The epidemic of COVID-19 has affected the psychological health of people, especially frontline medical and paramedical staff. Several coping strategies have been used to combat the impact of this virus on their lives.

Describe the impact of coronavirus on mental health and identify coping strategies

We carried out a cross-sectional, descriptive and analytical study, conducted over a period of two months ( september and october 2020), in 22 hospitals in Tunisia, including frontline medical and paramedical staff. To evaluate anxiety and depression, we used the Beck Inventory. To identify coping strategies, we used the Brief COPE.

We collected 78 professionals. The mean age was 29.86+-5.4. The majority were medical residents (67.9%) working in covid units in 39.7% of cases. The rythm of work was daily in almost half of the cases, giving direct care to the patients tested positive in 76.9%. More than half had not received adequate training, and protective equipment was available in only 50% of cases. We found 35.9% of the staff who had to move for fear of infecting their families. More than half of the frontline staff were victims of stigma (57.7%). Depression and anxiety were tested minor in 40%. The most used coping strategy in the face of this distressing virus was social support (64.1%) followed by emotion-focused mechanisms (53,8%). Social support strategy was significantly correlated with prevention of anxiety (p=0.048)

Participants practiced and recommended various coping strategies to deal with stress, depression and anxiety emerging from COVID-19 pandemic.

No significant relationships.

The COVID19 pandemic came with unprecedented measures that impacted every aspect of the student’s life making them vulnerable to psychological distress.

The aim of this study was to assess anxiety and depressive symptoms in relation to the coping strategies during the COVID19 pandemic among medical students.

We conducted a web-based cross-sectional study among Tunisian medical students. We used an anonymous survey comprising sociodemographic characteristics, the Hospital Anxiety and Depression scale and the brief COPE.

A total of 216 students participated in the study; 78% were female and most respondents were enrolled in first and second year of medical studies (53%). The frequency of depressive and anxiety symptoms were respectively 28% and 40%; females experienced significantly higher depression and anxiety scores (p<10¯³ and p=0.02 respectively). Most used coping strategies were self-blame, planning, acceptance, distraction, positive reframing, active coping and religion (99%-96%). The least used coping strategies were substance use (13%) and denial (52%). We found that gender was associated with a significant difference in the coping styles where females scored higher on religious coping and denial whereas males used more humor coping. Depression and anxiety were significantly associated with denial coping. Humor, acceptance, positive reframing and active coping were significantly associated with lower depression rates. Humor coping and active coping were associated with lower anxiety rates.

Our study shows alarming rates of depression and anxiety among Tunisian medical students during the COVID19 pandemic. A targeted intervention to promote mental health using the coping styles might be useful in this population.

No significant relationships.

Post-traumatic stress disorder (PTSD) following intensive care is a relatively new entity. It is triggered due to traumatic experiences in a setting of threat to life due to illness. Prolonged stay in intensive care predisposes to delusional memories related to the stay experience and may increase likelihood of post-traumatic stress.It may also present as anxiety or depression.

This study explored the prevalence of post-traumatic symptoms in intensive care, find its correlates and its impact on health-related quality of life (HRQoL).

225 adult patients admitted for at least 1 day in the intensive care unit (ICU) of a general hospital in Bangalore,India were recruited and assessed at 1 week,1 month and 3 months after ICU discharge. Subjects were assessed for ICU related memories, PTSD, anxiety and depression scores and quality of life at and post discharge.

59.6% of the study population had significant post-traumatic stress, including anxiety in 62.35%, depression in 10.58% and mixed anxiety-depression in 27.06%. Delusional memories were found in 31.6%. Presence of delusional memories was found to have significant correlation with post-traumatic stress and had a negative impact on HRQoL.

This study was the first of its kind from Asia. More systematic studies on PTSD following ICU stay and its correlates are required as available evidence lacks homogeneity. Suitable preventive measures should be taken to reduce prevalence of post-traumatic stress in intensive care due to its lasting impact on HRQoL.

No significant relationships.

The effects on the population’s mental health due to the rapid global spread of COVID-19 are even greater for specific groups such as pregnant women.

To compare levels of depressive and anxiety symptoms of pregnant women before vs. during the COVID-19 pandemic and to analyze the role of COVID-19 fear in perinatal psychological disorder.

200 Brazilian women evaluated during the pandemic in May-June 2020 (Sample-1) with the Brazilian Covid-19 Fear Scale for the Perinatal Period (Barros et al. 2020) and Screening for Perinatal Depression and the Perinatal Anxiety Crawl Scale, both with α> .90. Sample-1 was compared with a sample of 300 Portuguese women; these responded to the same questionnaires, before the pandemic, in 2017 and 2018 (Sample-2).

Sample-1 had significantly higher mean scores of depression (52.73 ± 20.26 vs. 35.87 ± 16.98, t = 10.77, p <.001) and anxiety (36.58 ± 18.23 vs. 18.50 ± 13.71, t = 11.94, p <.001) and correlated significantly (p <.05) and moderate (r.30) with the fear of COVID-19. Hierarchical regression analyzes showed that, even after controlling for the effect of risk factors for PPP (Pereira et al. 2020), fear of COVID-19 is a significant predictor of depressive symptomatology levels (increments of 2-5%) and anxious (10-15%) during the pandemic.

The Sample-1 being from a different country may be a confusing factor, however, the magnitude of differences in PPP levels and the relevant role of fear in COVID-19, alert us to be aware of perinatal mental health.

Parents of hospitalized children with chronic illness (HCCI) during the COVID-19 epidemic may face huge pressure and worry, leading to mental health issues. Parent’s depression and anxiety disorders increase the risk of mental health problems in the child and affect his/her recovery.

The aim of this study was to assess the prevalence rate of depressive and anxiety symptoms among a pilot sample of parents of HCCI (in- and out-patients) with diagnosis of epilepsy (9), cystic fibrosis (8) and congenital heart anomalies (6) during COVID-19 pandemic. Pediatric patients were under a regular Children Hospital medical and psychological follow-up program.

We conducted a cross-sectional study among 23 Italian parents (15 F; 8 M) of HCCI during the COVID-19 epidemic period. We performed face-to face interviews and assessed depressive and anxiety symptoms with the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorders (GAD-7) questionnaire during scheduled follow up visits.

The anxiety score of parents of HCCI was 4.43 ± 3.17, of which 39.1% of parents were anxious (≥5 points), while the depression score was 4.04 ± 2.67, of which 30.4% of parents show depressive symptoms (≥5 points). The prevalence of comorbid depressive and anxiety symptoms was 26.1% among the entire sample.

Preliminary data of our pilot study showed a high prevalence of anxious depressive symptoms and comorbidity among parents of HCCI. Timely provision of psychologic interventions are needed during and after COVID-19 pandemic in order to empower parenting and promote children recovery and quality of life.

No significant relationships.

The aim of this study was to evaluate the anxiety and depression status, family functions, parenting attitudes, and quality of life in the mothers of children with CHD.

The study enrolled 120 mothers: 40 of children with cyanotic CHD, 40 of children with non-cyanotic CHD, and 40 of healthy controls. Short Form-36 for quality of life, Hospital Anxiety–Depression Scale for anxiety and depression, Family Assessment Device for the detection of problems affecting family functions, and Parental Attitude Research Instrument for measuring child-rearing attitudes were used in the study.

Statistically significant decreases were found in the general health standards of mothers of non-cyanotic children (p=0.035) and in the emotional and physical role difficulty of mothers of cyanotic children (p=0.006, p=0.010). When anxiety and depression levels of the parents were examined, the anxiety level of the cyanotic group was found to be significantly higher than that of the other groups (p=0.031). When family behaviours were assessed, there was a statistically significant decrease in role status in the families having a child with cyanotic CHD (p=0.035). In the Parental Attitude Research Instrument test, the husband and wife incompatibility sub-scale was found to be statistically significantly lower in the cyanotic CHD group (p=0.030).

When there is a diseased person in the family, the focus should not be solely on the problems of the patient but also on preventive methods to be implemented in order to protect the mental health of all family members.

Advances in overall management have led to an increasing number of adolescents with congenital heart disease reaching adulthood. This study aimed to evaluate the health-related quality of life in adolescents with heart disease, and examine its relationship with the adolescents’ knowledge and understanding of their congenital heart disease, its severity, and its relationship to the degree of anxiety and depression, feeling of optimism and sense of coherence experienced by the adolescents together with their social support.

Adolescents with heart disease were recruited from an ambulatory setting at a tertiary centre. Patients completed self-report questionnaires including the Paediatric Quality of Life Inventory 3.0-Cardiac Module, a questionnaire assessing the adolescents’ knowledge of their cardiac condition, the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Life Orientation Test-Revised, and Sense of Coherence-13, supplemented by clinical information provided by the attending cardiologists. A total of 114 patients aged 12–20 years were recruited over 15 months. In all, 98% of patients were in New York Heart Association class I. Their health-related quality of life was found to positively correlate with a low level of anxiety and depression (Pearson correlation, r = −0.57, p < 0.001), a good knowledge of their cardiac condition (r = 0.31, p < 0.01), feelings of optimism (r = 0.39, p < 0.001), adequate social support (r = 0.27, p < 0.01), and a strong sense of coherence (r = 0.24, p < 0.01).

Adolescents’ knowledge and understanding of their cardiac abnormality together with an improved sense of well-being had a positive influence on their health-related quality of life.