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      The impact of COVID‐19‐related mental health issues on menstrual cycle characteristics of female healthcare providers

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          Abstract

          Aim

          To investigate the association between menstrual cycle regularity in healthcare providers and COVID‐19 pandemic‐related anxiety, depression, stress.

          Methods

          A cross‐sectional study was conducted by administrating online questionnaires to female healthcare workers in Turkey. Women aged 18–40 years with regular menstrual cycles for more than 1 year before the beginning of the pandemic were included in the study and they were divided into two groups according to menstrual cycle regularity during the pandemic. The questionnaires included sociodemographic characteristics, medical and reproductive history, lifestyle information of participants, COVID‐19 Stress Scales (CSS), and a short version of the Depression Anxiety Stress Scale (DASS‐21).

          Results

          A total of 952 women were included in the study, 679 had regular menstrual cycles, and 273 had irregular menstrual cycles. The prevalence of irregular menses among Turkish women healthcare workers aged 18–40 years was 28.7%. The CSS subdimensions and total scores were significantly higher in the irregular menstruation group than in women with regular menstruation ( p < 0.001). The DASS‐21 depression, anxiety, and stress subdimensions were likewise significantly higher in women with irregular menstruation ( p < 0.001). Besides, both the univariable and the multivariable logistic regression results showed the relationship between irregular menstruation and CSS total score.

          Conclusion

          The current study showed the association between the COVID‐19 pandemic‐induced anxiety, perceived stress, depressive symptoms, and increased prevalence of menstrual cycle irregularity among healthcare providers.

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          Most cited references53

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          The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

          The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.
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            Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis

            Background The COVID-19 pandemic has had a significant impact on public mental health. Therefore, monitoring and oversight of the population mental health during crises such as a panedmic is an immediate priority. The aim of this study is to analyze the existing research works and findings in relation to the prevalence of stress, anxiety and depression in the general population during the COVID-19 pandemic. Method In this systematic review and meta-analysis, articles that have focused on stress and anxiety prevalence among the general population during the COVID-19 pandemic were searched in the Science Direct, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases, without a lower time limit and until May 2020. In order to perform a meta-analysis of the collected studies, the random effects model was used, and the heterogeneity of studies was investigated using the I2 index. Moreover. data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software. Results The prevalence of stress in 5 studies with a total sample size of 9074 is obtained as 29.6% (95% confidence limit: 24.3–35.4), the prevalence of anxiety in 17 studies with a sample size of 63,439 as 31.9% (95% confidence interval: 27.5–36.7), and the prevalence of depression in 14 studies with a sample size of 44,531 people as 33.7% (95% confidence interval: 27.5–40.6). Conclusion COVID-19 not only causes physical health concerns but also results in a number of psychological disorders. The spread of the new coronavirus can impact the mental health of people in different communities. Thus, it is essential to preserve the mental health of individuals and to develop psychological interventions that can improve the mental health of vulnerable groups during the COVID-19 pandemic.
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              2019-nCoV epidemic: address mental health care to empower society

              A novel coronavirus (2019-nCoV) has been identified as originating in Wuhan, Hubei Province, China. It has widely and rapidly spread in China and several other countries, causing an outbreak of acute infectious pneumonia. According to the official website of the National Health Commission, 1 as of Feb 4, 2020, 24 324 people have been confirmed to have a 2019-nCoV infection and 490 deaths have resulted from 2019-nCoV in 31 provinces in mainland China. 1 16 678 confirmed cases were in Hubei province. 2 Nearly 160 cases of 2019-nCoV have been detected and confirmed in southeast Asia (Thailand, Singapore, Malaysia, Vietnam, Philippines, and Cambodia), east Asia (Japan and Korea), south Asia (India, Nepal, and Sri Lanka), western Asia (United Arab Emirates), Europe (Germany, France, Italy, UK, Russia, Finland, Spain, and Sweden), North America (USA and Canada), and Australia. 3 Approximately 13% of people with confirmed 2019-nCoV infection are reported to have severe respiratory symptoms, 2% have died, and 4% have been cured. 1 Human-to-human transmission is occurring, and WHO has recommended limiting human-to-human transmission by reducing secondary infections among close contacts and health-care workers, preventing transmission amplification events, and preventing further international spread.3, 4 The outbreak of 2019-nCoV in China has caused public panic and mental health stress. The increasing number of patients and suspected cases, and the increasing number of outbreak-affected provinces and countries have elicited public worry about becoming infected. The unpredictable future of this epidemic has been exacerbated by myths and misinformation, often driven by erroneous news reports and the public's misunderstanding of health messages, thus causing worry in the population. Further travel bans and some executive orders to quarantine travellers during the Spring Festival holiday might have generated public anxiety while trying to contain the outbreak. The medical health-care workers who are caring for individuals who are either severely ill, feel scared, or experiencing bereavement are themselves exposed to trauma. Health-care workers are also at risk of getting infected, and they carry a large burden in the clinical treatment and public prevention efforts in Chinese hospitals and community settings. The challenges and stress they experience could trigger common mental disorders, including anxiety and depressive disorders, and posttraumatic stress disorder, 5 which in turn could result in hazards that exceed the consequences of the 2019-nCoV epidemic itself. To efficiently cope with the 2019-nCoV outbreak, the Chinese Government has implemented rapid and comprehensive public health emergency interventions. To date, all of the 31 provincial-level regions in mainland China with confirmed 2019-nCoV cases have activated so-called level 1 public health emergency responses (ie, the highest level of emergency public health alerts and responses within the national public health management system). 6 The provincial governments are responsible for organising, coordinating, and handling all emergency public health treatments, disclosing information, and gathering emergency materials and facilities under the guidance of the State Council. For health-care sectors, in addition to public health interventions, dealing with public psychological barriers and performing psychological crisis intervention is included in the level 1 response. The National Health Commission has released guidelines for local authorities to promote psychological crisis intervention for patients, medical personnel, and people under medical observation during the 2019-nCoV outbreak. 7 Peking University is preparing a mental health handbook for the public that describes how to deal with stress and other psychological problems occurring due to the outbreak of 2019-nCoV. 8 The Chinese Government strives to improve the public's awareness of prevention and intervention strategies by providing daily updates about surveillance and active cases on websites and social media. Increasingly, psychologists and psychiatrists use the internet and social media (eg, WeChat, Weibo, etc) to share strategies for dealing with psychological stress. For example, experts from Peking University Sixth Hospital made six suggestions for the public to cope with mental stress. 9 These included assessing the accuracy of information disclosed, enhancing social support systems (eg, families and friends), eliminating stigma associated with the epidemic, maintaining a normal life under safe conditions, and using the psychosocial service system, particularly telephone-based and internet-based counselling for health-care staff, patients, family members, and the public. Numerous psychiatric hospitals, psychological counselling centres, and psychology departments within universities have launched specialised hotlines to provide psychological counselling services for people in need. 7 We believe that including mental health care in the national public health emergency system will empower China and the world during the campaign to contain and eradicate 2019-nCoV.
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                Author and article information

                Contributors
                thtkmz@hotmail.com
                Journal
                J Obstet Gynaecol Res
                J Obstet Gynaecol Res
                10.1111/(ISSN)1447-0756
                JOG
                The Journal of Obstetrics and Gynaecology Research
                John Wiley & Sons Australia, Ltd (Kyoto, Japan )
                1341-8076
                1447-0756
                16 June 2021
                September 2021
                16 June 2021
                : 47
                : 9 ( doiID: 10.1111/jog.v47.9 )
                : 3241-3249
                Affiliations
                [ 1 ] Department of Obstetrics and Gynecology Bezmialem University, Faculty of Medicine Istanbul Turkey
                [ 2 ] Department of Psychiatry Kırıkkale Yüksek İhtisas Hospital Kırıkkale Turkey
                [ 3 ] Department of Obstetrics and Gynecology Acibadem Health Group Istanbul Turkey
                [ 4 ] Department of Clinical Psychology Istanbul Kent University Istanbul Turkey
                Author notes
                [*] [* ] Correspondence: Taha Takmaz, Bezmialem University Hospital, İskender Paşa Mh Adnan Menderes Bulvarı, Vatan Cad, 34093 Fatih, Istanbul 34093, Turkey.

                Email: thtkmz@ 123456hotmail.com

                Author information
                https://orcid.org/0000-0003-0793-2348
                Article
                JOG14900
                10.1111/jog.14900
                8447072
                34137123
                9499a28f-bc43-43ef-b58a-0af365e9d328
                © 2021 Japan Society of Obstetrics and Gynecology.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 13 May 2021
                : 17 March 2021
                : 06 June 2021
                Page count
                Figures: 1, Tables: 4, Pages: 9, Words: 5561
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                September 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.7 mode:remove_FC converted:17.09.2021

                anxiety,covid‐19,depression,healthcare providers,menstrual cycle irregularity,stress

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