The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop ...evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference.
From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21).
This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20-24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (
< 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (
< 0.05).
During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
Chronic unpredictable mild stress (CUMS) can not only lead to depression-like behavior but also change the composition of the gut microbiome. Regulating the gut microbiome can have an antidepressant ...effect, but the mechanism by which it improves depressive symptoms is not clear. Short-chain fatty acids (SCFAs) are small molecular compounds produced by the fermentation of non-digestible carbohydrates. SFCAs are ubiquitous in intestinal endocrine and immune cells, making them important mediators of gut microbiome-regulated body functions. The balance between the pro- and anti-inflammatory microglia plays an important role in the occurrence and treatment of depression caused by chronic stress. Non-absorbable antibiotic rifaximin can regulate the structure of the gut microbiome. We hypothesized that rifaximin protects against stress-induced inflammation and depression-like behaviors by regulating the abundance of fecal microbial metabolites and the microglial functions.
We administered 150 mg/kg rifaximin intragastrically to rats exposed to CUMS for 4 weeks and investigated the composition of the fecal microbiome, the content of short-chain fatty acids in the serum and brain, the functional profiles of microglia and hippocampal neurogenesis.
Our results show that rifaximin ameliorated depressive-like behavior induced by CUMS, as reflected by sucrose preference, the open field test and the Morris water maze. Rifaximin increased the relative abundance of Ruminococcaceae and Lachnospiraceae, which were significantly positively correlated with the high level of butyrate in the brain. Rifaximin increased the content of anti-inflammatory factors released by microglia, and prevented the neurogenic abnormalities caused by CUMS.
These results suggest that rifaximin can regulate the inflammatory function of microglia and play a protective role in pubertal neurodevelopment during CUMS by regulating the gut microbiome and short-chain fatty acids.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
This study evaluated the chronic effects of fluoxetine, a commonly prescribed SSRI antidepressant, on the peripheral and central levels of inflammatory cytokines including IL-1β, IL-6, TNF-α and ...IL-17 over a 4-interval in a rat model of chronic mild stress (CMS) which resembles the human experience of depression. Twenty-four Sprague-Dawley rats were randomly assigned to CMS+vehicle (n = 9), CMS+fluoxetine (n = 9) and the control (n = 6) groups. Sucrose preference and forced swim tests were performed to assess behavioral change. Blood samples were collected on day 0, 60, 90 and 120 for measurement of cytokine levels in plasma. On day 120, the brain was harvested and central level of cytokines was tested using Luminex. Four months of fluoxetine treatment resulted in changes in the sucrose preference and immobility time measurements, commensurate with antidepressant effects. The CMS+vehicle group exhibited elevated plasma levels of IL-1β, IL-17, and TNF-α on day 60 or 120. Rats treated with fluoxetine demonstrated lower IL-1β in plasma and brain after 90 and 120-day treatment respectively (p<0.05). There was a trend of reduction of IL-6 and TNF-α concentration. This study revealed the potential therapeutic effects of fluoxetine by reducing central and peripheral levels of IL-1β in the alleviation of depressive symptoms.
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The prevalence of depression may be affected by changes in psychiatric practices and the availability of online mental health information in the past two decades. This study aimed to evaluate the ...aggregate prevalence of depression in communities from different countries between 1994 and 2014 and to explore the variations in prevalence stratified by geographical, methodological and socio-economic factors. A total of 90 studies were identified and met the inclusion criteria (n = 1,112,573 adults) with 68 studies on single point prevalence, 9 studies on one-year prevalence, and 13 studies on lifetime prevalence of depression. A random-effects model meta-analysis that was performed to calculate the aggregate point, one-year and lifetime prevalence of depression calculated prevalences of 12.9%, 7.2% and 10.8% respectively. Point prevalence of depression was significantly higher in women (14.4%), countries with a medium human development index (HDI) (29.2%), studies published from 2004 to 2014 (15.4%) and when using self-reporting instruments (17.3%) to assess depression. Heterogeneity was identified by meta-regression and subgroup analysis, and response rate, percentage of women and year of publication, respectively, were determined contribute to depression prevalence. This meta-analysis allows benchmarking of the prevalence of depression during the era when online health information emerged, facilitating future comparisons.
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Although cognitive behavioural therapy for insomnia (CBT-I) has been recommended the initial therapy for insomnia, its clinical usage remains limited due to the lack of therapists. Digital CBT-I ...(dCBT-I) can potentially circumvent this problem. This meta-analysis aims to evaluate the short-term and long-term efficacy of dCBT-I for adults with insomnia.
Systematic search of PubMed, EMBASE, PsycINFO, and CENTRAL from inception till 5 March 2020 was conducted. Randomised controlled trials (RCTs) comparing dCBT-I with controls (wait-list/treatment-as-usual/online education) in adults with insomnia were eligible. The primary outcome was insomnia severity index (ISI) at post-intervention, short-term follow-up (ranging 4 weeks to 6 months) and 1-year follow-up. Mean differences were pooled using the random-effects model.
94 articles were assessed full-text independently by two team members and 33 studies were included in this meta-analysis. 4719 and 4645 participants were randomised to dCBT-I and control respectively. dCBT-I significantly reduces ISI at post-intervention with mean difference −5.00 (95% CI −5.68 to −4.33, p < 0.0001) (I2 = 79%) compared to control. The improvements were sustained at short-term follow-up, −3.99 (95% CI −4.82 to −3.16, p < 0.0001) and 1-year follow-up, −3.48 (95% CI −4.21 to −2.76, p < 0.0001). Compared to dCBT-I, face-to-face CBT-I produced greater improvement in ISI, 3.07 (95% CI 1.18 to 4.95, p = 0.001). However, this was within the non-inferiority interval of 4 points on ISI.
This meta-analysis provides strong support for the effectiveness of dCBT-I in treating insomnia. dCBT-I has potential to revolutionise the delivery of CBT-I, improving the accessibility and availability of CBT-I content for insomnia patients worldwide.
•dCBT-I reduced ISI by mean difference of −5.00 (95% CI −5.68 to −4.33, p < 0.0001).•dCBT-I also improved SOL, WASO, TST, SE, and NWAK at post-intervention.•Improvements in ISI were sustained at short-term and 1-year follow-up.•dCBT-I was found to be non-inferior to face-to-face CBT-I.•dCBT-I is an effective therapeutic option for patients with insomnia.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Starting from April 1st, 2020, the nationwide partial lockdown in Vietnam has shown the effectiveness in stopping the community transmission of COVID-19, however, it also produced adverse impacts on ...the economy and inhabitants’ life. A cross-sectional study using a web-based approach was conducted in the second week of April 2020 to examine the influence of the national social distancing on the quality of life and economic well-being of Vietnamese citizens under COVID-19 pandemic. The data included socio-economic characteristics, impact of COVID-19 on household income, health status, and health-related quality of life (HRQOL). Ordered logistic regression and multivariable Tobit regression model were employed to examine factors correlated to income change and HRQOL. Results showed that among 341 participants, 66.9% reported household income loss due to the impact of COVID-19. People holding undergraduate degrees, working in other sectors rather than healthcare, and having definite-term contract had a higher likelihood of income reduction. The mean score of EQ-5D-5L and EQ-VAS was 0.95 (± 0.07) and 88.2 (± 11.0), respectively. The domain of Anxiety/Depression had the highest proportion of reporting any problems among 5 dimensions of EQ-5D-5L (38.7%). Being female, having chronic conditions and living in the family with 3–5 members were associated with lower HRQOL scores. A comprehensive assessment of the influence of COVID-19 along with public health interventions, especially mental health programs, should be implemented to mitigate the negative effects of this pandemic on the economic status and quality of life of citizens.
The twenty-first century viral respiratory epidemics have taught us valuable lessons. Our systematic review examined the impact of these epidemics, including coronavirus disease 2019 (COVID-19), on ...mental health among different population groups, drawing on their insights for recommendations for the current COVID-19 pandemic.
Searches were performed on PubMed, Embase, PsycINFO, Web of Science, Scopus, CINAHL, and Cochrane on April 4, 2020. Studies that had undefined mental health outcomes or did not use a validated scale for measure were excluded. Quality assessment was carried out
the Newcastle-Ottawa Scale.
We included 95 studies, most of which were conducted in Hong Kong (31.6%) and China (21.4%). A total of 30 (30.9%) studies are on the general public, 41 (42.2%) on healthcare workers, and 26 (26.6%) on patients and quarantined individuals. Furthermore, 36 (37.1%) of the studies are of high quality, 48 (49.5%) are of moderate quality, and 13 (13.4%) are of low quality. The most significant mental health outcomes reported include anxiety, depression, and post-traumatic stress disorder symptoms. The subgroups identified to have a higher risk of psychiatric symptoms among the general public include females, the elderly, individuals with chronic illness, migrant workers, and students. Long-term mental health impact was reported in some healthcare workers and epidemic patients, even up to 3 years in the former. Interestingly, when compared to non-quarantined groups, quarantine was not significantly associated with worse mental health outcomes.
Important implications for the COVID-19 pandemic were highlighted. Respiratory epidemics pose a significant psychological morbidity onto many population groups. Psychological support for vulnerable groups, including healthcare workers and patients, should be implemented to prevent them from spiraling into clinical psychiatric conditions.
This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents.
A systematic ...search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions.
: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7-7.7%) and 4.5% (95% CI: 3.4-5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5-17%) and 7.5% (95% CI: 4.5-12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2-22.7%) and 14.2% (95% CI: 11.6-17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9-28.4%) and 19.5% (95% CI: 13.3-27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0-17.0%) and 14.2% (95% CI: 10.1-19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury.
: This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.
COVID-19, the most severe public health problem to occur in the past 10 years, has greatly impacted people's mental health. Colleges in China have reopened, and how to prevent college students from ...suffering secondary damage due to school reopening remains elusive. This cross-sectional study was aimed to evaluate the psychological impact of COVID-19 after school reopening and explore via machine learning the factors that influence anxiety and depression among students. Among the 478 valid online questionnaires collected between September 14th and September 20th, 74 (15.5%) showed symptoms of anxiety (by the Self-Rating Anxiety Scale), and 155 (32.4%) showed symptoms of depression (by Patient Health Questionnaire-9). Descriptive analysis of basic personal characteristics indicated that students at a higher grade, having relatives or friends who have been infected, fearing being infected, and having a pessimistic attitude to COVID-19 easily experience anxiety or depression. The Synthetic Minority Oversampling Technique (SMOTE) was utilized to counteract the imbalance of retrieved data. The Akaike Information Criterion (AIC) and multivariate logistic regression were performed to explore significant influence factors. The results indicate that exercise frequency, alcohol use, school reopening, having relatives or friends who have been infected, self-quarantine, quarantine of classmates, taking temperature routinely, wearing masks routinely, sleep quality, retaining holiday, availability of package delivery, take-out availability, lockdown restriction, several areas in school closed due to COVID-19, living conditions in the school, taking the final examinations after school reopening, and the degree to which family economic status is influenced by COVID-19 are the primary influence factors for anxiety or depression. To evaluate the effect of our model, we used 5-fold cross-validation, and the average area under the curve (AUC) values of the receiver operating characteristic (ROC) curves of anxiety and depression on the test set reached 0.885 and 0.806, respectively. To conclude, we examined the presence of anxiety and depression symptoms among Chinese college students after school reopening and explored many factors influencing students' mental health, providing reasonable school management suggestions.
Social networking is proliferating globally and in Vietnam, but this led to several negative aspects of adolescents' health, including physical activity, sleep quality, and depressive and anxiety ...symptoms. This study aimed to identify the relationship between social media usage and examine risk factors (Fear of Missing out and Risk of Neglect) on social media usage, and the overall quality of life and mental health among individuals actively using social media networks. An online cross-sectional study was conducted in three cities in Vietnam (Hanoi, Tuyen Quang, and Can Tho) from September through to October 2021. A structured questionnaire assessed for characteristics of social media use and other associated factors. 1891 participants were recruited, with 98.4% having access to social media. s. Factors like "PHQ-9 score", "Problematic Internet use", and "Time average used social media per day", were negatively associated with the EQ5D5L Index. By contrast, "Gender", and "Using smartphone" were positive factors of the EQ5D5L Index. "FOMO score" and "self-harm and suicide" were positive factors of the PHQ-9 score while "Using smartphone" was negative. In terms of self-harm and suicide, "FOMO score" and "Problematic Internet use" were positive factors, by contrast, "Using smartphone" was a negative factor. This is the first study to examine social media addiction among Vietnamese adolescents, its relationship with FOMO score, stresses associated with rejection and neglect, and the overall quality of life. Our results highlighted there is a relationship between FOMO score and impaired overall quality of life, increased depressive symptoms, and an association between stresses relating to negative rejection and FOMO score.
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