Evidence from previous coronavirus outbreaks has shown that infected patients are at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and sleep disturbances. To construct a comprehensive picture of the mental health status in COVID-19 patients, we conducted a systematic review and random-effects meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbances in this population. We searched MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Wanfang Data, Wangfang Med Online, CNKI, and CQVIP for relevant articles, and we included 31 studies (n = 5153) in our analyses. We found that the pooled prevalence of depression was 45% (95% CI: 37-54%, I2  = 96%), the pooled prevalence of anxiety was 47% (95% CI: 37-57%, I2  = 97%), and the pooled prevalence of sleeping disturbances was 34% (95% CI: 19-50%, I2  = 98%). We did not find any significant differences in the prevalence estimates between different genders; however, the depression and anxiety prevalence estimates varied based on different screening tools. More observational studies assessing the mental wellness of COVID-19 outpatients and COVID-19 patients from countries other than China are needed to further examine the psychological implications of COVID-19 infections.

https://nyaspubs.onlinelibrary.wiley.com/doi/pdf/10.1111/nyas.14506

The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis

Background The coronavirus disease (COVID-19) pandemic has been spreading and brought unprecedented psychological pressure on people across the entire globe since December 2019. Objectives To synthesize the existing evidence of the prevalence of mental health status during the epidemic and provide the basis for mental health education. Materials and methods The literature search was conducted in nine databases from December 2019 to October 2020. The risk of bias for each study was assessed, and the random-effects meta-analysis was used to estimate the prevalence of specific mental health problems. The review protocol was registered in PROSPERO with the registration number CRD42020208619. Results About 27 studies were included in the analysis with a total of 706,415 participants combined, and 14 mental health problems were gathered. Meta-analysis showed that the prevalence of depression was 39% (95% CI: 27-51%) and that of anxiety was 36% (95% CI: 26-46%). Subgroup analysis indicated that the prevalence of depression and anxiety varied among nations and due to the survey date. The prevalence of depression (60%, 95% CI: 46-74%) and anxiety (60%, 95% CI: 46-74%) in non-Chinese college students was higher than those in Chinese college students (26%, 95% CI: 21-30% and 20%, 95% CI: 14-26%). The proportion of depression (54%, 95% CI: 40-67%) and anxiety (37%, 95% CI: 26-48%) was higher after March 1 than before it (21%, 95% CI: 16-25% and 19%, 95% CI: 13-25%). Conclusions The meta-analysis results presented that the prevalence of depression (39%) or anxiety (36%) among college students greatly increased during the COVID-19 pandemic. In addition, the mental health of college students is affected by the nations and the survey date. It was necessary to take measures to reduce mental health risks during the pandemic.

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Impact of the COVID-19 Pandemic on the Mental Health of College Students: A Systematic Review and Meta-Analysis

The Pittsburgh Sleep Quality Index (PSQI) dimensionality is much debated, with the greatest number of reported factor structures. Therefore, this review appraised the methodologies of studies investigating the factor structure of the PSQI. MEDLINE, PsycInfo, AJOL, BASE, Cochrane Library, Directory of Open Access Journals (Lund University), CINAHL, and Embase were searched systematically to include articles published till 23rd March, 2018. The articles with the objective of factor analysis of the PSQI (20 articles) or with a major section on the same subject (25 articles) were included. There was no limitation about participant characteristics. Descriptive analysis of articles for measures of the suitability of the data for factor analysis, details of the exploratory factor analysis (EFA) and details of the confirmatory factor analysis (CFA) was performed. The analysis used by the majority did not employ the simplest scheme for interpreting the observed data: the parsimony principle. Other shortcomings included under- or non-reporting of sample adequacy measures (11 out of 45 articles), non-use of EFA (20 out of 45 articles), use of EFA without relevant details, non-use of CFA (11 out of 45 articles), and use of CFA without relevant details. Overall, 31 out of 45 articles did not use either EFA or CFA. We conclude that the various PSQI factor structures for standard sleep assessment in research and clinical settings may need further validation. Not applicable because this was a review of existing literature.

/pdf/dimensionality-of-the-pittsburgh-sleep-quality-index-a-4cww7prsj8.pdf

Dimensionality of the Pittsburgh Sleep Quality Index: a systematic review.

Background: The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report questionnaire that measures general sleep quality in the elderly. However, its psychometric properties have yet to be thoroughly examined in longveous persons. Objectives: This study aimed to explore the reliability, validity and factor structure of the Chinese-language version of the PSQI in community-dwelling centenarians. Methods: A total of 958 centenarians (mean age = 102.8 years; 81.8% females) recruited from 18 regions in Hainan, China, completed the PSQI scale. Cronbach’s alpha coefficient was used to measure the internal consistency. Correlations between the global PSQI score and physical function, depression symptoms, self-reported health status and subjective well-being were used to assess divergent validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to explore the validity and factor structure of the PSQI in this sample. Results: The Cronbach’s α coefficient of the PSQI was 0.68, and it increased to 0.78 after two components (medication use and daytime dysfunction) were removed. The Spearman correlation coefficients of the PSQI score with each component were statistically significant (P<0.01). EFA yielded a two-factor structure model of the original PSQI-7 and a one-factor structure model of the simplified PSQI-5. The one-factor model with 5 components (2/df =1.59, CFI=0.99, RMSEA=0.03) fit the data well and had good invariance across demographic characteristics in this sample. Conclusions: The original PSQI showed acceptable applicability in Chinese community-dwelling centenarians, and its psychometric characteristics moderately improved after sleeping medication and daytime dysfunction were removed. Further validation studies on PSQI are needed among centenarians from varied backgrounds.

/pdf/reliability-validity-and-factor-structure-of-pittsburgh-2a216de63a.pdf

Reliability, Validity, and Factor Structure of Pittsburgh Sleep Quality Index in Community-Based Centenarians.

This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44–4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70–2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86–7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04–1.52; P﻿ = 0.018), being single (OR, 1.45; 95%CI 1.21–1.74; P < 0.001), higher education (OR, ﻿1.25; 95% CI, 1.03–1.53; P = 0.025)﻿; and clinical factors: suboptimal adherence (OR,1.51; 95% CI,1.23–1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12–3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47–2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.

/pdf/burden-of-sleep-disturbances-and-associated-risk-factors-a-1se5jt0oas.pdf

Burden of sleep disturbances and associated risk factors: A cross-sectional survey among HIV-infected persons on antiretroviral therapy across China

The purpose of this study was to examine the structural validity of the Pittsburgh Sleep Quality Index (PSQI) in Chinese undergraduate students. A cross-sectional questionnaire survey with 631 Chinese undergraduate students was conducted, and the questionnaire package included a measure of demographic characteristics, Pittsburgh Sleep Quality Index (PSQI), Chinese editions of Center for Epidemiologic Studies-Depression, State- Trait Anxiety Inventory, Rumination Response Scale, and Perceived Social Support Scale. Results showed that the item “use of sleep medicine” was not suitable for use with this population, that a two-factor model provided the best fit to the data as assessed through confirmatory factor analysis, and that other indices were consistently correlated with the sleep quality but not the sleep efficiency factor.

/pdf/structural-validity-of-the-pittsburgh-sleep-quality-index-in-1fj2dzbc9p.pdf

Structural Validity of the Pittsburgh Sleep Quality Index in Chinese Undergraduate Students.

This study explored the mediating effect of civic interest in the relationship between adolescents' civic education and volunteering (organized and personal). Participants were 967 adolescents in northern China (435 girls, 520 boys, 12 who did not specify their gender; Mage
 = 15.31 years), who completed the Civic Interest Scale, the Civic Education Scale, and the Volunteer Behavior Scale in a cross-sectional survey. Results indicated that personal volunteering was significantly more common than organized volunteering, and that civic interest partially mediated
 the relationships between civic education and organized volunteering, and between civic education and personal volunteering. School location (big city/small city vs. small town) moderated the mediating model, with larger mediating effects being present for respondents living in a small city
 compared to a big city, but no significant differences being found in the structural path between big-city and small-town settings or between smallcity and small-town settings. In sum, during adolescence, personal volunteering was the main form of volunteer activity, and the partial mediating
 mechanism of civic interest was common to both organized and personal volunteering types.

Suran Guo

Papers

Structural Validity of the Pittsburgh Sleep Quality Index in Chinese Undergraduate Students.

Effects of civic education on adolescents' organized and personal volunteering: Mediating role of civic interest