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      Psychological distress in North America during COVID-19: The role of pandemic-related stressors

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          Abstract

          Rationale

          The COVID-19 pandemic has wreaked havoc on lives around the globe. In addition to the primary threat of infection, widespread secondary stressors associated with the pandemic have included social isolation, financial insecurity, resource scarcity, and occupational difficulties.

          Objective

          The current study examined the impact of these disruptions on psychological distress during the initial adjustment phase to the pandemic in North America.

          Method

          A sample of 2463 residents of the US and Canada completed both baseline and follow-up surveys across several weeks between March and May 2020.

          Results

          Those participants perceiving stress related to higher levels of personal threat to health and to the well-being of family members at baseline reported higher levels of depressive symptoms at follow-up, even after controlling for baseline depressive symptoms. In addition, pandemic-related secondary stressors (social isolation, financial insecurity, occupational difficulty, and resource scarcity) were all independently associated with depressive symptoms at follow-up, controlling for both baseline depression and perceived health threats. The results were robust and held up after controlling for demographic factors. Women, young adults, and those who reported lower income were all at higher risk for subsequent depressive symptoms.

          Conclusion

          Findings from the present study can help to identify key groups at risk for mental health problems during the pandemic, and indicate actionable areas for targeted intervention.

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          Most cited references67

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          The psychological impact of quarantine and how to reduce it: rapid review of the evidence

          Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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            Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

            Background: 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. Methods: 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). Results: 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 (p < 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 (p < 0.05). Conclusions: 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.
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              Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

              Summary The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.
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                Author and article information

                Journal
                Soc Sci Med
                Soc Sci Med
                Social Science & Medicine (1982)
                Elsevier Ltd.
                0277-9536
                1873-5347
                7 January 2021
                February 2021
                7 January 2021
                : 270
                : 113687
                Affiliations
                [a ]Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T1Z4, Canada
                [b ]Department of Sociology, The University of Texas at Austin, 305 E 23rd St, A1700, RLP 3.306, Austin, TX, 78712-1086, USA
                [c ]Department of Psychology, Karnatak University Dharwad, Pavate Nagar, Dharwad, Karnataka State, 580 003, India
                Author notes
                []Corresponding author.
                Article
                S0277-9536(21)00019-8 113687
                10.1016/j.socscimed.2021.113687
                9757831
                33465600
                d8ce28ff-3c2e-46ce-9630-5ac900632ab2
                © 2021 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 29 December 2020
                : 4 January 2021
                Categories
                Article

                Health & Social care
                depression,pandemic,coronavirus,stress,covid-19,mental health,social isolation,psychological distress

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