Self-reported mental health status of pregnant women in Sweden during the COVID-19 pandemic: A cross-sectional survey

Background: The COVID-19 pandemic has contributed to unprecedented worries and challenges for pregnant women due to social restrictions and changes in maternity care provision. We aimed to investigate the mental health impact of COVID-19 pandemic on pregnant women in Sweden and explore factors associated with poor perinatal mental health in this specific context. Method: This was a nation-wide cross-sectional survey of pregnant women living in Sweden. Validated questionnaires were distributed through non-profit organizations´ websites and social media channels from May 2020 to February 2021. Perinatal depression, anxiety, and acute stress reaction were assessed using the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7(GAD-7) and Impact Event Scale (Revised)(IES-R), respectively. Sociodemographic characteristics and self-perceived mental well-being were also obtained. Factors associated with mental health outcomes were analyzed using multivariate logistic regression model. Results: Among a total of 522 participants, 42.5% (n=222) reported depression (EPDS ≥13), 25.3% (n=132) moderate to severe anxiety (GAD-7 score≥10), and 23.4% (n=122) moderate to severe acute stress reaction (IES-R ≥33). 27.4% participants (n=143, 27.4%) expressed concerns regarding their mental well-being during the pandemic. Pregnant mothers who had sick family members reported more severe poor mental health outcomes than those who did not (median [Interquartile range (IQR)] EPDS scores: 14.0 [8.75 – 18.0] vs 10.0 [6.0 – 14.0], p<.001; median [IQR] GAD7 scores: 7.0 [4.0 – 12.25] vs 5.0 [3.0 – 9.0], p<.001; median (IQR) IES-R scores: 20.0 [9.0 – 38.0] vs 15.0 [7.0 – 28.0], p=.008). Logistic regression analyses revealed that risk factors for poor mental health outcomes were having a sick family member with any illness, unemployment, giving birth, and experiencing an exceptional stressful life event. Having a higher educational level, younger age, and changing career during the pandemic were protective. Conclusion: Depression and anxiety were highly prevalent among pregnant women in Sweden during the COVID-19 pandemic, indicating a need for professional mental health support for this vulnerable group of population. Unemployment was an associated risk factor whereas younger age and higher educational level were protective suggesting an important role of socio-economic factors in modulating the impact of COVID-19 pandemic on perinatal mental health.

Detection of six novel de novo mutations in individuals with low resilience to psychological stress

Genetic bases of psychological stress resilience have been studied previously, but mechanisms and genetic variants which are involved in stress resilience are still unclear. The present study aimed to evaluate the associations between variants in dopaminergic pathway genes with stress resilience. Subjects of the present study were divided into four groups. Group A included persons with normal reactions to major life events stressors; group B included persons with an acute stress reaction to major life events stressor; group C included persons with normal reactions to Crises/catastrophes stressors, and group D included persons with an acute stress reaction to Crises/catastrophes stressors. DNA was extracted from the subject’s blood, and the entire length of 14 genes DRD1, DRD2, DRD3, DRD4, DRD5, COMT, DBH, TH, MAOA, DDC, DAT, 5-HTT, BDNF, and GDNF were sequenced by automated sequencers ABI 3700. Results showed 24 point mutations in 12 genes, including 16 SNPs and six novel mutations, which were significantly correlated to low-stress resilience. Most of the SNPs were known as risk alleles in psychiatric disorders. Several associations were found between genetic variants and psychological characteristics. Findings suggest dopaminergic as an important pathway in stress and stress resilience also indicated shared genetic bases between low-stress resilience and several psychiatric disorders.

A STUDY OF PROFILE OF PATIENTS REFERRED TO PSYCHIATRY DEPARTMENT FROM OTHERS DEPARTMENTS

Introduction: The aim is to study the Profile of patients referred to Psychiatry department in a Medical College & Hospital in Rajasthan. Material and Methods: A study of 100 subsequent patients was conducted in psychiatry department, Diagnosis was made by psychiatrists based on ICD-10 guidelines. Data was analyzed using appropriate statistical techniques. Results: 18.00% of patients were diagnosed as Mixed anxiety & depression followed by depressive disorder 23.00%. Somatoform disorder and acute stress reaction adds 5% each. 3.00% diagnosed as psychosexual disorder followed by nil psychiatric diagnosis 2%, schizophrenia and organic psychosis/delirium 1% each. Conclusion: Psychiatric co-morbidity may present in acute & chronic physical illness. The C-L psychiatry would play a major role in the management of psychiatric co-morbidity. The General medicine was the main department for referring patients. Keywords: Psychiatry references from medical& surgical departments, Consultation Liaison Psychiatry.

Examining the development of PTSD symptoms in individuals who witness acute stress reaction on the battlefield

Adler et al describe an innovative perspective on battlefield posttraumatic stress disorder (PTSD) symptoms in response to an acute stress reaction (ASR), tracking not the individual experiencing ASR, but rather the service members who witness another team member experiencing an ASR. PTSD symptoms, reactions, observations and responses in the witness are assessed.

Spontaneous pneumomediastinum secondary to acute stress reaction: a case report

Objective: As spontaneous pneumomediastinum (PMS) is a rare and idiopathic entity, the present report proposes to record one of the few cases of a patient who presented PMS after intense cries induced by psychiatric illness. Case details: A 50-year-old male patient who was admitted to emergency department with agitation, cold sweating, tachycardia and echolalia, associated with screams. Symptoms lasted for about 15 hours and they have started after the patient witnessed a first-degree relative (father) dying at home due to COVID-19. A thorax computed tomography scan found a Pneumomediastinum that involved the upper mediastinum with mild extension to lower neck, near the Thyroid gland. After acute stress reaction diagnosis, accordingly with DSM-IV criteria, patient followed observation for two days and punctual benzodiazepines use, having no clinical complications during hospital stay. Pneumomediastinum was completely resolved. Final considerations: Screams motivated by psychiatric condition can be added to SPM causes list and should motivate phisician awareness, since it may bare life-threatening complications associated.

Psychological impact of COVID-19 outbreak among Jimma University Medical Centere visitors in Southwestern Ethiopia: a cross-sectional study

BackgroundCOVID-19 has posed several medical, psychosocial and economic impacts among the majority of the society. The ambiguity of its transmission, the intense desire of self-protection, family, and friends, the unknown impact of catching the disease itself, unstoppable spread, the panic and outright misinformation lead to acute stress reaction syndrome. However, reliable data related to this contagion lack the prevalence of acute stress reaction syndrome and associated factors among Jimma University Medical Centre hospital visitors in Southwestern Ethiopia.AimsThe main objective of the study was to assess the prevalence and factors associated with acute stress reaction syndrome during the COVID-19 outbreak among Jimma University Medical Centre Hospital visitors, Ethiopia.MethodsAn interviewer-administered cross-sectional study was conducted among 247 visitors of the Jimma University Medical Centre in Ethiopia. The study was conducted within 2 weeks of the first COVID-19 cases detected on 13 March 2020 in Ethiopia. Data on demographic and socioeconomic status were collected during the interview using structured questionnaires. The psychological impact was assessed using the Impact of Event Scale-Revised, and symptoms of insomnia were measured using the Insomnia Severity Index. Social support was evaluated using Oslo three-item Social Support Scale. Logistic regression was employed to determine the associations between dependent and independent variables. Besides, psychosocial stress score was generated using principal component analysis. A paired permutation test was also performed to determine the variability of psychosocial stress between groups.ResultsThe mean age of participants was 30.47 years, and 76.5% of the participants were male. Acute stress reaction syndrome was detected in 44.1% of hospital visitors. Of the participants, 38.5%, 17.4%, 8.5% and 35.6% had a minimal, mild, moderate and severe psychological impact, respectively. Factors positively associated with acute stress reaction syndrome were individuals who perceived that COVID-19 leads to stigma (adjusted OR (AOR): 3.24, 95% CI 1.11 to 9.45), mild insomnia (AOR: 14.74, 95% CI 6.14 to 35.40), moderate to severe insomnia (AOR: 35.1, 95% CI 10.76 to 114.66), low social support (AOR: 4.08, 95% CI 1.31 to 12.67) and governmental employees (AOR: 8.09, 95% CI 1.38 to 47.18).ConclusionThe study revealed the existence of a high prevalence of acute stress reaction syndrome during the COVID-19 outbreak among different groups of the community. Therefore, our results will contribute to the global awareness of the psychological impact of the COVID-19 outbreak.