Impact psychologique de la pandémie de la COVID-19 : comparaison entre des Français métropolitains et de l’île de La Réunion

ObjectivesThe COVID-19 pandemic raised a lot of anxiety around the world. France is composed of several overseas territories with major cultural differences but also with a different exposure to the COVID-19. Reunion Island is the most populated overseas French department, but few researches have focused on this population. Therefore, the main objective was to explore and compare the impact of the COVID-19 pandemic (perceived stress, risk and fear of being infected, severity, lockdown respect, perceived stress, quality of life, quality of relationship, loneliness, resilience) during the lockdown among residents of metropolitan France and of Reunion Island.Material and methodsA sample of 347 participants, aged from 18 to 78 (M = 37.90; DS = 13.20) replied to a questionnaire posted online during the last ten days of the lockdown in France. The sample is divided into 227 metropolitans (M = 38.24 DS = 13.41; 13.2% of men) and 120 residents of Reunion Island (M = 37.26; DS = 12.81; 31.7% of men). Resilience, loneliness and perceived stress have been assessed using validating scales while specific items have been created to assess COVID-19 impacts.ResultsThe majority of the total sample has been little exposed to the COVID-19, but the estimated severity was high throughout the sample. Several significant differences have been observed between overseas and metropolitans. The latter, who were more exposed, were more respectful of lockdown measures and felt more concerned about being contaminated. They also had different professional activities (work at home, stop working) since the lockdown than did the overseas sample. Non-significant higher scores of resilience and quality of life during the lockdown contrast in the overseas sample, who estimated risk, fear and severity similarly. In correlational analyses, many relationships were significant only in one sample. For example, in metropolitans the higher the loneliness, the higher the severity. In the other sample, the higher the perceived stress, the higher the respect of lockdown measures, while more metropolitans felt lonely the more they respected these measures. Regressional analysis showed different predictive variables of the scores of perceived stress and fear of being contaminated. In metropolitans, stress was explained by COVID-19 related variables (fear, severity, respect), loneliness and negatively by resilience and quality of life while in the other sample it was explained by fear of being infected and negatively by resilience. Fear of being infected was explained by risk and stress in the overseas, but also by quality of life in the metropolitan sample.ConclusionsThis study brings new data on the important psychosocial impact of the COVID-19 pandemic on two French samples. Observed differences highlight a higher fear of being infected among the metropolitans who were generally more exposed. Overseas from La Réunion did not feel more spared by this risk, despite the limited number of cases since the appearance of the first case in March 11th and the end of the lockdown in May 11th. Despite exposure, our results could be explained by several cultural differences such as way of life or beliefs. Overseas life in Reunion Island might bring more resilience and less loneliness given the particular familial, social and religious functioning. Given the limits of this study and the lack of similar comparisons, more work could highlight the protective factors of these populations.     

Self-reported mental health symptoms,quality of life and coping strategies in French health sciences students during the early stage of the COVID-19 pandemic: An online survey

IntroductionHealth sciences students usually report high rates of mental health problems. The COVID-19 pandemic context may have serious psychological impacts in this at-risk population. We aimed to assess the self-reported mental health status, health-related quality of life and coping strategies of health sciences students during the early stage of the pandemic.MethodAn online 128-item questionnaire sent to 17,673 health sciences students from the Claude Bernard University Lyon 1 in April 2020 assessed: a) sociodemographic characteristics, b) conditions of lockdown, c) depressive (Beck Depression Inventory- Short Form, BDI-SF), anxiety (State-Trait Anxiety Inventory-A, STAI-A) and traumatic symptoms (Impact of Event Scale -Revised, IES-R), d) health-related quality of life (SF12) and e) coping strategies (Brief Coping Orientation to Problems Experienced, Brief COPE).ResultsThe participation rate was 9.9% (n = 1,765). A total of 19.5% of participants reported an IES-R > 33, 11.6% depressive symptoms, 58.1% anxiety symptoms, and 4.4% suicidal ideation. Their mental health-related quality of life was significantly poorer than for physical health. Female gender, COVID-like symptoms, social isolation due to the lockdown, pandemic-related financial restraint and exams-related stress were significantly associated with poorer self-reported mental health conditions. Volunteering in the healthcare system was significantly associated with lower mental health scores. Coping strategies were mostly oriented toward avoidance and positive appraisal.ConclusionFrench health sciences students exhibited high levels of self-reported mental health problems and a poor mental health-related quality of life during the early stage of the COVID-19 pandemic. Specific risk factors related to the pandemic partly explain the observed prevalence.     

Increased in-hospital mortality from COVID-19 in patients with schizophrenia

BackgroundThere is limited information describing the presenting characteristics and outcomes of patients with schizophrenia (SCZ) requiring hospitalization for coronavirus disease 2019 (COVID-19).AimsWe aimed to compare the clinical characteristics and outcomes of COVID-19 SCZ patients with those of non-SCZ patients.MethodThis was a case-control study of COVID-19 patients admitted to 4 AP–HM/AMU acute care hospitals in Marseille, southern France. COVID-19 infection was confirmed by a positive result on polymerase chain reaction testing of a nasopharyngeal sample and/or on chest computed scan among patients requiring hospital admission. The primary outcome was in-hospital mortality. The secondary outcome was intensive care unit (ICU) admission.ResultsA total of 1092 patients were included. The overall in-hospital mortality rate was 9.0%. The SCZ patients had an increased mortality compared to the non-SCZ patients (26.7% vs. 8.7%, P = 0.039), which was confirmed by the multivariable analysis after adjustment for age, sex, smoking status, obesity and comorbidity (adjusted odds ratio 4.36 [95% CI: 1.09–17.44]; P = 0.038). In contrast, the SCZ patients were not more frequently admitted to the ICU than the non-SCZ patients. Importantly, the SCZ patients were mostly institutionalized (63.6%, 100% of those who died), and they were more likely to have cancers and respiratory comorbidities.ConclusionsThis study suggests that SCZ is not overrepresented among COVID-19 hospitalized patients, but SCZ is associated with excess COVID-19 mortality, confirming the existence of health disparities described in other somatic diseases.     

A serial model of the interrelationship between perceived vulnerability to disease,fear of COVID-19, and psychological distress among teachers in South Africa

The current study examined the serial relationship between perceived vulnerability to disease, fear of COVID-19, anxiety, and psychological distress among school teachers. Participants were South African school teachers (n = 355) who completed the Perceived Vulnerability to Disease Questionnaire, Fear of COVID-19 Scale, trait scale of the State-Trait Anxiety Inventory, Beck Hopelessness Scale, and the Centre for Epidemiological Depression Scale. A path analysis confirmed that teachers who appraised themselves as more susceptible to disease, experienced heightened levels of fear of COVID-19, which led to heightened levels of anxiety, depression, and hopelessness. Specifically, germ aversion and perceived infectability were separately associated with heightened fear of COVID-19, which in turn was associated with heightened anxiety. This serial relationship was associated with heightened levels of hopelessness and depression. The current study extends research on the impact of the COVID-19 pandemic among a distinct subgroup of the population.     

Effect of COVID-19 on mental health among the young population in Lebanon

BackgroundCOVID-19 is a global pandemic that has raised worldwide public health concerns. The wide spread of the virus has led to unprecedented disturbance to regular life for people around the globe and impacted their mental health.AimsThe aims of the current study were to investigate the prevalence of psychiatric symptoms related to insomnia, depression, and anxiety, and identify risk factors contributing to psychological stress in Lebanese young population during COVID-19 pandemic.MethodA cross-sectional study was done on the Lebanese young population. Participants were 4397 males and females aged 18 to 35 years who filled a self-administered online questionnaire. Three validated scales were used to measure the mental health status of the participants during the COVID-19 pandemic: 7-item Insomnia Severity Index for insomnia, the Patient Health Questionnaire 9-item depression module for depression, and the 7-item Generalized Anxiety Disorder scale for anxiety.ResultsThe median interquartile range scores for anxiety, insomnia, and depression, were 8 (4–13), 10 (5–14), and 9 (5–12) respectively. Higher anxiety scores were reported with female gender (P < 0.001) and alcohol usage (P = 0.04). Moderate to severe insomnia was associated with single (P = 0.02) and divorced marital status (P = 0.003), university education (P < 0.001), consumption of caffeinated beverages (P = 0.02) and energy drinks (P = 0.03). Higher depression scores were associated with status of being the only person working at home (P = 0.01), family income more than 500 USD (P = 0.008), multiple insurance plans (P = 0.01), and contact with a confirmed COVID-19 case (P = 0.01).ConclusionsThe findings of this study demonstrate the considerable impact of COVID-19 pandemic and lockdown on Lebanese young population's mental status such as anxiety, depression and insomnia. Further follow-up studies are warranted to assess the long-term mental effects that can be imposed by the pandemic.     

Bio-psychosocial study on the impact of the COVID-19 lockdown on depression and anxiety in a sample of 1753 French-speaking subjects

The aim of this article was to study the impact of the COVID19 lockdown on anxiety and depressive symptoms on the basis of responses to an online survey from 1753 French-speaking subjects, conducted between April 27 and May 11, 2020.MethodUsing a biopsychosocial model, the effects of socio-demographic characteristics (age, gender at birth, socio-professional category, sexual orientation), lockdown conditions (material factors: urban density of the place of residence, surface area of the place of residence during lockdown), social characteristics: living with a partner during lockdown, presence of children during lockdown) and psychosocial history (attachment styles) on anxiety – evaluated on the GAD7 – and depression – evaluated on the MDI – were investigated. Ordinal regression analyses were conducted.ResultsThe rates of depression observed (moderate or severe depression: 22.5%) and anxiety (moderate or severe anxiety: 18.4%) were higher than usual but lower than what has been documented in other studies on the effects of lockdown. Women appeared to be more vulnerable than men (Anxiety: AOR = 1.647, CI 95% = 1.647–2.530; Depression: AOR = 1.622, CI 95% = 1.274–2.072). Bisexual individuals had an increased likelihood of anxiety symptoms (AOR = 1.962, CI 95% = 1.544–2.490) and depression (AOR = 1.799, CI 95% = 1.394–2.317). For homosexuals, only links with depression were observed (AOR = 1.757, CI 95% = 1.039–2.906). People in a situation of economic vulnerability were more prone to anxiety disorders (e.g. people with no working activity: AOR = 1.791, CI 95% = 1.147–2.790) or depression (e.g. people with no working activity: AOR = 2.581, CI 95% = 1.633–4.057). Links with attachment styles were also found. Fearful subjects were particularly vulnerable (anxiety: AOR = 2.514, CI 95% = 1.985–3.190; depression: AOR = 2.521, CI 95% = 1.938–3.289), followed by subjects with an anxious attachment style (anxiety: AOR = 1.949, CI 95% = 1.498–2.540; depression: AOR = 1.623, CI 95% = 1.207–2.181). The impact of lockdown on avoidant subjects only concerned depression (AOR = 1.417, CI 95% = 1.034–1.937). Being with a partner during lockdown appeared to have a protective effect against depression (AOR = .693, CI 95% = .555–.866). Neither the presence of children, the surface area of the lockdown residence, nor the population density of the place of residence was associated with anxiety or depression.ConclusionThe impact of lockdown on mental health depends on a range of dimensions that need to be apprehended in order to tailor post-lockdown psychological and social support. Management based on a biopsychosocial approach should be favored.     

Depression and sexual functions in epilepsy patients: Comparison before and during the COVID-19 pandemic

ObjectiveThe new coronavirus disease 2019 (COVID-19) is a major health problem with a high rate of spread. We aimed to investigate herein the effects of the COVID-19 outbreak on depression and sexual dysfunction in patients with epilepsy.Material and MethodsOne hundred and sixteen epilepsy patients admitted to our hospital from October–November 2019 were evaluated for sexual functions and depression using the Arizona Sexual Experiences Scale (ASEX) and Beck Depression Scale, respectively. These scales were re-applied in June 2020 and July 2020 to assess the impact of the outbreak on sexual function and depression in the same group of patients. The demographic and clinical characteristics of the patients were recorded and analyzed in SPSS.ResultsDuring the pandemic period, the total Beck Depression Scale values increased significantly in the patients with epilepsy compared to the pre-pandemic period (P = 0.048), and depressive symptoms showed an increasing trend (P = 0.032). Although an increase in sexual dysfunction was also recorded, it was not statistically significant compared to the pre-pandemic period. In eight patients (6.9%), seizure frequency increased during the pandemic period. In the multivariate analysis, the only parameter that predicted the increase in seizure frequency was the number of drugs used. The Beck Depression Scale values were positively correlated with total male/female ASEX values, age, marital status, duration of illness, and seizure frequency.ConclusionThe COVID-19 outbreak caused an increase in the tendency to depression in epilepsy patients and has also had a negative effect on sexual function. During public health outbreaks, clinicians should focus not only on seizure control in patients with epilepsy but also on their mental health.     

Assessment of COVID-19 trauma responses. Who has been more traumatized during the pandemic?

Background and ObjectiveTo evaluate the effect of cognitive and sociodemographic characteristics of healthcare and non-healthcare workers on their traumatic responses to the COVID-19 pandemic.MethodsData were collected using an online survey between August-September 2020. The survey included the following scales: Beck Anxiety Inventory (BAI), Anxiety Sensitivity Index (ASI), and Impact of Event Scale-Revised (IES-R). Traumatic responses were categorized into three types: avoidance (IES-R_A), intrusion (IES-R_I), and hyperarousal (IES-R_H).ResultsThe study included a total of 672 participants, comprised of 399 (59.4%) men, and 273 (40.6%) women with a mean age of 39.25 ± 933 years. The results indicated that women had higher IES-R_I (r = .5.78, p < 0.001), IES-R_A (r = 4.47, p < 0.001), and IES-R_H (r = .5.20, p < 0.001) scores compared to men. Patients with a history of psychiatric diseases had significantly higher IES-R_I (r = ?3.82, p < 0.001), IES-R_A (r = ?2.00, p < 0.05), and IES-R_H (r = ?4.06, p < 0.001) scores compared to patients with no history of psychiatric diseases. Non-healthcare workers had significantly higher IES-R_A (r = ?2.69, p < 0.01) scores compared to healthcare workers.ConclusionFemale gender and a positive history of psychiatric diseases were found to lead to an increase in the frequency of all three traumatic responses to COVID-19. Contrary to expectation, being a healthcare worker was not found as a factor facilitating trauma response formation in our study.     

Facing Your Fear of COVID-19: Resilience as a Protective Factor Against Burnout in South African Teachers

ObjectiveFrontline workers have been distinctively impacted by the rapid spread of the COVID-19 pandemic. Teachers, as frontline employees in the educational system, had to contend with unprecedented changes to their work role, as well as new job demands coupled with insufficient resources and the effects of the pandemic on their personal lives. While some teachers struggled to cope and reported intense levels of fear of COVID-19 and burnout, others were able to adapt and experienced a sense of growth and accomplishment. Therefore, the current study aimed to examine the role of resilience in the relationship between fear of COVID-19 and burnout among South African schoolteachers using a survey design.Materials and methodsSchoolteachers in South Africa (n = 355) were administered the Maslach Burnout Inventory, the Fear of COVID-19 Scale, and the Connor–Davidson Resilience Scale-10.ResultsThe results showed a positive relationship between fear of COVID-19 and emotional exhaustion and depersonalization. Moreover, structural equation modeling confirmed a health-sustaining role for resilience as it had a significant direct effect on burnout. Resilience also partially mediated the impact of fear of COVID-19 on depersonalization as well as emotional exhaustion, and fully mediated the impact of fear of COVID-19 on personal accomplishment.ConclusionsOur findings underscore that promoting individual- and institutional-level strategies to support teachers is necessary to build resilience, especially in the context of the COVID-19 pandemic.     

Neurological manifestations associated with SARS-CoV-2 and other coronaviruses: A narrative review for clinicians

IntroductionThe past two decades have been marked by three epidemics linked to emerging coronaviruses. The COVID-19 pandemic highlighted the existence of neurological manifestations associated with SARS-CoV-2 infection and raised the question of the neuropathogenicity of coronaviruses. The aim of this review was to summarize the current data about neurological manifestations and diseases linked to human coronaviruses.Material and methodsArticles have been identified by searches of PubMed and Google scholar up to September 25, 2020, using a combination of coronavirus and neurology search terms and adding relevant references in the articles.ResultsWe found five cohorts providing prevalence data of neurological symptoms among a total of 2533 hospitalized COVID-19 patients, and articles focusing on COVID-19 patients with neurological manifestations including a total of 580 patients. Neurological symptoms involved up to 73% of COVID-19 hospitalized patients, and were mostly headache, myalgias and impaired consciousness. Central nervous system (CNS) manifestations reported in COVID-19 were mostly non-specific encephalopathies that represented between 13% and 40% of all neurological manifestations; post-infectious syndromes including acute demyelinating encephalomyelitis (ADEM, n = 13), acute necrotizing encephalopathy (ANE, n = 4), Bickerstaff's encephalitis (n = 5), generalized myoclonus (n = 3) and acute transverse myelitis (n = 7); other encephalitis including limbic encephalitis (n = 9) and miscellaneous encephalitis with variable radiologic findings (n = 26); acute cerebrovascular diseases including ischemic strokes (between 1.3% and 4.7% of COVID-19 patients), hemorrhagic strokes (n = 17), cerebral venous thrombosis (n = 8) and posterior reversible encephalopathy (n = 5). Peripheral nervous system (PNS) manifestations reported in COVID-19 were the following: Guillain–Barré syndrome (n = 31) and variants including Miller Fisher syndrome (n = 3), polyneuritis cranialis (n = 2) and facial diplegia (n = 2); isolated oculomotor neuropathy (n = 6); critical illness myopathy (n = 6). Neuropathological studies in COVID-19 patients demonstrated different patterns of CNS damage, mostly ischemic and hemorrhagic changes with few cases of inflammatory injuries. Only one case suggested SARS-CoV-2 infiltration in endothelial and neural cells. We found 10 case reports or case series describing 22 patients with neurological manifestations associated with other human coronaviruses. Among them we found four MERS patients with ADEM or Bickerstaff's encephalitis, two SARS patients with encephalitis who had a positive SARS-CoV PCR in cerebrospinal fluid, five patients with ischemic strokes associated with SARS, eight MERS patients with critical illness neuromyopathy and one MERS patient with Guillain–Barré Syndrome. An autopsy study on SARS-CoV patients demonstrated the presence of the virus in the brain of eight patients.ConclusionThe wide range of neurological manifestations and diseases associated with SARS-CoV-2 is consistent with multiple pathogenic pathways including post-infectious mechanisms, septic-associated encephalopathies, coagulopathy or endothelitis. There was no definite evidence to support direct neuropathogenicity of SARS-CoV-2.     

Validation of the fear of COVID-19 scale in South Africa: Three complementary analyses

Fear is the most common response to disease outbreaks. Persistent and prolonged fear can elevate the levels of psychological distress and aggravate preexisting mental health problems. Therefore, prompted by the central role of fear in psychological responses to COVID-19, the Fear of COVID-19 Scale was developed, which is the only instrument that can assess emotional fear reactions in relation to the current pandemic. In this study, we extend research on the psychometric properties of this instrument by adopting three complementary approaches: classical test theory, Rasch analysis, and Mokken analysis. Combining these methods allows for a more nuanced overview of the psychometric properties of the instrument. The sample comprised South African teachers (n = 355) who completed the Fear of COVID-19 Scale. All three approaches confirmed the reliability and the construct, convergent, and concurrent validity of the scale as used with South African teachers. In addition, all three approaches confirmed that the scale is sufficiently homogenous to be considered unidimensional.     

Impact of disease-modifying treatments on humoral response after COVID-19 vaccination: A mirror of the response after SARS-CoV-2 infection

ObjectiveTo analyze the humoral response after COVID-19 vaccination in patients with multiple sclerosis (MS) according to disease-modifying treatments (DMTs) and in comparison with the humoral response after SARS-CoV-2 infection.MethodsWe included 28 MS patients with serological results after COVID-19 vaccination (Pfizer-BioNTech or Moderna ARNm) and 61 MS patients with serological results after COVID-19 (COVID-19 group) among patients followed up at the MS Center of Strasbourg, France, between January and April 2021. The primary endpoint was the IgG index according to DMTs (anti-CD20 mAb, sphingosine 1-phosphate receptor [S1PR] modulator and other treatments) and COVID-19 vaccine or COVID-19 groups.ResultsIn the vaccinated MS patients, the median IgG index was lower in patients treated with anti-CD20 mAb and in patients treated with S1PR modulator compared to patients receiving other or no DMTs (4.80 [1.58–28.6], 16.5 [16.3–48.5], 1116 [434–1747] and 1272 [658–1886], respectively, P < 0.001). Similar results were found for MS patients after COVID-19.ConclusionsPatients with MS and treated with S1PR modulators or anti-CD20 mAb had a reduced humoral response after COVID-19 vaccine.     

Relationship between work stressors and mental health in frontline nurses exposed to COVID-19: A structural equation model analysis

The current cross-sectional study aimed to explore the relationship between work stressors and mental health in frontline nurses exposed to COVID-19. Participants were recruited from 16 general hospitals in Anhui province from February 2020 to March 2020. The general sociodemographic questionnaire, Nurse Job Stressors Scale, Simplified Coping Style Questionnaire, NEO Five-Factor Inventory, Perceived Social Support Scale, and Kessler Psychological Distress Scale were used in this study. Based on 723 valid questionnaires retrieved (100%), the total mean scores of work stressors and mental health of frontline nurses were (94.38 ± 23.42) and (22.81 ± 7.16), respectively. The results of the structural equation model showed that work stressors had an indirect positive effect (β = 0.484, P < 0.01), social support had a direct negative effect (β = ?0.934, P < 0.01), personality traits had a direct positive effect (β = 0.209, P < 0.01), and positive coping style had both direct positive (β = 0.246, P < 0.01) and indirect negative effects (β = ?0.873, P < 0.01) on frontline nurses’ mental health. In conclusion, nursing staff can reinforce positive influences by accepting social support, adopting positive coping methods, and weakening negative influences factors to reduce or buffer their negative mental states and further reduce work stress.     

General public knowledge,attitudes, and practices towards persons with epilepsy in South Ethiopia: A comparative community-based cross-sectional study

IntroductionDespite being a common disorder, epilepsy is misunderstood by the general public, leading to fear, secrecy, stigmatization, and the risk of social discrimination.ObjectiveThis study aimed to compare knowledge, attitudes, and practices (KAP) towards persons with epilepsy among rural and urban dwellers in South Ethiopia.MethodsA comparative cross-sectional community-based study was conducted among 1316 (656 from rural and 660 from urban) adult respondents in South Ethiopia.ResultsThe most cited causes of epilepsy were brain disease (40.6%) by urban respondents and evil spirits (34.6%) by rural respondents. More urban (21.7%) than rural (16.5%) respondents believed that epilepsy is contagious (P = 0.016). About 39% of rural compared with 7% of urban respondents would not allow their children to associate with a person with epilepsy (P < 0.001), and 56.7% of rural compared with 24.8% of urban respondents objected to themselves or their children marrying someone with epilepsy (P < 0.001). The majority of the respondents in both groups (75.5% from urban and 56.4% from rural) would recommend a medical doctor for the treatment of epilepsy, but herbal medicine and spiritual treatments such as prayers and Holy water were still commonly practiced.ConclusionThis study demonstrated a significant difference in epilepsy KAP between urban and rural dwellers, with the former having more positive attitudes. A comprehensive epilepsy educational campaign is necessary to advance understanding among the general population, thereby improving patient care.     

Stress coping strategies in patients with psychogenic non-epileptic seizures and how they relate to trauma symptoms,alexithymia, anger and mood

PurposeThe purpose of the present study was to assess stress coping strategies employed by patients with psychogenic non-epileptic seizures (PNES) and determine whether these approaches were associated with other psychopathological features. Ineffective stress coping strategies can have a variety of unhealthy consequences fueling psychopathology just as psychopathology can also have an impact on stress coping. Because of this, the study of stress coping has the potential to inform our understanding of the PNES condition and underscore a potential target for psychological treatment.MethodsEighty-two consecutive patients with PNES were studied using the Coping Inventory for Stressful Situations (CISS). The CISS is a self-rating coping strategies scale that has three main subscales (Task-Oriented, Emotion-Focused, and Avoidance-Oriented). Other psychological variables that were thought to potentially influence the chosen coping mechanisms including alexithymia, symptoms of post-traumatic stress disorder, anger expression and select scales from the Minnesota Multiphasic Personality Inventory 2-RF (MMPI 2-RF) were also evaluated.ResultsFifty patients (60.9%) endorsed using at least one coping strategy that was 1.5 standard deviations or more away from the normal adult mean. Over 30% of the participants endorsed using elevated Emotion-Focused coping strategies (T score ≥ 65), and just over 25% endorsed underusing Task-Oriented coping strategies (T score ≤ 35). Elevations in avoidance strategies were endorsed by only 15.9% of the respondents. ANOVA comparing T scores between the coping strategies was significant (F = 13.4, p = .0001) with a significantly lower Task-Oriented strategy than Emotion-Focused (p = .001) and Avoidance (p = .005) strategies.Patients with high scores of Emotion-Focused coping strategies also had significantly high scores on diverse psychopathology factors including elevations on depressive mood, intrusive experiences, anger state, and general anger scores. In contrast, those who used Task-Oriented strategies and who used Avoidance-Focused strategies had less psychopathology including low positive emotion scores (RC2).ConclusionNearly one-third of patients with PNES tended to use the less effective Emotion-Oriented coping strategies and one fourth reported underusing the more effective Task-focused strategies. Substantial differences were noted between coping strategies with a significantly lower Task-Oriented strategy than Emotion-Focused and Avoidance strategies. In addition, high Emotion-Focused coping was seen in patients with underlying psychological symptoms that were not observed in other coping strategies. This information supports the relevance of assessing stress coping in patients with PNES because it allows the identification of useful behavioral targets for the psychotherapist.     

The relationship between common mental disorders (CMDs), food insecurity and domestic violence in pregnant women during the COVID-19 lockdown in Cape Town,South Africa

Purpose

We aimed to explore the relationship between common mental disorders (CMDs), food insecurity and experiences of domestic violence among pregnant women attending public sector midwife obstetric units and basic antenatal care clinics in Cape Town during the COVID-19 lockdown.

Methods

Perinatal women, attending 14 healthcare facilities in Cape Town, were enrolled in the study during baseline data collection before the COVID-19 lockdown. During the lockdown period, fieldworkers telephonically contacted the perinatal women who were enrolled in the study and had provided contact details. The following data were collected from those who consented to the study: socio-demographic information, mental health assessment, food insecurity status and experiences of domestic violence. Poisson regression was used to model the associations of a number of risk factors with the occurrence of CMDs.

Results

Of the 2149 women enrolled in the ASSET study, 885 consented to telephonic interviews. We found that 12.5% of women had probable CMDs and 43% were severely food insecure. Psychological distress increased significantly during the lockdown period, compared to before the COVID-19 outbreak. Using multivariate Poisson regression modelling, we showed that the risk of CMDs was increased in women who were severely food insecure or who experienced psychological or sexual abuse.

Conclusions

This study provides evidence of the effect of the COVID-19 lockdown on the mental health status of perinatal women living in low-resource settings in Cape Town and highlights how a crisis such as the COVID-19 lockdown amplifies the psycho-social risk factors associated with CMDs in perinatal women.

     

Stigmatizing attitudes and social perception towards mental illness among Moroccan medical students

ObjectivesThis study aimed to explore medical students’ attitudes, social perception, and knowledge towards mental illness and identify the associated factors.MethodsA cross-sectional study was conducted in the Medical Faculty of Fez. A representative sample of 420 Moroccan students from the first to the seventh years was selected randomly during the academic year (2018/2019). They completed the Mental Illness Clinicians Attitudes scale (MICA) and a self-questionnaire exploring sociodemographic data, the university course, social perception and knowledge towards mental illness, and the potential consideration of psychiatry as a career.ResultsThe average age of participants was 21.73 years (SD ± 2.60), and 72.4% (n = 304) of respondents were female (M/F gender ratio = 0.39). The participants held stigmatizing attitudes and negative social perceptions towards mental illness, as indicated by the high score of the MICA scale (mean = 57.24; SD ± 9.95). Females (p = 0.02) and married students (p = 0.02) showed significantly more tolerant attitudes. The attitudes of students (p = 0.37) who completed the psychiatry clerkship were slightly more favorable (p = 0.15). There was no significant difference in attitudes according to the level of study (p = 0.06). Students with a lower socioeconomic level tended to be less stigmatizing (p = 0.08). The assessment of knowledge about mental illness among students objectified major gaps. A total of 17.9% (n = 75) considered psychiatry as a career.ConclusionThe attitudes of medical students in this study were stigmatizing, and this should without delay motivate Moroccan research, educational and health authorities to investigate further scientific research in this area to address these attitudes and remedies.