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      Mobility restrictions and mental health among young adults during the COVID-19 pandemic in Ecuador Translated title: Restricción de movilidad y salud mental entre adultos jóvenes durante la pandemia de COVID-19 en Ecuador

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          Abstract

          ABSTRACT Objective: To study the association between mobility restriction and mental health outcomes among Ecuadorian young adults. Method: The present is a cross-sectional study that included a non-probabilistic sample of mostly highly educated young adults. Socio-demographic and mental health data were collected through an online survey, between May and June 2020, when confinement was mandatory in Ecuador. Data on mobility was extracted from Google Community Mobility Reports. Four aspects of the participants' mental health were evaluated: eating behavior (emotional eating), depression, sleep quality and sense of coherence as a proxy of resilience, using previously validated instruments. Data were analyzed using multiple linear regression models in R. Results: Sample included 8426 young adults, with a mean age of 22.85 (standard deviation: 4.43), most of whom were women (n=5943, 70.53%). During mandatory confinement, in Ecuador mobility in general was reduced by nearly 50% in comparison to January/February, 2020. Less healthy eating behavior, depression, worse sleep quality and lower sense of coherence were associated with higher mobility restriction to workplaces and groceries/pharmacies. Women and youngsters more often showed depression, less healthy eating behavior, worse quality of sleep and lower sense of coherence in comparison with men and older respondents. Conclusions: Mobility restrictions during COVID-19 pandemic were associated with worse self-reported mental health in a sample of young highly-educated Ecuadorian adults. Women and youngsters were the most affected. Our findings highlight the need of implementing health promotion measures directed to ameliorate the effects of confinement on mental health, focusing on women and youngsters.

          Translated abstract

          RESUMEN Objetivo: Estudiar la asociación entre la restricción de movilidad y la salud mental en personas adultas jóvenes de Ecuador. Método: Estudio transversal que incluyó una muestra no probabilística de personas adultas jóvenes con alto nivel de educación. Los datos sociodemográficos y de salud mental se recolectaron entre mayo y junio de 2020, cuando el confinamiento fue obligatorio, usando una encuesta en línea. Los datos sobre movilidad se extrajeron de Google Community Mobility Reports. Se evaluaron cuatro aspectos de la salud mental: alimentación emocional, depresión, calidad de sueño y sentido de coherencia como proxy de resiliencia, usando instrumentos previamente validados. Los datos se analizaron con modelos de regresión lineal múltiple usando R. Resultados: La muestra incluyó 8426 jóvenes, con una edad media de 22,85 años (desviación estándar: 4.43), mujeres en su mayoría (n=5943, 70.53%). Durante el confinamiento obligatorio, la movilidad se redujo aproximadamente un 50%. Comportamientos alimentarios menos saludables, depresión, peor calidad del sueño y menor sentido de coherencia se asociaron con mayor restricción de movilidad a lugares de trabajo y pequeños comercios o farmacias. Mujeres y jóvenes mostraron con mayor frecuencia depresión, conductas alimentarias menos saludables, peor calidad del sueño y menor sentido de coherencia. Conclusiones: Las restricciones de movilidad durante la pandemia de COVID-19 se asociaron con una peor salud mental en personas adultas jóvenes con alto nivel de educación. Mujeres y jóvenes fueron los más afectados. Es necesario implementar medidas de promoción de la salud dirigidas a paliar los efectos del confinamiento en la salud mental, especialmente en mujeres y jóvenes.

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          Most cited references35

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          While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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            The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

            Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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              Prevalence and predictors of PTSS during COVID-19 Outbreak in China Hardest-hit Areas: Gender differences matter

              Highlights • The prevalence of posttraumatic stress symptoms (PTSS) in China hardest-hit areas a month after the COVID-19 outbreak was 7%. • Hierarchical regression analysis and non-parametric test suggested that women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. • Participants with better sleep quality or less frequency of early awakenings reported lower PTSS.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                December 2022
                : 36
                : 6
                : 512-519
                Affiliations
                [2] Quito orgnameHospital de Especialidades Carlos Andrade Marín orgdiv1Department of Neurology Ecuador
                [4] Milagro orgnameUniversidad Estatal de Milagro orgdiv1Research Group in Nutrition, Dietetics, Biotechnology and Food Analysis Ecuador
                [7] Rotterdam South Holland orgnameErasmus MC: Universitair Medisch Centrum Rotterdam orgdiv1Department of Neuroscience Netherlands
                [3] Riobamba Chimborazo orgnameEscuela Superior Politécnica de Chimborazo orgdiv1Faculty of Public Health orgdiv2School of Medicine Ecuador
                [6] Oslo orgnameUniversity of Oslo orgdiv1Department of Community Medicine and Global Health Norway
                [5] Valencia Valencia orgnameUniversitat de Valencia orgdiv1Department of Pharmacy and Pharmaceutical Technology and Parasitology Spain
                [1] Riobamba Chimborazo orgnameEscuela Superior Politécnica de Chimborazo orgdiv1Faculty of Public Health orgdiv2School of Nutrition and Dietetics Ecuador
                Article
                S0213-91112022000600006 S0213-9111(22)03600600006
                10.1016/j.gaceta.2021.12.008
                6e967c4a-3c90-489d-92b7-1d49261e8b0d

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 22 December 2021
                : 26 May 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 8
                Product

                SciELO Spain

                Categories
                Original Articles

                COVID-19,Salud mental,Adultos jóvenes,Ecuador,Depresión,Resiliencia psicológica,Mental health,Young adults,Depression,Resilience psychological

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