various stressors and also their coping strategies were elucidated. Results: At the risk of post-traumatic stress disorder symptoms were found among 20.6% and at risk of suppressed immune system functioning which is presumed to have its effect for the next 10 years was 13.8%. The main stressors of COVID-19 with increased IES-R score were not staying with family members, influence of social media, Any acquaintance with COVID-19 infected person effect on daily life and white-collar group. Coping measurements with a brief resilient coping scale found 17.4% as low resilient copers. Conclusion: This identification of high-risk post-traumatic stress disorder symptoms needs to be addressed earlier to bring up preventive strategies such as counseling services in the occupational health care centers of our industries.

Psychological stress of emergency medical staff after the largest mass murder incident in post-World War II era.

BackgroundA mass‐casualty incident occurred on July 26, 2016, at Tsukui Yamayuri‐en, which is a welfare facility for people with intellectual disabilities. Nineteen residents with intellectual disabilities were killed, and 26 other residents and staff members were injured. Kitasato University Hospital Emergency and Disaster Medical Center treated many patients in serious condition at the site and in the hospital.AimsThe authors investigated the symptom severity and distributions of posttraumatic stress disorder (PTSD) among the emergency medical staff in charge.The subjects of this study were the staff members, mostly working at the Emergency and Disaster Medical Center, who treated the people injured in the incident.MethodsWe conducted a questionnaire survey using Impact of Event Scale‐Revised (IES‐R) on 104 staff members, and 79 responded.ResultsThe IES‐R scores of nurses were significantly higher than those of doctors. There was no significant difference in the scores between male and female staff members, and there was no correlation between the score of each IES‐R subscale and age.ConclusionResults suggest that mental care should be provided to emergency medical staff, especially nurses who treat trauma patients involved in disasters and heinous crimes.

Prevalence, Intensity, and Clinical Impact of Dyspnea in Critically Ill Patients Receiving Invasive Ventilation.

Rationale: Dyspnea is a traumatic experience. Only limited information is available on dyspnea in intubated critically ill patients. Objectives: Our objectives were 1) to quantify the prevalence and severity of dyspnea; and 2) to evaluate the impact of dyspnea on ICU length of stay and post-traumatic stress disorder (PTSD) 90 days after ICU discharge. Methods: This was a prospective cohort study in 10 ICUs in France. In patients intubated for more than 24 hours, dyspnea was quantified with a visual analog scale (from 0 to 10) as soon as they were able to communicate, the following day, and before spontaneous breathing trials. PTSD was defined by an Impact of Event Scale-Revised score of at least 22. Measurements and Main Results: Among the 612 patients assessed, 34% reported dyspnea, with a median dyspnea rating of 5 (interquartile range, 4-7). ICU length of stay was not significantly different between patients with versus without dyspnea (6 [3-12] and 6 [3-13] days, respectively; P = 0.781). Mortality was not different between groups. Of the 153 patients interviewed on Day 90, a higher proportion of individuals with probable PTSD was observed among patients who were dyspneic on enrollment (29% vs. 13%; P = 0.017). The density of dyspnea (number of dyspneic episodes divided by time from enrollment to extubation) was independently associated with PTSD (odds ratio, 1.07; 95% confidence interval, 1.01-1.13; P = 0.031). Conclusions: Dyspnea was frequent and intense in intubated critically ill patients. ICU length of stay was not significantly different among patients reporting dyspnea, but PTSD was more frequent at Day 90. Clinical trial registered with www.clinicaltrials.gov (NCT02336464).

A study to evaluate the impact of COVID-19 on the mental health of medical students

Background and Aim: The COVID-19 pandemic has imposed huge challenges on medical students and medical educators as they are the frontline workers in health-care management. The present study was conducted to evaluate and compare depression, anxiety, and stress levels and the Impact of Event Scale scores among different phases of undergraduate medical students. Materials and Methods: The present study was conducted online at Burdwan Medical College after taking institutional ethical clearance and informed consent from participants. The Depression, Anxiety, and Stress Scale-21 (DASS-21) scores and the Impact of Event Scale-Revised (IES-R) scores of all phases of MBBS students were evaluated during the first and second waves of the pandemic. Jamovi software was used for statistical analysis and ANOVA was used to compare different groups. Results: There was no significant difference in the DASS-21 scores among all five groups during the first wave, but significant differences were observed in IES-R scores. On post hoc analysis, significant differences were observed in the Intrusion, Avoidance, and Hyperarousal scores between 1st- and 5th-year, 2nd- and 5th-year, and 4th- and 5th-year students. During the second wave, significant differences in DASS-21 and IES-R parameters were observed between the different phases of MBBS students. There were significant positive correlations between IES-R scores and DASS-21 scores among 1st-year students and a significant negative correlation between IES-R scores and anxiety scores among 2nd-year students during the first evaluation. There were significant positive correlations between IES-R scores and DASS-21 scores among 1st-year students and a significant positive correlation between IES-R scores and stress scores among 5th-year students during the second evaluation. Conclusion: Senior batches of MBBS students were more mentally affected by the impact of the pandemic as evaluated by DASS-21 scores and IES-R scores. Levels of depression, stress, and anxiety were also increased during the second wave as compared to the first wave of the present pandemic.

Impact of coronavirus 2019 pandemic on post-traumatic stress disorder symptoms among pregnant women in Jordan.

Objective:To examine the prevalence of psychological symptoms of the coronavirus disease 2019 outbreak among pregnant women and its association with gestational age and post-traumatic stress disorder symptoms.Methods:A cross-sectional study was conducted between June and November 2020 to assess the impact of the COVID-19 pandemic on mental health in pregnancy using the Impact of Event Scale-Revised. Pregnant women 18 years and older were recruited from antenatal and obstetrics clinics in Jordan. A total of 481 pregnant women participated in an online survey developed on Google Forms. A self-administered structured questionnaire was used to collect sociodemographic data, mental health information, and lifestyle changes. The Impact of Event Scale-Revised, the Perceived Support Scale, and the Mental Health Lifestyle Scale were administered. Variables related to sociodemographic information and dietary behavior and perception during the COVID-19 pandemic were also assessed.Results:The results showed that 58.6% of pregnant women reported the presence of post-traumatic stress disorder symptoms and women in the second trimester were more likely to show post-traumatic stress disorder symptoms compared with the first and third trimesters (p = 0.001). Moreover, a higher level of education, employment, poor dietary habits, and changes due to the pandemic were significantly associated with the Impact of Event Scale-Revised score and the presence of post-traumatic stress disorder symptoms.Conclusion:The COVID-19 pandemic was associated with high rates of psychological distress among pregnant women. Identifying mothers at risk of post-traumatic stress disorder symptoms may help improve maternity services and prevent adverse child outcomes.

Psychological impact of COVID-19 on Healthcare Workers in King Hamad University Hospital, Kingdom of Bahrain

Background: The COVID-19 pandemic is a global health crisis with a likely long-term psychological impact on healthcare workers (HCWs). As the pandemic moves towards endemic status, little knowledge exists on how it has affected HCWs in the Kingdom of Bahrain. This study aims to evaluate the psychological impact and related factors of HCWs during the COVID-19 pandemic. Factors were assessed at two time periods: 1- July 2020 (T1: 6 months after the pandemic started in Bahrain) and 2- 6-month follow-up during January 2021 (T2: 12 months). Methods: An online cross-sectional survey using standardized questionnaires; Impact of Event Scale-Revised (IES-R), the Beck Anxiety Inventory (BAI), and factors including lifestyle, exposure to COVID-19, and knowledge of the centre’s psychological support services was circulated during both the time periods. Results: Based on a sample size of 366 (T1) and 537 (T2) HCWs, mild/positive PTSD prevalence increased from 18.9% (T1) to 19.6 % (T2), but anxiety decreased from 31.1% (T1) to 27.4% (T2). Sleep-related disturbances significantly decreased from T1 to T2 (32.5 % vs 24.8%, p = 0.013). Although the frequency of HCWs with psychological distress and anxiety did not change significantly over time, there was a decrease in severity of both psychological distress (p=0.06) and anxiety (p=0.005). HCWs (75%) who were aware of available psychological support services also had lower IES-R and BAI scores. Conclusion: COVID-19 has caused psychological distress and anxiety to HCWs, but rates were lower compared to other studies. Further development of COVID-19 leadership strategies incorporating interventions focused on psychological support for HCWs is needed. Keywords: COVID-19, Trauma, Mental health, Anxiety, Psychological impact, Post-traumatic stress disorder

The Hidden Factors Affecting Academic Performance Among Chinese Middle School Students: Traumatic Experience and Posttraumatic Stress Symptoms.

Background and PurposeThe role of posttraumatic stress disorder (PTSD) in the path from traumatic exposure (TE) to academic performance (AP) is still not explicitly illustrated. The current study aimed to examine the moderator role of PTSD on the relationship between TE and AP, and then to investigate whether this moderator role is influenced by gender.Participants and MethodsA sample of Chinese students (n=235) who had experienced the major earthquake of Wenchuan was chosen. PTSD and TE were measured by the Impact of Event Scale – Revised (IES-R) and an earthquake-related experience questionnaire, respectively. AP was collected from their up-to-date general examination. Data for 221 participants (53.4% female; mean age=14.03 years, SD=0.824) were finally included in the analysis. Parsimonious latent-variable interaction analysis and hierarchical regression analysis were adopted to examine the moderator role of PTSD.ResultsThe average IES-R score was 27.57 (SD=13.265, range 0–67). The average score for earthquake exposure was 5.86 (SD=2.069, range 1–12). The results showed that both TE and the interaction term of PTSD*TE had significant negative correlations with AP, while PTSD was not associated with AP. Subsequent hierarchical regression analysis found that the relationship of the interaction term and AP was only significant in female students, and a simple slope plot showed a distinct pattern of the moderating effect of PTSD in both genders.ConclusionThis study supported that PTSD moderated the connection between TE and AP in middle school students who had undergone a major earthquake trauma, which was influenced by gender. Students who experienced major trauma with drastic exposure history and manifested PTSD symptoms need specified intervention to avoid further deterioration in performance in school.

Psychological and traumatic stress and the risk of developing diabetes and psychiatric disorders after a disaster-relief mission: An eight-year longitudinal study of Japan Maritime Self-Defense Force personnel dispatched for the 2011 Great East Japan Earthquake disaster-relief mission

The Great East Japan Earthquake caused triple disasters—the earthquake itself, tsunamis, and nuclear leakage. Japan Maritime Self-Defense Force (JMSDF) personnel engaged in disaster-relief suffered various degrees of psychological stress, which is associated with psychiatric as well as physical disorders, such as diabetes. This study aimed to assess the effect of mission-related stress on the development of diabetes and psychiatric disorders in these personnel using JMSDF annual physical check-up data from 2010 to 2018 and Impact of Events Scale-Revised (IES-R) and Kessler Psychological Distress Scale (K-10) questionnaire data. Cox proportional hazard models were used to assess the hazard ratios (HRs) of developing diabetes and psychiatric disorders in the dispatched (N = 3686) vs. non-dispatched (N = 13,953) groups and high IES-R (score ≥25) vs. low IES-R score and high K-10 (score ≥25) vs. low K-10 score subgroups. We found a significantly higher HR of developing diabetes in the high IES-R score subgroup (2.02; 95% confidence interval [CI], 1.08–3.80). However, the HRs were not significant when comparing dispatched vs. non-dispatched groups and high vs. low K-10 score subgroups. Although the HR of developing psychiatric disorders was significantly lower in the dispatched group (0.64; 95% CI, 0.48–0.84), it was significantly higher in the high IES-R (7.95; 95% CI, 3.38–18.74) and high K-10 (8.76; 95% CI, 4.34–17.68) score subgroups. Thus, this study indicates the importance of paying closer attention to the risk of diabetes and psychiatric disorders in individuals with high IES-R or K-10 scores after disaster-relief activities.

Impact of COVID-19 on Mental Health of Chinese Residents in Its Initial Stage.

This study aims to investigate the effect of coronavirus disease 2019 (COVID-19) on the Chinese public’s mental health during its early stage. We collected the data through an online questionnaire survey. Specifically, we adopted the impact of event scale-revised (IES-R) and state-trait anxiety inventory (STAI) to assess symptomatic responses to exposure to traumatic life events and public anxiety, respectively, in the COVID-19 pandemic outbreak. Then, we evaluated the differences in the scores among various socio-demographic groups using Kruskal-Wakkis H tests and t-tests and analyzed the IES-R, state anxiety (SA) score, and trait anxiety (TA) score using the Pearson correlation analysis. Finally, we conducted a path analysis to determine the mediating role of post-traumatic stress disorder symptoms (measured by the IES-R) in the relationship between TA and SA. The results show that the average of the SA and TA scores were 48.0 ± 10.4 and 38.0 ± 8.2, respectively; the respondents who suffered from mild, moderate, and severe psychological impacts because of the health crisis accounted for 21.9, 5.2, and 13.1%, respectively; farmers have the highest IES-R score than others; people with the highest income have the lowest SA level; a significant positive correlation existed between the IES-R and STAI scores; and TA produces both direct and indirect (through the IES-R) effects on SA. Overall, the general Chinese public exhibited much higher anxiety levels than normal in the early days of the pandemic outbreak. Accordingly, we strongly recommend psychological counseling and intervention support to mitigate the adverse psychological impacts of such an event.