1.Clinical analysis of suspected COVID-19 patients with anxiety and depression.
Xin LI ; Tian DAI ; Hong WANG ; Junnian SHI ; Wei YUAN ; Jing LI ; Lijun CHEN ; Tianming ZHANG ; Shanshan ZHANG ; Yan KONG ; Ning YUE ; Hui SHI ; Yuping HE ; Huifang HU ; Furong LIU ; Caixia YANG
Journal of Zhejiang University. Medical sciences 2020;49(2):203-208
		                        		
		                        			OBJECTIVE:
		                        			To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis.
		                        		
		                        			METHODS:
		                        			Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients.
		                        		
		                        			RESULTS:
		                        			Female patients are more likely to have anxiety (=3.206, 95%: 1.073-9.583, <0.05) and depression (=9.111, 95%: 2.143-38.729, <0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (=3.267, 95%: 1.082-9.597, <0.05).
		                        		
		                        			CONCLUSIONS
		                        			During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.
		                        		
		                        		
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			etiology
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			isolation & purification
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			complications
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			etiology
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			complications
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
2.Efficacy of internet-based integrated intervention on depression and anxiety symptoms in patients with COVID-19.
Ning WEI ; Bo-Chao HUANG ; Shao-Jia LU ; Jian-Bo HU ; Xiao-Yi ZHOU ; Chan-Chan HU ; Jing-Kai CHEN ; Jin-Wen HUANG ; Shu-Guang LI ; Zheng WANG ; Dan-Dan WANG ; Yi XU ; Shao-Hua HU
Journal of Zhejiang University. Science. B 2020;21(5):400-404
		                        		
		                        			
		                        			Public health crises, such as the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since Dec. 2019, are widely acknowledged as severe traumatic events that impose threats not only because of physical concerns but also because of the psychological distress of infected patients. We designed an internet-based integrated intervention and evaluated its efficacy on depression and anxiety symptoms in patients infected by SARS-CoV-2.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			Cell Phone
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Internet
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Mindfulness
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Psychological Distress
		                        			;
		                        		
		                        			Relaxation Therapy
		                        			;
		                        		
		                        			Self Care
		                        			;
		                        		
		                        			methods
		                        			
		                        		
		                        	
3.Dialectical behavior therapy-based psychological intervention for woman in late pregnancy and early postpartum suffering from COVID-19: a case report.
Jin-Wen HUANG ; Xiao-Yi ZHOU ; Shao-Jia LU ; Yi XU ; Jian-Bo HU ; Man-Li HUANG ; Hua-Fen WANG ; Chan-Chan HU ; Shu-Guang LI ; Jing-Kai CHEN ; Zhong WANG ; Shao-Hua HU ; Ning WEI
Journal of Zhejiang University. Science. B 2020;21(5):394-399
		                        		
		                        			
		                        			At the end of 2019, a new form of pneumonia disease known as the corona virus disease 2019 (COVID-19) rapidly spread throughout most provinces of China, and the total global number of COVID-19 cases has surpassed 500 000 by Mar. 27, 2020 (WHO, 2020). On Jan. 30, 2020, the World Health Organization (WHO) declared COVID-19 a global health emergency (WHO, 2020). COVID-19 causes most damage to the respiratory system, leading to pneumonia or breathing difficulties. The confirmed case fatality risk (cCFR) was estimated to be 5% to 8% (Jung et al., 2020). Besides physical pain, COVID-19 also induces psychological distress, with depression, anxiety, and stress affecting the general population, quarantined population, medical staff, and patients at different levels (Kang et al., 2020; Xiang et al., 2020). Previous research on patients in isolation wards highlighted the risk of depressed mood, fear, loneliness, frustration, excessive worries, and insomnia (Abad et al., 2010).
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Dialectical Behavior Therapy
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Postpartum Period
		                        			;
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Pregnant Women
		                        			;
		                        		
		                        			psychology
		                        			
		                        		
		                        	
4.Explore the Optimal Resolvent of Medical Needs and Mental Health for Patients with Lung Cancer during Epidemic Novel Coronavirus Pneumonia.
Haiyan XU ; Ke YANG ; Guangjian YANG ; Lu YANG ; Yuling MI ; Xiaohong CUI ; Min YANG ; Dan WANG ; Yan WANG
Chinese Journal of Lung Cancer 2020;23(4):247-254
		                        		
		                        			BACKGROUND:
		                        			With the rapid spread of novel coronavirus pneumonia (NCP) worldwide and the escalation of prevention and control efforts, the routine medical needs of patients have been restricted. The aims were to investigate medical needs of lung cancer patients and their mental health status during the epidemic periods, so as to provide rational recommendations for subsequent diagnosis and treatment.
		                        		
		                        			METHODS:
		                        			The questionnaire was sent in the form of an electronic questionnaire at 7am on 4th, March, 2020, until 7am 6th, March, 2020, 368 questionnaires were recollected from 25 provinces (autonomous regions/municipalities) in 48 h.
		                        		
		                        			RESULTS:
		                        			Of the 368 patients, 18 patients were excluded as they didn't receive anti-tumor treatment, and 350 patients were included in the final analysis. 229 cases were treated with oral targeted drugs, and 121 cases were treated with chemotherapy or immunotherapy. 41.3% of patients treated with intravenous chemotherapy or immunotherapy experienced treatment discontinuation, and the proportion of treatment discontinuation in chemotherapy or immunotherapy was higher than those treated with oral targeted drugs (21.0%). Whether oral targeted drugs or intravenous chemotherapy or immunotherapy, more than 60% of patients experienced delays in imaging examinations. Nearly one third of patients developed new symptoms or exacerbation of existing symptoms. 26.6%-28.9% of patients have changed their treatment plans through online consultation. During novel coronavirus pneumonia, 40%-75% of lung cancer patients have mental health problems, and more than 95% of patients support government's prevention and control measures.
		                        		
		                        			CONCLUSIONS
		                        			During the emergence of NCP, the medical needs of patients with lung cancer have not been enough, especially those who discontinued chemotherapy or immunotherapy. When medical institution resumes work, priority should be given to them. At the same time, mental health problems of patients should be valued and resolved timely.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Antineoplastic Agents
		                        			;
		                        		
		                        			therapeutic use
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			physiology
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			virology
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lung Neoplasms
		                        			;
		                        		
		                        			drug therapy
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			virology
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			virology
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
6.Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic.
Qian Hui CHEW ; Ker Chiah WEI ; Shawn VASOO ; Hong Choon CHUA ; Kang SIM
Singapore medical journal 2020;61(7):350-356
		                        		
		                        			INTRODUCTION:
		                        			Emerging infectious disease outbreaks, such as the present coronavirus disease 2019 (COVID-19) pandemic, often have a psychological impact on the well-being of the general population, including survivors and caregivers. Our study aimed to synthesise extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks.
		                        		
		                        			METHODS:
		                        			We conducted a narrative synthesis of the published literature over the last two decades with a quality appraisal of included articles that reported both psychological responses and coping strategies within infectious disease outbreaks.
		                        		
		                        			RESULTS:
		                        			A total of 144 papers were identified from the search, 24 of which were included in the review. Overall, 18 studies examined the psychosocial responses of the general population towards the severe acute respiratory syndrome epidemic, four studies focused on the Ebola epidemic and two studies covered the H1N1 outbreak. Common themes in psychological responses included anxiety/fears, depression, anger, guilt, grief and loss, post-traumatic stress and stigmatisation, but also a greater sense of empowerment and compassion towards others. Coping strategies adopted included problem-focused coping (seeking alternatives, self- and other-preservation), seeking social support, avoidance, and positive appraisal of the situation.
		                        		
		                        			CONCLUSION
		                        			Amid the range of psychosocial responses seen in past infectious disease outbreaks, practical considerations for the current COVID-19 pandemic need to focus on the individual in the context of the larger social environment, with an emphasis on raising awareness of the range of possible psychosocial responses, access to psychological help, self-care, empowering self-support groups and sustained engagement with updated, reliable information about the outbreak.
		                        		
		                        		
		                        		
		                        			Adaptation, Psychological
		                        			;
		                        		
		                        			physiology
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Health Personnel
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mental Health
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Stress, Psychological
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			etiology
		                        			;
		                        		
		                        			psychology
		                        			
		                        		
		                        	
8.Knowledge, attitude, and practice survey regarding coronavirus disease 2019 among residents in Hunan Province.
Chunyan LI ; Jingcan XU ; Liqing YUE ; Minxue SHEN ; Minhui DAI ; Neng LIU
Journal of Central South University(Medical Sciences) 2020;45(6):665-672
		                        		
		                        			OBJECTIVES:
		                        			To evaluate residents' knowledge, attitude and behavior towards coronavirus disease 2019 (COVID-19) in Hunan Province, and to explore the factors influencing behaviors.
		                        		
		                        			METHODS:
		                        			A self-designed questionnaire was used to conduct an online survey for 4 139 Hunan residents. The contents included general population information, residents' knowledge, attitude and practice to COVID-19.
		                        		
		                        			RESULTS:
		                        			Mean scores of knowledge, attitude, and behavior were 29.82±3.16, 6.71±1.12, and 14.93±1.45, respectively. Residents had the highest score of major symptoms of COVID-19 (3.96±0.39), but the lowest was the main transmission routes (3.47±0.89). A total of 22.68% of the residents were very or relatively afraid of the outbreak, but 95.22% of the residents had confidence in defeating COVID-19. In behavior dimension, "handling of suspicious symptoms" had the lowest score (3.58±0.75). The behavior implementation rate of "keep the surfaces of household items clean" (80.50%), "doing more exercise, reasonable diet, working and resting regularly" (84.59%), and "avoid hand contacting with eyes, mouth or nose" (89.51%) were relatively low. Pearson correlation coefficient showed that the knowledge, attitude, and practices score were correlated with each other (knowledge vs behavior: =0.366; knowledge vs attitude: =0.041; attitude vs behavior: =0.100; all <0.05). Multiple linear regression analysis showed that the knowledge, attitude and behavior on COVID-19 were mostly influenced by education background (all <0.05), and the independent factors affecting behavior included knowledge and attitude, gender, permanent residence, education background (all <0.05).
		                        		
		                        			CONCLUSIONS
		                        			Residents in Hunan Province have a good knowledge, attitude, and behavior to COVID-19. Nevertheless there are still weak links to be improved in all dimensions. It is necessary to strengthen knowledge and behavior of family protection, and care for residents' psychological health, especially persons with low education degree, male and rural residents.
		                        		
		                        		
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Health Knowledge, Attitudes, Practice
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
9.Mental health status of patients with coronavirus disease 2019 in Changsha.
Xuemei QIN ; Kongliang SHU ; Mi WANG ; Wentao CHEN ; Mei HUANG ; Aiping YANG ; Yun ZHOU ; Yan ZHANG ; Yumeng JU ; Jiyang LIU
Journal of Central South University(Medical Sciences) 2020;45(6):657-664
		                        		
		                        			OBJECTIVES:
		                        			The epidemic of coronavirus disease 2019 (COVID-19) brought psychological stress to the public, especially to patients. This study aims to investigate the mental health of patients with COVID-19 in Changsha.
		                        		
		                        			METHODS:
		                        			We took cross-section investigation for the mental health of 112 patients with COVID-19 via questionnaires. Mann-Whitney test, Chi-square test, and Fisher's exact test were performed to compare general and clinical data between the slight-ordinary patients and severe patients. Single sample -tests were used to compare the difference between the factor scores of the Symptom Check-List 90 (SCL-90) in COVID-19 patients with the norm of 2015 and factor scores of SCL-90 in patients with the severe acute respiratory syndrome (SARS).
		                        		
		                        			RESULTS:
		                        			The obsessive-compulsive, depression, sleep and eating disorders had the highest frequency among the positive symptoms of SCL-90 in patients with COVID-19 in Changsha. The factor scores of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 were higher than those of the norm (≤0.001 or <0.05). Slight-ordinary patients with COVID-19 in Changsha showed lower factor scores of somatization, depression, anxiety, and hostility compared with the patients with SARS (<0.001 or <0.05). There was no difference in factor scores of SCL-90 between the patients with severe COVID-19 and those with SARS(>0.05).
		                        		
		                        			CONCLUSIONS
		                        			The levels of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 in Changsha are higher than those of the norm. However, the mental health of slight-ordinary patients with COVID-19 is better than that of patients with SARS. It needs to provide targeting psychological interventions depending on the severity of patients.
		                        		
		                        		
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			Feeding and Eating Disorders
		                        			;
		                        		
		                        			Health Status
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mental Health
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Sleep Wake Disorders
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
10.Medical students mental health, professional pride, and intention to work in the frontline during coronavirus disease 2019 pandemic.
Juan ZHAN ; Shenghua SUN ; Lihua XIE ; Yijiang WEN ; Jianguo FU
Journal of Central South University(Medical Sciences) 2020;45(6):649-656
		                        		
		                        			OBJECTIVES:
		                        			To understand medical students' mental health, professional pride, and intention to work in the front-line during coronavirus disease 2019 (COVID-19) pandemic, and provide a reference for psychological intervention.
		                        		
		                        			METHODS:
		                        			We used the depression-anxiety-stress scale and self-designed questionnaire on professional pride, intention to work in the front-line and the extent of family support. Medical students from 4 medical schools in Fujian and Hunan were investigated. Their mental health status, professional pride and first-line work willingness with different characteristics were compared, and the influential factors for professional pride and first-line work willingness were analyzed.
		                        		
		                        			RESULTS:
		                        			A total of 266 valid questionnaires were collected. During the pandemic, there were significant differences in the proportion of depressed students among different college and universities, majors and stages (<0.05), and the professional pride was significantly different (<0.001). Medical students with different mental health status showed significant differences in professional pride (<0.01). Marriage, pressure and extent of family support were the influential factors for their professional pride (<0.05). The latter two were also influential factors for their intention to work in the front-line (<0.05).
		                        		
		                        			CONCLUSIONS
		                        			During the pandemic, students from college and nursing have relatively better mental health and higher professional pride. The professional pride is low in medical students who married, with abnormal stress or low family support. The intention to work in front-line is decreased in students with abnormal stress or low family support.
		                        		
		                        		
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Family
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Intention
		                        			;
		                        		
		                        			Mental Health
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Professionalism
		                        			;
		                        		
		                        			Social Support
		                        			;
		                        		
		                        			Stress, Psychological
		                        			;
		                        		
		                        			Students, Medical
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
            
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