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      The Psychological and Mental Impact of Coronavirus Disease 2019 (COVID-19) on Medical Staff and General Public – A Systematic Review and Meta-analysis

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          Highlights

          • •

            We included 62 studies from 17 countries assessing psychological distress of COVID-19

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            We found a high psychological burden among medical staff and the general public

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            However, the psychological distress was significantly higher among patients

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            We identified risk factors of psychological burdens to identify high-risk people

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            Professional medical services should be allocated to high-risk population

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            More self-help materials should be made available for people with milder impact

          Abstract

          The coronavirus disease 2019 (COVID-19) pandemic has caused enormous psychological impact worldwide. We conducted a systematic review and meta-analysis on the psychological and mental impact of COVID-19 among healthcare workers, the general population, and patients with higher COVID-19 risk published between 1 Nov 2019 to 25 May 2020. We conducted literature researching used Embase, PubMed, Google scholar and WHO COVID-19 databases. Among the initial search of 9207 studies, 62 studies with 162,639 participants from 17 countries were included in the review. The pooled prevalence of anxiety and depression was 33% (95% confidence interval: 28%-38%) and 28% (23%-32%), respectively. The prevalence of anxiety and depression was the highest among patients with pre-existing conditions and COVID-19 infection (56% [39%-73%] and 55% [48%-62%]), and it was similar between healthcare workers and the general public. Studies from China, Italy, Turkey, Spain and Iran reported higher-than-pooled prevalence among healthcare workers and the general public. Common risk factors included being women, being nurses, having lower socioeconomic status, having high risks of contracting COVID-19, and social isolation. Protective factors included having sufficient medical resources, up-to-date and accurate information, and taking precautionary measures. In conclusion, psychological interventions targeting high-risk populations with heavy psychological distress are in urgent need.

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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

          Cuiyan Wang, Riyu Pan, Xiaoyang Wan … (2020)
          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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            Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

            Jianbo Lai, Simeng Ma, Ying Wang … (2020)
            Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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              Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

              Emily A. Holmes, Rory C O'Connor, V. Perry … (2020)
              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

                Contributors
                Min Luo
                Lixia Guo
                Mingzhou Yu
                Haiyan Wang
                Journal
                Journal ID (nlm-ta): Psychiatry Res
                Journal ID (iso-abbrev): Psychiatry Res
                Title: Psychiatry Research
                Publisher: Published by Elsevier B.V.
                ISSN (Print): 0165-1781
                ISSN (Electronic): 1872-7123
                Publication date PMC-release: 7 June 2020
                Publication date (Electronic): 7 June 2020
                Electronic Location Identifier: 113190
                Affiliations
                [a ]Department of Anesthesiology, The 965 th Hospital of Qinlian Support Army, Jilin, 132011 China
                [b ]Department of Psychology, 96605 Army Hospital, Jilin, 134000 China
                [c ]Department of Ophthalmology, The 965 th Hospital of Qinlian Support Army, Jilin, China
                [d ]Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, 400042 China
                Author notes
                [* ]Corresponding author. 710875839@ 123456qq.com
                Article
                Publisher ID: S0165-1781(20)31020-9 Publisher ID: 113190
                DOI: 10.1016/j.psychres.2020.113190
                PMC ID: 7276119
                PubMed ID: 32563745
                SO-VID: 64bb1280-0ff8-42d1-b459-9fd3a1aa8901
                Copyright © © 2020 Published by Elsevier B.V.
                License:

                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
                Date received : 22 April 2020
                Date revision received : 4 June 2020
                Date accepted : 4 June 2020
                Categories
                Subject: Article

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: psychological intervention,covid-19,review,stress,anxiety,depression,psychological impact
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: psychological intervention, covid-19, review, stress, anxiety, depression, psychological impact

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