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      Depression, anxiety symptoms, Insomnia, and coping during the COVID-19 pandemic period among individuals living with disabilities in Ethiopia, 2020

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          Abstract

          Background

          People with disabilities face multiple barriers that prevent them from accessing care and essential information related to the COVID-19 pandemic that poses additional stress and psychopathology. Therefore, the investigation of psychopathologies during the COVID-19 outbreak and emergency response is critical.

          Methods

          A cross-sectional survey was implemented from July 15/2020 to July 30/2020. The PHQ-9, GAD-7 scale, insomnia severity index-7, and brief resilient coping scale were administered to participants. The collected data was then entered into Epi-data version 3.1 and exported to SPSS-20 for analysis. Descriptive statistical procedures were employed to describe the various psychopathologies. A binary logistic regression method was used to identify the related factors for the psychopathologies. Furthermore, an odds ratio with its 95%CI was driven to show association strength, and a P-value <0.05 was declared as statistically significant.

          Results

          A significant proportion of individuals living with disability had psychopathologies; 46.2% for depression symptoms, 48.1% for generalized anxiety disorder symptoms, and 71% for insomnia symptoms. Nearly 45.7% of participants were low resilient copers to their psychopathology. Depression was significantly higher in divorced/widowed/separated (AOR = 3.4, 95% CI: 1.28–8.92, P-value = 0.006), non-educated (AOR = 2.12, 95% CI: 1.12, 5.90, P-value = 0.001), and unemployed (AOR = 2.1, 95% CI: 1.32, 5.11, P-value = 0.005) as well as a daily laborer (AOR = 2.4, 95% CI: 1.20, 4.89, P-value = 0.014) subjects. Generalized anxiety disorder was also significantly higher in young age (<40 years) (AOR = 1.7, 95% CI: 1.32, 2.98, P-value = 0.02), single (AOR = 2.3, 95% CI: 1.24, 5.3, P-value = 0.011), widowed/divorced/separated (AOR = 1.5, 95% CI: 1.12, 2.78, P-value = 0.032), preparatory school completed (AOR = 3.00, 95% CI: 1.59, 5.46, P-value = 0.001), daily laborer (AOR = 2.7, 95% CI: 1.21, 5.23, P-value = 0.003), and unemployed (AOR = 2.5, 95% CI: 1.17, 4.78, P-value = 0.005) participants. Moreover, insomnia was significantly higher in single (AOR = 1.5, 95% CI: 1.12, 3.09, P-value = 0.027), divorced/widowed/separated(AOR = 6.2, 95% CI: 1.08, 11.29, P-value = 0.032), unemployed (AOR = 3.00, 95% CI: 1.22, 7.03, P-value = 0.001), blind (AOR = 2.8, 95% CI: 1.42, 6.35, P-value = 0.001), and deaf (AOR = 10.2, 95% CI: 4.52, 35.33, P-value = 0.002) participants.

          Conclusion

          Depression, anxiety, and insomnia were highly prevalent among individuals with a disability during the COVID-19 period. Multiple sociodemographic and disability-related factors were associated with this high psychopathology. Attention has to be given by the government and other stakeholders to intervene in psychopathology and its associated factors.

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          Most cited references46

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          Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

          Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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            A brief measure for assessing generalized anxiety disorder: the GAD-7.

            Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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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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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: SupervisionRole: ValidationRole: Writing – original draft
                Role: VisualizationRole: Writing – review & editing
                Role: VisualizationRole: Writing – review & editing
                Role: Writing – original draft
                Role: Writing – review & editing
                Role: Formal analysisRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                30 December 2020
                2020
                30 December 2020
                : 15
                : 12
                : e0244530
                Affiliations
                [001]Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
                Gachon University Gil Medical Center, REPUBLIC OF KOREA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-0961-7835
                Article
                PONE-D-20-30020
                10.1371/journal.pone.0244530
                7773255
                33378397
                aa583026-7c84-49f4-b20d-f4ca242669ef
                © 2020 Necho et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 23 September 2020
                : 14 December 2020
                Page count
                Figures: 4, Tables: 4, Pages: 18
                Funding
                Wollo University has granted the financial resource but the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                Medicine and Health Sciences
                Medical Conditions
                Disabilities
                Medicine and Health Sciences
                Medical Conditions
                Sleep Disorders
                Dyssomnias
                Insomnia
                Medicine and Health Sciences
                Neurology
                Sleep Disorders
                Dyssomnias
                Insomnia
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                Medicine and Health Sciences
                Epidemiology
                Pandemics
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuropsychiatric Disorders
                Anxiety Disorders
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuroses
                Anxiety Disorders
                Medicine and Health Sciences
                Otorhinolaryngology
                Otology
                Hearing Disorders
                Deafness
                Custom metadata
                The data used for this study are available at https://doi.org/10.5061/dryad.bnzs7h495.
                COVID-19

                Uncategorized
                Uncategorized

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