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Kai Yuan

Bio: Kai Yuan is an academic researcher from Peking University. The author has contributed to research in topics: Mental health & Psychological intervention. The author has an hindex of 12, co-authored 38 publications receiving 779 citations. Previous affiliations of Kai Yuan include Tianjin University & McGovern Institute for Brain Research.

Papers
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Journal ArticleDOI
01 Jul 2020
TL;DR: The mental health burden associated with CO VID-19 is considerable among the general population of China, suggesting that mental health interventions are in urgent demand during the COVID-19 pandemic, especially for some at-risk populations.
Abstract: Importance People exposed to coronavirus disease 2019 (COVID-19) and a series of imperative containment measures could be psychologically stressed, yet the burden of and factors associated with mental health symptoms remain unclear Objective To investigate the prevalence of and risk factors associated with mental health symptoms in the general population in China during the COVID-19 pandemic Design, Setting, and Participants This large-sample, cross-sectional, population-based, online survey study was conducted from February 28, 2020, to March 11, 2020 It involved all 34 province-level regions in China and included participants aged 18 years and older Data analysis was performed from March to May 2020 Main Outcomes and Measures The prevalence of symptoms of depression, anxiety, insomnia, and acute stress among the general population in China during the COVID-19 pandemic was evaluated using the Patient Health Questionnaire–9, Generalized Anxiety Disorder–7, Insomnia Severity Index, and Acute Stress Disorder Scale Logistic regression analyses were used to explore demographic and COVID-19–related risk factors Results Of 71 227 individuals who clicked on the survey link, 56 932 submitted the questionnaires, for a participation rate of 799% After excluding the invalid questionnaires, 56 679 participants (mean [SD] age, 3597 [822] years; 27 149 men [479%]) were included in the study; 39 468 respondents (696%) were aged 18 to 39 years During the COVID-19 pandemic, the rates of mental health symptoms among the survey respondents were 279% (95% CI, 275%-282%) for depression, 316% (95% CI, 312%-320%) for anxiety, 292% (95% CI, 288%-296%) for insomnia, and 244% (95% CI, 240%-247%) for acute stress Participants with confirmed or suspected COVID-19 and their family members or friends had a high risk for symptoms of depression (adjusted odds ratios [ORs], 327 [95% CI, 184-580] for patients; 153 [95% CI, 126-185] for family or friends), anxiety (adjusted ORs, 248 [95% CI, 143-431] for patients; 153 [95% CI, 127-184] for family or friends), insomnia (adjusted ORs, 306 [95% CI, 173-543] for patients; 162 [95% CI, 135-196] for family or friends), and acute stress (adjusted ORs, 350 [95% CI, 202-607] for patients; 177 [95% CI, 146-215] for family or friends) Moreover, people with occupational exposure risks and residents in Hubei province had increased odds of symptoms of depression (adjusted ORs, 196 [95% CI, 177-217] for occupational exposure; 142 [95% CI, 119-168] for Hubei residence), anxiety (adjusted ORs, 193 [95% CI, 175-213] for occupational exposure; 154 [95% CI, 130-182] for Hubei residence), insomnia (adjusted ORs, 160 [95% CI, 145-177] for occupational exposure; 120 [95% CI, 101-142] for Hubei residence), and acute stress (adjusted ORs, 198 [95% CI, 179-220] for occupational exposure; 149 [95% CI, 125-179] for Hubei residence) Both centralized quarantine (adjusted ORs, 133 [95% CI, 110-161] for depression; 146 [95% CI, 122-175] for anxiety; 163 [95% CI, 136-195] for insomnia; 146 [95% CI, 121-177] for acute stress) and home quarantine (adjusted ORs, 130 [95% CI, 125-136] for depression; 128 [95% CI, 123-134] for anxiety; 124 [95% CI, 119-130] for insomnia; 129 [95% CI, 124-135] for acute stress) were associated with the 4 negative mental health outcomes Being at work was associated with lower risks of depression (adjusted OR, 085 [95% CI, 079-091]), anxiety (adjusted OR, 092 [95% CI, 086-099]), and insomnia (adjusted OR, 087 [95% CI, 081-094]) Conclusions and Relevance The results of this survey indicate that mental health symptoms may have been common during the COVID-19 outbreak among the general population in China, especially among infected individuals, people with suspected infection, and people who might have contact with patients with COVID-19 Some measures, such as quarantine and delays in returning to work, were also associated with mental health among the public These findings identify populations at risk for mental health problems during the COVID-19 pandemic and may help in implementing mental health intervention policies in other countries and regions

502 citations

Journal ArticleDOI
14 Jun 2020
TL;DR: Investigating the prevalence of psychological problems in different healthcare workers during the COVID-19 pandemic in China found that front-line healthcare workers had a higher risk of anxiety, insomnia and overall psychological problems, and attention to negative or neutral information about the pandemic, receiving negative feedback from families and friends, and unwillingness to join front- line work if given a free choice were three major factors.
Abstract: Background Healthcare workers fighting against the coronavirus disease 2019 (COVID-19) pandemic are under tremendous pressure, which puts them at an increased risk of developing psychological problems. Aims This study aimed to investigate the prevalence of psychological problems in different healthcare workers (ie, physicians, medical residents, nurses, technicians and public health professionals) during the COVID-19 pandemic in China and explore factors that are associated with the onset of psychological problems in this population during this public health crisis. Methods A cross-sectional, web-based survey was conducted in February 2020 among healthcare workers during the COVID-19 pandemic. Psychological problems were assessed using the Generalized Anxiety Disorder Scale, Patient Health Questionnaire and Insomnia Severity Index. Logistic regression analyses were used to explore the factors that were associated with psychological problems. Results The prevalence of symptoms of anxiety, depression, insomnia and the overall psychological problems in healthcare workers during the COVID-19 pandemic in China was 46.04%, 44.37%, 28.75% and 56.59%, respectively. The prevalence of the overall psychological problems in physicians, medical residents, nurses, technicians and public health professionals was 60.35%, 50.82%, 62.02%, 57.54% and 62.40%, respectively. Compared with healthcare workers who did not participate in front-line work, front-line healthcare workers had a higher risk of anxiety, insomnia and overall psychological problems. In addition, attention to negative or neutral information about the pandemic, receiving negative feedback from families and friends who joined front-line work, and unwillingness to join front-line work if given a free choice were three major factors for these psychological problems. Conclusions Psychological problems are pervasive among healthcare workers during the COVID-19 pandemic. Receiving negative information and participating in front-line work appear to be important risk factors for psychological problems. The psychological health of different healthcare workers should be protected during the COVID-19 pandemic with timely interventions and proper information feedback.

326 citations

Journal ArticleDOI
TL;DR: Wang et al. as discussed by the authors conducted a cross-sectional, nationwide study to ascertain the psychological effect of quarantine and identify factors associated with mental health outcomes among population quarantined to further inform interventions of mitigating mental health risk especially for vulnerable groups under pandemic conditions.
Abstract: Quarantine and isolation measures urgently adopted to control the COVID-19 pandemic might potentially have negative psychological and social effects. We conducted this cross-sectional, nationwide study to ascertain the psychological effect of quarantine and identify factors associated with mental health outcomes among population quarantined to further inform interventions of mitigating mental health risk especially for vulnerable groups under pandemic conditions. Sociodemographic data, attitudes toward the COVID-19, and mental health measurements of 56,679 participants from 34 provinces in China were collected by an online survey from February 28 to March 11, 2020. Of the 56,679 participants included in the study (mean [SD] age, 36.0 [8.2] years), 27,149 (47.9%) were male and 16,454 (29.0%) ever experienced home confinement or centralized quarantine during COVID-19 outbreak. Compared those without quarantine and adjusted for potential confounders, quarantine measures were associated with increased risk of total psychological outcomes (prevalence, 34.1% vs 27.3%; odds ratio [OR], 1.34; 95% CI, 1.28-1.39; P < 0.001). Multivariable logistic regression analyses showed that vulnerable groups of the quarantined population included those with pre-existing mental disorders or chronic physical diseases, frontline workers, those in the most severely affected areas during outbreak, infected or suspected patients, and those who are less financially well-off. Complying with quarantine, being able to take part in usual work, and having adequate understanding of information related to the outbreak were associated with less mental health issues. These results suggest that quarantine measures during COVID-19 pandemic are associated with increased risk of experiencing mental health burden, especially for vulnerable groups. Further study is needed to establish interventions to reduce mental health consequences of quarantine and empower wellbeing especially in vulnerable groups under pandemic conditions.

168 citations

Journal ArticleDOI
TL;DR: A systematic review and meta-analysis of the worldwide prevalence of post-traumatic stress disorder after large-scale pandemics as well as associated risk factors was conducted in this paper.
Abstract: Pandemics have become more frequent and more complex during the twenty-first century Posttraumatic stress disorder (PTSD) following pandemics is a significant public health concern We sought to provide a reliable estimate of the worldwide prevalence of PTSD after large-scale pandemics as well as associated risk factors, by a systematic review and meta-analysis We systematically searched the MedLine, Embase, PsycINFO, Web of Science, CNKI, WanFang, medRxiv, and bioRxiv databases to identify studies that were published from the inception up to August 23, 2020, and reported the prevalence of PTSD after pandemics including sudden acute respiratory syndrome (SARS), H1N1, Poliomyelitis, Ebola, Zika, Nipah, Middle Eastern respiratory syndrome coronavirus (MERS-CoV), H5N1, and coronavirus disease 2019 (COVID-19) A total of 88 studies were included in the analysis, with 77 having prevalence information and 70 having risk factors information The overall pooled prevalence of post-pandemic PTSD across all populations was 226% (95% confidence interval (CI): 199-254%, I2: 997%) Healthcare workers had the highest prevalence of PTSD (269%; 95% CI: 203-336%), followed by infected cases (238%: 166-310%), and the general public (193%: 153-232%) However, the heterogeneity of study findings indicates that results should be interpreted cautiously Risk factors including individual, family, and societal factors, pandemic-related factors, and specific factors in healthcare workers and patients for post-pandemic PTSD were summarized and discussed in this systematic review Long-term monitoring and early interventions should be implemented to improve post-pandemic mental health and long-term recovery

150 citations

Journal ArticleDOI
TL;DR: Because social, economic, and health problems related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.
Abstract: Fentanyl is a powerful opioid anesthetic and analgesic, the use of which has caused an increasing public health threat in the United States and elsewhere. Fentanyl was initially approved and used for the treatment of moderate to severe pain, especially cancer pain. However, recent years have seen a growing concern that fentanyl and its analogs are widely synthesized in laboratories and adulterated with illicit supplies of heroin, cocaine, methamphetamine, and counterfeit pills, contributing to the exponential growth in the number of drug-related overdose deaths. This review summarizes the recent epidemic and evolution of illicit fentanyl use, its pharmacological mechanisms and side effects, and the potential clinical management and prevention of fentanyl-related overdoses. Because social, economic, and health problems that are related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.

97 citations


Cited by
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Journal ArticleDOI
TL;DR: The prevalence of sleep problems during the COVID-19 pandemic is high and approximately affect 40% of people from the general and healthcare populations.
Abstract: STUDY OBJECTIVES: No systematic review or meta-analysis has yet been conducted to examine the impact of the pandemic on the prevalence of sleep problems among the general population, healthcare workers, or COVID-19 patients. Therefore, this systematic review was conducted to assess the impact and prevalence of sleep problems among those categories. METHODS: APA PsycINFO; Cochrane; Cumulative Index to Nursing and Allied Health Literature (CINAHL); EBSCOhost; EMBASE; Google Scholar; MEDLINE; ProQuest Medical; ScienceDirect; Scopus; and Web of Science from 01 November 2019 to 05 July 2020. Additionally, four preprints servers (medRxiv.org; Preprints.org; psyarxiv.com; arXiv.org; biorxiv.org) were also searched for papers accepted after peer-review but not yet published and indexed. There was no language restriction. The random-effect models meta-analysis model were used with the DerSimonian and Laird methodology. RESULTS: Forty-four papers, involving a total of 54,231 participants from 13 countries, were judged relevant and contributed to the systematic review and meta-analysis of sleep problems during COVID-19. The global pooled prevalence rate of sleep problems among all populations was 35.7% [95%CI 29.4-42.4%]. COVID-19 patients appeared to be the most affected group, with a pooled rate of 74.8% [95%CI 28.7-95.6%]. Healthcare workers and the general population had comparative rates of sleep problems with rates of 36.0% [95%CI 21.1-54.2%] and 32.3% [95%CI 25.3-40.2%], respectively. CONCLUSIONS: The prevalence of sleep problems during the COVID-19 pandemic is high and approximately affect 40% of people from the general and healthcare populations. COVID-19 active patients appeared to have higher prevalence rates of sleep problems.

427 citations

Journal ArticleDOI
TL;DR: This review sets the basis for a better understanding of the psychological conditions of workers during the pandemic, integrating individual and social perspectives, and providing insight into possible individual, social, and occupational approaches to this “psychological pandemic”.
Abstract: The Coronavirus Disease 2019 (COVID-19) pandemic has deeply altered social and working environments in several ways. Social distancing policies, mandatory lockdowns, isolation periods, and anxiety of getting sick, along with the suspension of productive activity, loss of income, and fear of the future, jointly influence the mental health of citizens and workers. Workplace aspects can play a crucial role on moderating or worsening mental health of people facing this pandemic scenario. The purpose of this literature review is to deepen the psychological aspects linked to workplace factors, following the epidemic rise of COVID-19, in order to address upcoming psychological critical issues in the workplaces. We performed a literature search using Google Scholar, PubMed, and Scopus, selecting papers focusing on workers' psychological problems that can be related to the workplace during the pandemic. Thirty-five articles were included. Mental issues related to the health emergency, such as anxiety, depression, post-traumatic stress disorder (PTSD), and sleep disorders are more likely to affect healthcare workers, especially those on the frontline, migrant workers, and workers in contact with the public. Job insecurity, long periods of isolation, and uncertainty of the future worsen the psychological condition, especially in younger people and in those with a higher educational background. Multiple organizational and work-related interventions can mitigate this scenario, such as the improvement of workplace infrastructures, the adoption of correct and shared anti-contagion measures, including regular personal protective equipment (PPE) supply, and the implementation of resilience training programs. This review sets the basis for a better understanding of the psychological conditions of workers during the pandemic, integrating individual and social perspectives, and providing insight into possible individual, social, and occupational approaches to this "psychological pandemic".

418 citations

Journal ArticleDOI
TL;DR: Given the very limited evidence regarding the impact of interventions to tackle mental health problems in HCWs, the risk factors identified represent important targets for future interventions.

266 citations

Journal ArticleDOI
TL;DR: In this article, the authors provided a contemporary global prevalence of mental health issues among the general population amid the coronavirus disease-2019 (COVID-19) pandemic.
Abstract: To provide a contemporary global prevalence of mental health issues among the general population amid the coronavirus disease-2019 (COVID-19) pandemic. We searched electronic databases, preprint databases, grey literature, and unpublished studies from January 1, 2020, to June 16, 2020 (updated on July 11, 2020), with no language restrictions. Observational studies using validated measurement tools and reporting data on mental health issues among the general population were screened to identify all relevant studies. We have included information from 32 different countries and 398,771 participants. The pooled prevalence of mental health issues amid the COVID-19 pandemic varied widely across countries and regions and was higher than previous reports before the COVID-19 outbreak began. The global prevalence estimate was 28.0% for depression; 26.9% for anxiety; 24.1% for post-traumatic stress symptoms; 36.5% for stress; 50.0% for psychological distress; and 27.6% for sleep problems. Data are limited for other aspects of mental health issues. Our findings highlight the disparities between countries in terms of the poverty impacts of COVID-19, preparedness of countries to respond, and economic vulnerabilities that impact the prevalence of mental health problems. Research on the social and economic burden is needed to better manage mental health problems during and after epidemics or pandemics. Systematic review registration: PROSPERO CRD 42020177120.

251 citations