Related Worries Research Articles

Associations of childhood neglect, difficulties in emotion regulation, and psychological distresses to COVID-19 pandemic: An intergenerational analysis

BackgroundAlthough individuals' psychological responses to trauma are varied, significant associations between parental and offspring's reactions have been documented among trauma-exposed families. Common susceptible factors originated from intergenerational transmission may be underlying mechanisms of this phenomenon. ObjectiveThis study aimed to investigate the intergenerational transmission of depression and anxiety during early outbreak of COVID-19 and further examined whether the transmission of child neglect and difficulties in emotion regulation (ER) was associated with the transmission of psychological distresses. MethodsSelf-reported questionnaires of depression, anxiety, COVID-19 related worries, difficulties in ER, physical and emotional neglect suffered in childhood were completed by 2011 Chinese parent - offspring dyads. Path analysis was used to examine hypothesized relationships. ResultsThe proportions of physical neglect and emotional neglect were 31.2% and 16.9% respectively among parents, while 28.6% and 20.8% respectively among offspring. There were remarkably similar in response patterns between parents and offspring. Parents' COVID-19 related worries, depression and anxiety levels were significantly associated with offspring's COVID-19 related worries, depression and anxiety. Difficulties in ER not only impacted psychological distresses directly, but also mediated the relationships between childhood neglect and psychological distresses among both parents and offspring. Difficulties in ER and childhood neglect, as important risk factors, were modestly transmitted from parent to offspring. ConclusionsFamily members shared a certain degree of similarity in psychological reactions to trauma. Transmitted susceptible factors from parents to offspring may contribute to this similarity. Family therapy may be suitable for family members exposed to the same traumatic events.

Subjective social status, COVID-19 health worries, and mental health symptoms in perinatal women

Pregnant women and those who have recently given birth are considered an at-risk population during the COVID-19 pandemic with regards to the impact of both general stress and pandemic-related stressors. The extent to which subjective social status (SSS), one's perception of relative standing compared to others in a social hierarchy, might mitigate the effects of COVID-19-related health worries on mental health has not yet been reported, despite SSS often outperforming socioeconomic status as a predictor of various health outcomes including depression. This cross-sectional survey study tested the moderating effect of SSS on association between COVID-19- related health worries and mental health symptoms (depressive and generalized anxiety) among a sample of 1,637 perinatal women from the United States who took part in the Perinatal Experiences and COVID-19 Effects (PEACE) Study between May 2020 and June 2021. We found that high subjective social status was protective against depressive symptoms when self-reported COVID-19-related worry was low. When COVID-19-related worry was high, subjective social status was no longer influential. Higher levels of COVID-19-related health worries were associated with more anxiety symptoms, and higher subjective social status did not moderate anxiety symptomatology at either level of COVID-19-related worry. Although higher SSS has historically been protective against mental health decline, in the context of the COVID-19 pandemic it may not be sufficiently protective against anxiety, or against depression for those who experience high levels of worry regarding the effects of COVID-19 on health.

Social and Psychological Effects of COVID-19 Pandemic on Adolescents' and Young Adults' Mental Health: A Cross-Cultural Mediation Study.

The ongoing pandemic has dramatically disrupted daily life, increasing the risk of developing psychiatric disorders and poor mental wellbeing. The compound effects of social, political and psychological stressors have increased psychological symptoms among adolescents and young people, with worries about COVID-19 playing a central role in the clinical course of their mental health problems caused by the pandemic. The aim of this cross-cultural study was to examine the social psychological effects of COVID-19 on adolescents’ and young people’s mental health and wellbeing in Ibero-American population. Participants involved 6,283 adolescents and young adults from five different Spanish-Speaking countries (83.7% female) aged between 12 and 30 years (M = 18.79; SD = 3.48). Participants completed the Worries about COVID-19 and its Consequences Scale (W-COV), the Satisfaction with Life Scale (SWLS), and the Depression, Anxiety and Stress Scale (DASS-21). Descriptive analyses, multivariate ANOVAs and Pearson correlations were performed, as well as Structural Equation Modelling (SEM) testing a mediational model. The results indicate cross-cultural difference in COVID-19 related worries, emotional symptoms and life satisfaction. Results from SEM confirmed the overall indirect effects of COVID-19 cases, political response and participants’ conditions during lockdown on depression, anxiety, stress and life satisfaction mediated by COVID-19 related worries. These findings suggest that the social psychological factors underlying psychological symptoms could be partly explained by increased worries about COVID-19 and its personal, social, economic and political consequences, which may offer guidance to policy makers and health services for safeguarding youth mental well-being.

Investigation of the predictive influence of personal and gubernatorial politics on COVID-19 related behaviors and beliefs.

Given the varied emotional and behavioral responses to the COVID-19 pandemic across the United States, further attention to the personal and societal influences on such responses is necessary. We investigated the predictive influence of personal political affiliation and the congruity of personal and governor political affiliation on COVID-19 emotional and behavioral responses, with specific attention to the influence of intolerance of uncertainty (IU) on emotional response. These factors were assessed in two studies of adults in the United States (N = 480, N = 272). We utilized a series of hierarchical linear and logistic regressions to assess predictors of 4 outcomes: (1) trust in governor’s response to the pandemic, (2) COVID-19 related worry, and the (3) usage and (4) perceived efficacy of protective health behaviors (e.g., wearing a mask). Across these studies, we found that IU predicted increased COVID-19 related worry. Further, age and personal political affiliation, but not concordance with governor affiliation, predicted COVID-19 behavioral responses. These findings are discussed in relation to the potential importance of linking health messaging to personal characteristics.

Searching for Certainty During a Pandemic: A Longitudinal Investigation of the Moderating Role of Media Consumption on the Development of Posttraumatic Stress Symptoms During COVID-19.

The current study longitudinally examined the moderating effects of consuming different types of media (i.e., formal [news] and informal [social media, WhatsApp]) in the association among COVID-19–related worries, intolerance of uncertainty (IU), and posttraumatic stress symptoms (PTSSs). Data were collected at two time points during July and September 2020, with approximately 60 days between measurements. Results showed that both COVID-19–related worries and IU were found to be positively associated with PTSSs. An interaction with formal media consumption was found, so that when one's formal media consumption was high, he or she were most vulnerable to the aforementioned effects on the development of PTSSs. Our findings point to the interactive effects of both COVID-19 worries and IU with media consumption on the development of PTSSs. Although media consumption might provide information during uncertainty, it may also intensify PTSSs during times of crisis. Implications and limitations are discussed.

The associations of parental COVID-19 related worries, lifestyles, and insomnia with child insomnia during the COVID-19 outbreak.

The impacts of the Coronavirus Disease 2019 (COVID‐19) pandemic on sleep health have been studied extensively. However, little is known about sleep problems within the family system during the pandemic. This study aimed to examine the influence of the COVID‐19 pandemic on insomnia in both adults and children, and to explore whether parental COVID‐19 related worries, lifestyles, and insomnia were associated with child insomnia. A total of 1355 parent–child dyads (39.2% fathers, mean age 38.37 years, SD = 5.34; 52.7% boys, mean age 12.47 years, SD = 1.67) were recruited from Jiangxi province in China from 4 to 18 February 2020. Data on insomnia, COVID‐19 related worries, physical activity, and screen time were collected using online questionnaires. Path analysis showed that COVID‐19 related worries and screen time were positively associated with insomnia in both parents and children; while children's physical activity was negatively related to children's insomnia. Parents' insomnia, COVID‐19 related worries, physical activity, and screen time were positively associated with children's insomnia, COVID‐19 related worries, physical activity, and screen time, respectively. Bootstrap tests showed that parents' worries were positively associated with children's insomnia via parents' insomnia and children's worries; parents' physical activity was negatively associated with children's insomnia via children's physical activity, parents' screen time was positively associated with children's insomnia via parents' insomnia and children's screen time. Both parental and child sleep are affected by the pandemic. Parental insomnia, stress reaction, and lifestyles contribute to child insomnia. Child sleep health may be maintained or improved by family bonds, home exercise, and sleep schedules.

SARS-CoV-2 Omicron Variant: Exploring Healthcare Workers' Awareness and Perception of Vaccine Effectiveness: A National Survey During the First Week of WHO Variant Alert.

BackgroundAs the SARS-CoV-2 Omicron variant spreads in several countries, healthcare workers' (HCWs) perceptions and worries regarding vaccine effectiveness and boosters warrant reassessment.MethodsAn online questionnaire among HCWs in Saudi Arabia (KSA) was distributed from Dec 1st−6th 2021 to assess their perceptions, vaccine advocacy to the Omicron variant, and their perception of the effectiveness of infection prevention measures and vaccination to prevent its spread, their Omicron variant related worries in comparison to the other variants, and their agreement with mandatory vaccination in general for adults.ResultsAmong the 1,285 HCW participants, two-thirds were female, 49.8 % were nurses, 46.4% were physicians, and 50.0% worked in tertiary care hospitals. 66.9% considered vaccination to be the most effective way to prevent the spread of the Omicron variant and future variants. The respondents however perceived social distancing (78.0%), universal masking (77.8%), and avoiding unnecessary travel (71.4%) as slightly superior to vaccination to prevent the spread of SARS-CoV-2 variants. HCWs aging 55 or older agreed significantly with vaccine ineffectiveness to control Omicron spread, while those who believed in non-pharmacological infection prevention measures agreed significantly with vaccination for that purpose. Male HCWs had a significant agreement with mandatory vaccination of all eligible adult populations. On the other hand, unwilling HCWs to receive the vaccine had strong disagreements with mandatory vaccination.ConclusionsThe current study in the first week of Omicron showed that only two-thirds of HCWs felt that vaccination was the best option to prevent the spread of the Omicron variant, indicating the need for further motivation campaigns for vaccination and booster dose. HCWs had a strong belief in infection prevention measures to contain the spread of SARS-CoV-2 variants that should be encouraged and augmented.

Impact of stoma leakage in everyday life: data from the Ostomy Life Study 2019.

Many people with a stoma experience leakage of stomal effluent. To investigate the impact of leakage on individuals with a stoma. The Ostomy Life Study 2019 included a survey concerning experiences with stomal effluent leakage and the validated Ostomy Leak Impact tool. Respondents with frequent leakage episodes were significantly more affected emotionally and they were feeling less in control than those who rarely or never experienced leakage. The emotional impact of experiencing leakage onto clothes appeared to last up to 1 year after the last leakage incidence. Because of worrying about leakage users increased their product usage and, of those who were in employment, 65% reported that leakage and the related worry influenced their ability to work. Most people with a stoma were emotionally impacted by experiencing leakage, especially by leakage outside the baseplate (resulting in soiled clothes). New solutions are warranted that can help reduce the impact of leakage.

The Impact of COVID-19 Lockdown on Daily Activities, Cognitions, and Stress in a Lonely and Distressed Population: Temporal Dynamic Network Analysis

BackgroundThe COVID-19 pandemic and its associated lockdown measures impacted mental health worldwide. However, the temporal dynamics of causal factors that modulate mental health during lockdown are not well understood.ObjectiveWe aimed to understand how a COVID-19 lockdown changes the temporal dynamics of loneliness and other factors affecting mental health. This is the first study that compares network characteristics between lockdown stages to prioritize mental health intervention targets.MethodsWe combined ecological momentary assessments with wrist-worn motion tracking to investigate the mechanism and changes in network centrality of symptoms and behaviors before and during lockdown. A total of 258 participants who reported at least mild loneliness and distress were assessed 8 times a day for 7 consecutive days over a 213-day period from August 8, 2020, through March 9, 2021, in Germany, covering a “no-lockdown” and a “lockdown” stage. COVID-19–related worry, information-seeking, perceived restriction, and loneliness were assessed by digital visual analog scales ranging from 0 to 100. Social activity was assessed on a 7-point Likert scale, while physical activity was recorded from wrist-worn actigraphy devices.ResultsWe built a multilevel vector autoregressive model to estimate dynamic networks. To compare network characteristics between a no-lockdown stage and a lockdown stage, we performed permutation tests. During lockdown, loneliness had the highest impact within the network, as indicated by its centrality index (ie, an index to identify variables that have a strong influence on the other variables). Moreover, during lockdown, the centrality of loneliness significantly increased. Physical activity contributed to a decrease in loneliness amid the lockdown stage.ConclusionsThe COVID-19 lockdown increased the central role of loneliness in triggering stress-related behaviors and cognition. Our study indicates that loneliness should be prioritized in mental health interventions during lockdown. Moreover, physical activity can serve as a buffer for loneliness amid social restrictions.

COVID-19 Related Stressors, Parent-Child Relationship, and Alcohol Use and Mental Health Profiles Among White and Hispanic/Latinx First-Year College Students.

Transitioning to college during the novel coronavirus disease 2019 (COVID-19) pandemic may increase risk for alcohol use and mental health problems. We examined how COVID-19 related stressors and parent–child relationships are independently and interactively associated with alcohol use and mental health profiles in a sample of first-year college students (N = 425, 34.8% Hispanic/Latinx; 74.9% female) who completed an online survey in October 2020. Latent profile analysis identified four profiles: well-adjusted (53.2%), mental health problems only (21.6%), alcohol use only (17.4%), and comorbid (7.8%). COVID-19 related stressful events increased risk of being in the alcohol use only and comorbid profiles, whereas COVID-19 related worries increased risk of being in the mental health problems only profile. Parent–child relationship quality lowered risk of being in the mental health problems only and the comorbid profiles. In addition, parent–child relationship quality moderated the role of COVID-19 related worries such that COVID-19 related worries were associated with lower odds of being in the comorbid profile when parent–child relationship quality was high but not when parent–child relationship quality was low. Strengthening parent–child relationship quality appears important for promoting college students’ well-being.

COVID-19 related worry moderates the association between postpartum depression and mother-infant bonding

The aim of this study was to ask whether a substantial external stressor, such as the COVID-19 pandemic, affects the association between postpartum depression (PPD) and mother-infant bonding. Specifically, we aimed to determine whether worry regarding such an external threat differentially affected PPD and bonding by analyzing a longitudinal sample of postpartum women assessed before and during the pandemic. One-hundred forty women responded to online questionnaires at (T1) Pre-COVID-19: Six months postpartum (February 2018 to December 2019), and (T2) During COVID-19: Twenty-one months postpartum (April 2020 to January 2021). The strength of correlation between mother-infant bonding and PPD significantly declined from before (T1: R = 0.64, p < 0.00) to during the pandemic (T2: R = 0.44, p < 0.001; Difference = 0.20, p = 0.05). Furthermore, only PPD correlated with the worry due to the pandemic; thus the PPD-bonding association was weaker among women who were less concerned about the pandemic (F(3, 136) = 15.4, R2 = 0.25). The study suggests that emotions and cognitions related to motherhood, such as mother-infant bonding, may be more resilient to external pressures such as a pandemic than affective states such as PPD. (174 words).

The relationship between older adults’ technology use, in-person engagement, and pandemic-related mental health

Objective The objectives of this study are to 1) describe changes in in-person communication/activity and changes in older adult technology use during the COVID-19 pandemic and 2) examine whether less in-person communication/activity mediates the relationship between pandemic-related mental health and technology use. Method Linear regressions (stratified by age and financial strain) and structural equation modeling were employed using a nationally representative, cross-sectional survey of 3,188 older adults from the 2020 National Health and Aging Trends Study’s COVID-19 Questionairre. Results Older adults engaged in more technology-based activity (b = 0.24; p<.001), more technology-based health care communication (b = 0.22; p<.001), and more technology-based food acquisition (b = 0.21; p<.001) during the COVID-19 pandemic, as compared to before the pandemic. Results indicate that adults <80 years old demonstrated greater increases in technology-based activity, technology-based health communication, and technology-based food acquisition, compared to adults ≥80 years old. Change in in-person communication significantly mediated the relationship between pandemic-related mental health and technology-based communication (standardized coefficient= −0.012; p=.005), and change in in-person activity significantly mediated the relationship between pandemic-related mental health and technology-based activity (standardized coefficient= −0.017; p=.020). Conclusions This study suggests that older adults are utilizing technology more, and therefore should be considered in technology design and dissemination. Technology use could be an important positive response to help those with pandemic related worries stay safely engaged with friends and family. Technologies should be produced that are modifiable for older adults with disabilities and affordable for older adults with fixed incomes.

The transmission of psychological distress and lifestyles from parents to children during COVID-19

BackgroundThe coronavirus disease 2019 (COVID-19) outbreak had rapidly become a global health threat, and its impact on the mental health was transmitted among different populations, especially from parents to children. The study aimed to investigate Chinese parents’ influence on their children, in terms of mental health and lifestyles (screen time and physical exercise), during the COVID-19. MethodsSelf-reported online questionnaires of depression, anxiety, COVID-19 related worries, physical exercise, and screen time were completed by 3471 Chinese children and one of their parents (1514 fathers and 1957 mothers), during the COVID-19 epidemic in February 2020. Path analysis was used to examine the extent of transmission of psychological distress and whether lifestyles tied to transmission. ResultsDuring the quarantine, Chinese parents’ depression and anxiety both positively predicted their children's depression and anxiety; parents’ COVID-19 related worries, physical exercise and screen time separately had positive effects on children's COVID-19 related worries, physical exercise and screen time; parents’ depression and anxiety were positively influenced by their COVID-19 related worries, self-quarantine and quarantine of family members, relatives or friends; children's depression and anxiety positively predicted their non-suicidal self-injury and suicide ideation. Bootstrap analyses showed that parents’ COVID-19 related worries and lifestyles increased children's depression and anxiety via children's COVID-19 related worries and lifestyles, as well as parents’ depression and anxiety. ConclusionsWhen families face to public events, parents’ psychological distress and lifestyles are related to children's psychological stress and lifestyles. Interventions of parents’ psychological distress and lifestyles would improve family resilience.

Cancer Treatment During COVID-19: Resilience of Individuals With Advanced Non–Small Cell Lung Cancer Versus Community Controls

Background: Among all patients with cancer, those with advanced non–small cell lung cancer (NSCLC) experience the most distress. Although new therapies are improving survival, it is unknown whether receiving immunotherapy or targeted therapy during the COVID-19 pandemic increases patients’ psychological vulnerability. To meet clinical needs, knowledge of patients’ COVID-19 perceptions and safety behaviors is essential. Thus, this study compared patients’ psychological responses at diagnosis and during COVID-19 and compared patients with similar individuals without cancer during the same period. Patients and Methods: Patients with advanced NSCLC enrolled at diagnosis for cohort study participated (ClinicalTrials.gov identifier: NCT03199651). Those with follow-ups from April 28, 2020, through July 14, 2020 (n=76), were assessed again including COVID-19 measures. Simultaneously, community controls with similar sociodemographics and smoking histories were solicited (n=67). Measures were COVID-19 perceptions (Brief Illness Perception Questionnaire), social distancing, and depressive (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) symptoms. First, analyses evaluated differences in the psychological responses of patients with NSCLC at diagnosis and during COVID-19. Second, patients and controls were contrasted on COVID-19 perceptions, social distancing, and psychological symptoms. Results: The depressive and anxious symptoms of patients with NSCLC were greater at diagnosis (P&lt;.02) than during COVID-19, approximately 1 year later. Patients with NSCLC and controls did not differ in terms of sociodemographics, except those with NSCLC were more racially diverse and older, and had greater smoking history (P&lt;.03). Groups did not differ regarding concern, understanding, or perceived control over COVID-19 (P&gt;.406). Notably, controls anticipated the COVID threat would last longer, practiced more social distancing, were more concerned about family (P&lt;.04), and reported worse psychological symptoms (P&lt;.023). With less depression and anxiety, patients with NSCLC viewed COVID-19 as a shorter-term threat and had fewer COVID-19–related worries than did controls. For controls, COVID-19 was more salient, heightening worries and psychological symptoms. Conclusions: Despite multiple health stressors, patients with NSCLC demonstrated resilience when receiving cancer treatment during COVID-19. Nonetheless, this population remains psychologically vulnerable, requiring support at diagnosis and thereafter.

N03 Medication adherence in relation to Health-related Quality of Life in patients with Inflammatory Bowel Disease – A cross-sectional study

Abstract Background Inflammatory Bowel Diseases are chronic diseases often with complex treatment. The treatment is lifelong and complex and may include several different pharmaceutical groups and sometimes surgery. Not rarely is treatment resistance developed and the treatment may come with different degrees of side effects. Earlier research has shown insufficient to medication adherence and a lower degree of health-related quality of life in patients with inflammatory bowel disease. The aim is to describe the relationship between medication adherence and health-related quality of life in a Swedish population diagnosed with inflammatory bowel disease. Additional research questions are if any risk factors of low medication adherence can be identified from the collected variables. Methods This cross-sectional study included N=206 patients from three different regions in Sweden. The questionnaires MMAS-8 and Short Health Scale were used combined with a questionnaire regarding patient characteristics. The data and patient characteristics were described and analyzed using descriptive statistics. Ethical approval has been received from the Regional Ethical Review Board, Linköping, Sweden (no.: 2015/369-31). Results The majority of patients had Ulcerative Colitis (62.6%) There were no significant differences between the different groups of Inflammatory Bowel Disease regarding patient characteristics apart from having gone through surgical procedures, which were more common in patients with Crohn’s disease. A small correlation was shown between medication adherence and the health-related quality of life dimension social function (rho = -0.146; p &amp;lt;0.05). Medication adherence showed no significant correlations to the remaining health-related quality of life dimensions: disease related worry, symptom burden and sense of general well-being. Possible risk factors identified for low medication adherence were age between 30 and 50, working at high occupational level, and higher educational level. Conclusion The complexity of measuring medication adherence has been established, making it difficult to make any certain conclusions regarding the hypothesis in this report. This study showed no clear association between medication adherence and health-related quality of life in patients with inflammatory bowel disease. However, it visualized the need of optimizing the instruments used to measure medication adherence in individuals with a non-conventional treatment plan

Protective factors for the mental health of adolescents and young adults in coping with pandemic-related worries: A mediation study

Introduction/objective: Worries regarding COVID-19 and its economic, social, and psychological consequences, together with the strict measures implemented to control this health crisis, have threatened the mental health of adolescents. The aim of this study was to test the mediating role of resilience and life satisfaction in the association between COVID-19 related worries and mental health among adolescents and young adults. Method: A total of 3485 participants between 14-29 years of age (Medad = 19.68, DT = 3.36) completed an online survey regarding pandemic-related worries, resilience, life satisfaction, and emotional symp-toms (depression, anxiety, and stress). Structural Equation Modeling (SEM) was performed to test multi-group invariance. Results: Resilience and life satisfaction partly mediated the relationship between pandemic-related worries and emotional symptoms. Pandemic-related worries were positively associated with emotional symptoms. Resilience and life satisfaction mediated the impact of pandemic-related worries on emotional symptoms. The tested model was invariant according to gender and age. Conclusions: Our findings go beyond the con-text of the current pandemic, highlighting how young people’s worries regarding extraordi-nary circumstances may negatively impact on their mental health. This study highlights the mediating role of life satisfaction and resilience, thus emphasising the need for promoting these aspects to improve the mental health of young people during this global health crisis.

Disparities in COVID-19 Related Worry Among Older Adults in the United States

Racial disparities in COVID-19 exposure, illness, hospitalization and mortality have been well-documented, however, less is known about whether African Americans and other minorities experience greater worry related to the COVID-19 pandemic. Data from the special midterm release of the 2020 Health and Retirement Study (HRS) were used to examine the relationship between race (white, African American, and other) and ethnicity (Hispanic/Non-Hispanic) and COVID-19 related worry among older Americans (N=2,069). Participants were asked, “because of the coronavirus pandemic how worried are you about 1) your own health, 2) the health of others in your family? 3) Your financial situation? 4) Being able to get help if you needed it from family, friends, or others? 5) What will happen in the future?” (0=not at all worried and 10=very worried). Results from OLS regression controlling for age, gender and education showed that compared with whites, African Americans had significantly higher average worry for all items except the last (other race did not differ). On the other hand, Hispanics had significantly lower worry, on average, for each of the five items. In addition, women had significantly higher average worry, while age was negatively associated with all items except the first. These findings indicate that in addition to the previously documented disparities in COVID-19, older African Americans experienced more worry. This has important implications for long-term physical and mental health.

Prevalence and Predictors for Depression among Medical Students during Coronavirus Disease-19 Pandemic: A Cross-sectional Study

BACKGROUND: Since the declaration of the World Health Organization of the coronavirus (SARS-COV-2) as a pandemic, several countries have locked down and quarantined their residents with restrictive procedures to control spread of the disease. Due to pandemic related stressors, concerns and worries have developed regarding negative psychological impact on the mental well-being of the general population, particularly those known to have higher levels of psychological impairment with high vulnerability to mental health diseases such as medical students. AIM: The objectives of the study were to assess the prevalence of self-reported depression and to explore its predictors during the period of Coronavirus Disease 2019 first lock down among medical students. METHODS: This was a cross-sectional study design. The study was conducted at Kasr Alainy Medical School, Faculty of Medicine, Cairo University, Egypt, in June 2020. A simple random sample was picked of one subgroup of 4th year medical students (No. = 300) at faculty of medicine during the academic year 2019–2020. Self-administered questionnaires including Beck’s Depression Inventory scoring were distributed using Google form through communication social media such as WhatsApp. RESULTS: Out of the 300 participants, 238 responses were received with response rate 79.3%. Results indicated that 38.2% of the respondents were experiencing depression with different degrees with Beck’s Depression Inventory mean scores was 19.4 ± 11.6. Multiple logistic regression analysis point out that gender (odds ratio [OR] = 2.4 and p = 0.022) and “Good” grade level of academic performance (OR = 7.2 and p = 0.045) are significant predictors for developing depression among the participating medical students. CONCLUSION: A significantly high prevalence of depression is detected among medical students during the first wave of the SARS-COV-2 pandemic. The prevalence of depression is more among females than males and more with medical students achieving “Good” grade level.

The association of sensory phenotype and concomitant mood, sleep and functional impairment with the outcome of carpal tunnel surgery

BackgroundUp to 25% of people who have had carpal tunnel release surgery (CTR) fail to report improvement; however, evidence for prognostic indicators in this surgical cohort is limited. To identify candidate prognostic factors, this study investigated the association of quantitative sensory testing (QST) derived sensory phenotype and attendant impairment with patient-reported surgical outcome.MethodsWith ethical approval and informed consent, this prospective observational longitudinal study recruited patients from two London hospitals. Multimodal phenotyping measures including quantitative sensory testing (QST), pain parameters, insomnia, pain-related worry, mood and function, were evaluated prior to; and at 3- and 6-months post-surgery. Pain in median nerve distribution with electrophysiologically confirmed conduction delay and DN4 score ≥ 4 was defined as neuropathic. Primary outcome was patient-rated change at 6 months, dichotomised as poor outcome; “worse” or “no change” and good outcome; “slightly better”, “much better” or “completely cured”.ResultsSeventy-six patients participated. Prior to surgery, substantial heterogeneity in established categories of somatosensory function was observed with 21% of participants categorised as having a healthy sensory phenotype; 29% with thermal hyperalgesia; 32% mechanical hyperalgesia and 18% sensory loss. Seventy six percent of participants were classified as having neuropathic pain, 33% with high levels of pain related worry and 64% with clinical insomnia. Observed differences in pain, sleep impairment, psychological factors and function, between sensory phenotypic groups, was not significant. At 3- and 6-months post-surgery there was significant improvement in all phenotyping measures with a moderate to large effect size. Thermal and mechanical measures of somatosensation improved (p < 0.001), as did functional ability (p < 0.001). Symptom severity diminished (p < 0.001), as did pain-related worry (p < 0.001), anxiety (p = 0.02) and insomnia (p < 0.001). Patient-rated surgical outcome was good in 92% of the cohort, poor in 8%. Baseline sensory phenotype category was not associated with surgical outcome however pain-related worry, anxiety and functional interference were significantly associated with outcome (p ≤ 0.05).ConclusionIn patients undergoing carpal tunnel surgery, pain-related worry, anxiety and pain functional interference are candidate prognostic outcome factors and require further elucidation.

Anxiety sensitivity and intolerance of uncertainty are unique and interactive risk factors for COVID-19 safety behaviors and worries

ABSTRACT Intolerance of uncertainty (IU) and anxiety sensitivity (AS) predict distress during the COVID-19 pandemic. However, little is known about how AS and IU jointly predict COVID-19 worries and behaviors. Structural equation modeling was used to examine the direct and interactive effects of AS and IU as related to COVID-19 worries and behaviors in two samples of community adults recruited in April 2020 (N = 642; M age = 38.50 years, SD = 10.00) and May 2020 (N = 435; M age = 34.92 years, SD = 14.98). In sample 1, there was a significant AS by IU interaction predicting COVID-19-related catastrophizing worries, stockpiling, and cleaning behaviors such that the relationship of AS to COVID-19-related behaviors was stronger at high levels of IU. However, although AS predicted some COVID-19 related worries and behaviors, AS and IU did not interact in sample 2. Across samples, AS was directly related to financial and health worries, whereas IU was not a significant predictor after controlling for AS. These findings suggest AS consistently impacts COVID-19 worries and behaviors, particularly among individuals with high IU. Brief interventions targeting AS and IU may help people cope during the COVID-19 pandemic and reintegrate following the pandemic.