Anxiety and depression among patients with insomnia during the first wave and the release of the COVID-19 in Northeast China: A cross-sectional survey.

Li H ，Zhang Y ，Chen Q ，Sun Q ，Wang Y ，Tang M ，Wang D ，Wang Z ... -  《-》

Restless legs symptoms increased during COVID-19 pandemic. International ICOSS-survey.

Restless legs syndrome (RLS) has been associated with anxiety, depression, insomnia, lifestyle factors and infections. We aimed to study the prevalence of symptoms of RLS during the COVID-19 pandemic versus pre-pandemic. We hypothesized that pre-existing RLS symptoms worsened and pandemic-related factors may have triggered new symptoms of RLS. Adults (≥18 years) from fifteen countries across four continents participated in an online survey between May and August 2020. The harmonized questionnaire included a validated single question on RLS with response alternatives from 1 to 5 on a scale from never to every/almost every evening or night. Other measures were the Insomnia Severity Index (ISI), measures of symptoms of anxiety (GAD-2) and depression (PHQ-2), and questions on different pandemic-related factors. Altogether, 17 846 subjects (63.8 % women) were included in the final analyses. The mean age was 41.4 years (SD 16.1). During the pandemic, symptoms of RLS (≥3 evenings/nights per week) were more common 9.1 % (95 % CI 8.7-10.1) compared to 5.4 % (95 % CI 4.9-6.0) before the pandemic (P < 0.0001). Alltogether 1.3 % (95 % CI 1.1-1.6) respondents had new-onset symptoms (≥3 evenings/nights per week). Moderate-severe insomnia was strongly associated with RLS symptoms. The occurrences of new-onset RLS symptoms were 5.6 % (95 % CI 0.9-13.0) for participants reporting COVID-19 and 1.1 % (95 % CI 0.7-1.5) for non-COVID-19 participants. In the fully adjusted logistic regression model, the occurrence of new-onset RLS symptoms was associated with younger age, social restrictions and insomnia severity. In a similar analysis, RLS symptoms (≥3 evenings/nights per week) were associated with lower education, financial hardship, sleep apnea symptoms, use of hypnotics, insomnia severity, symptoms of depression and possible post-traumatic stress disorder. Our findings indicate that RLS symptoms were more common during the pandemic than before. Usually, the prevalence of RLS increases with age. However, during the pandemic, new-onset symptoms of RLS were more common in younger age groups. This may be due to the pandemic-related factors being more pronounced in the younger compared to the older. The association between insomnia, psychiatric symptoms and RLS warrants clinical attention.

Partinen E ，Inoue Y ，Sieminski M ，Merikanto I ，Bjorvatn B ，Bolstad CJ ，Chung F ，De Gennaro L ，Espie CA ，Holzinger B ，Matsui K ，Mota-Rolim S ，Morin C ，Nadorff MR ，Penzel T ，Plazzi G ，Wing YK ，Dauvilliers Y ，Partinen M ... -  《-》

Mental health problems and associated factors of students at different learning stages during and after COVID-19 pandemic in Sichuan, China.

Although students' mental health might be impacted severely during the COVID-19 pandemic, there is still limited clarity regarding mental health problems among students in different learning stages after the lifting of COVID-19 restrictions in China. This study aimed to explore the long-term effects of COVID-19 on students' mental health at different learning stage and provide recommendations on education and health policies after the lifting of COVID-19 constrictions. This large sample, cross-sectional, online survey was conducted among students (N = 82873) in 162 schools from December 14, 2022 to February 28, 2023 in Sichuan, China. The online self-report questionnaires were sent firstly to school teachers or professors, then these teachers or professors sent the questionnaires directly to their students at schools. The scales included the Chinese version of 9-item Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Insomnia Severity Index (ISI), the PTSD Checklist for DSM-5 (PCL-5). All the mentioned instruments showed satisfactory reliability and validity. The prevalence of depression symptom in middle school group, high school group and college group was 28.5%, 45.0%, 37.3%, the anxiety symptom was 24.0%, 38.4%, 29.7% and the PTSD was 25.7%, 40.6%, 32.1%, respectively. Among the 3 groups, the high school group had the highest rate of depression symptom (45.0%), anxiety symptom (38.4%), PTSD (40.6%), insomnia (39.9%) and lifetime suicidal ideation (28.9%). For all the three groups, there were same factors increased the risk of depression and anxiety symptoms, such as academy dissatisfaction, higher score of Internet Addiction Test (IAT), ISI, cyberbullying and traditional bullying et al., while higher score of Social Support Rating Scale (SSRS) decreased the risk. In addition, each group had unique risk factors for depression and anxiety symptoms. This study revealed that students at different learning stage were still experiencing serious mental health problem even after the lifting of COVID-19 restrictions in China. Special attention should be paid to the mental health of students, especially high school students. Education and health policies and psychosocial interventions should be developed according to the characteristics and various influencing factors of students at different learning stages.

Cai J ，Wang Y ，Wang C ，Deng ZY ，Mu YF ，Deng AP ，Song HJ ，Huang Y ，Fang DZ ，Liu GL ，Hu Y ，Yang X ，Zhang BZ ，Zhang W ，Ran MS ... -  《BMC Psychiatry》

Relationships between emotional state, sleep disturbance and health-related quality of life in patients with axial spondyloarthritis.

Axial spondyloarthritis (ax-SpA) is an autoinflammatory disease affecting multiple organs. While emphasizing the treatment of chronic diseases, it has been found that the prevalence of mental disorders and insomnia in patients is also increasing. We investigated mood status, sleep quality and the health-related quality of life (HRQoL) in these patients. A total of 94 pairs ax-SpA patients and age- and sex-matched healthy controls were included in this cross-sectional study. Demographic and clinical data were collected. We assessed the disease activity by the Ankylosing Spondylitis Disease Activity Score, including C-reactive protein (ASDAS-CRP), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI). The Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI) and the Medical Outcomes Survey Sheet Form-36 (SF-36) were used to evaluate mood status and quality of sleep and life, respectively. We evaluated the factors related to anxiety and depression scores, sleep disturbance scores and quality of life scores, and the predictors of anxiety, depression and sleep disturbance were analyzed. Forty-five active patients and forty-nine relieved patients were enrolled. We found that the median HADS anxiety (HADS-A), depression (HADS-D) subscale scores and PSQI score were significantly higher in active ax-SpA than in inactive patients, and were significantly higher than those in controls (HADS-A 9 vs. 5 vs. 3, p < 0.001; HADS-D 8 vs. 5 vs. 3, p < 0.001; PSQI 10 vs. 6 vs. 3, p < 0.001). Moreover, the HADS-A scores were positively correlated to positive HLA-B27 (p = 0.042), pain (p = 0.002) and the BASFI score (p = 0.012), HADS-D scores were positively correlate to disease course (p < 0.001) and PSQI scores were significantly positively correlated to the BASFI score (p = 0.009). Logistic regression analysis showed that BASFI was a risk factor for anxiety, age was a protective factor for depression and disease course was a risk factor for depression. The optimal cut-off value of BASFI in predicting anxiety was 1.55 with an area under the curve value of 0.8488 (p < 0.001), and the optimal cut-off value of age and the course of the disease in predicting depression was 50.5 years old with an area under the curve value of 0.62 (p = 0.0482) and 54 months with an area under the curve value of 0.7988 (p < 0.001). In addition, disease activity was negatively correlated with SF-36 dimensions, and anxiety, depression and sleep disturbance in ax-SpA patients also had significant negative effects on HRQoL (p < 0.05). Patients with active ax-SpA tend to be more anxious, depressed and sleep disturbed, and have worse HRQoL than patients in remission. Patients with ax-SpA are more likely to be anxious with worse spinal function, more likely to be depressed with younger age and longer course of disease. Therefore, the assessment of mental health, sleep and HRQoL should also be included in the long-term management of patients with ax-SpA. Key Points • Active ax-SpA patients tend to have more anxiety, depression, sleep disturbances and worse HRQoL compared with patients in remission • The optimal cut-off value of BASFI in predicting anxiety was 1.55, the age and the course of the disease in predicting depression was 50.5 years old and 54 months.

Cai Y ，Chen J ，Dou J ，Zhou N ，Shao H ，Shen X ，Hong M ，Chen J ，Fan X ，Hu Q ，Lu C ... -  《-》

Depression, anxiety and insomnia among isolated covid-19 patients: tele occupational therapy intervention vs. conventional one: a comparative study.

COVID-19 is known to cause psychological problems. Psychological rehabilitation can be performed to reduce anxiety, depression, and insomnia. Facing patients with infectious diseases can be difficult for medical staff. Therefore, this study compared the effects of psychiatric tele-rehabilitation (TR) and conventional psychiatric rehabilitation (CR) in isolated patients with COVID-19. This randomized controlled study, conducted at a single community-based hospital, included 40 patients (24 in the psychiatric tele-rehabilitation group [TRG] and 16 in the conventional psychiatric rehabilitation group [CRG]) with COVID-19 were recruited from November 18, 2021, to April 7, 2022. Psychiatric rehabilitation is an occupation-based intervention in which patients perform meaningful activities and tasks. Patients in the TRG selected activities, received counseling, and underwent monitoring over the phone, while those in the CRG participated in face-to-face sessions. The interventions were conducted for 50 min each day during an isolation period of 7 days in both groups, and all participants received the interventions individually. The primary outcome was anxiety assessed using the Visual Analog Scale (VAS) and the Zung Self-Rating Anxiety Scale (SAS). Secondary outcomes include the Visual Analog Scale (VAS) and the Patient Health Questionnaire-9 (PHQ-9) to evaluate depression, the Multidimensional State Boredom Scale-8 (MSBS-8) to assess boredom. The Korean version of the Insomnia Severity Index (ISI-K) was used to assess the quality of sleep, and the World Health Organization Quality of Life Assessment Instrument-BRIEF (WHOQOL-BREF) was used to evaluate quality of life. Questionnaires were administered at admission, discharge, and at the 6-month follow-up. In the time × group analysis, the SAS total score (p = .033) and the VAS score for depression (p = .012) in the CRG were significantly lower than those in the TRG at the time of discharge. The VAS score for anxiety (p = .007), total SAS score (p = .050), and VAS score for depression (p = .003) in the CRG were also significantly lower than those in the TRG at the 6-month follow-up. The PHQ-9, MSBS-8, ISI-K, and WHOQOL-BREF scores showed no significant interactions in the time × group analysis. TR was effective in reducing anxiety and improving quality of life during hospitalization, but had no remained effects after discharge. Otherwise, CR was more effective than TR for anxiety and depression during hospitalization and had remained effects at 6-month follow-up. However, considering the characteristics of infectious conditions that involve risk in contact, TR will still play an important role, and efforts will be needed to improve the effect that remained. The trial was registered with the Korea Clinical Trials Registry (KCT0006714, Date of registration 08/11/2021).

Jung JH ，Ko JY 《-》