We evaluated level of stress (worries) regarding COVID-19: (1) contracting, (2) dying from, (3) currently having, (4) family member contracting, (5) unknowingly infecting others with (6) experiencing significant financial burden following. We developed a brief resilience survey probing self-reliance, emotion-regulation, interpersonal-relationship patterns and neighborhood-environment, and applied it online during the acute COVID-19 outbreak (April 6–15, 2020), on a crowdsourcing research website ( advertised through social media. COVID-19 pandemic is a global calamity posing an unprecedented opportunity to study resilience. Patients who screen positive should be further evaluated with the PHQ-9 , other diagnostic instruments, or direct interview to determine whether they meet criteria for a depressive disorder.A new, ten-item, self-rated depression scale, the Brief Depression Scale (BDS), was validated in 275 psychiatric in-patients and out-patients with depressive illness and anxiety disorders and a. If the score is 3 or greater, major depressive disorder is likely. The authors identified a score of 3 as the optimal cutpoint when using the PHQ-2 to screen for depression.Higher resilience scores were associated with lower COVID-19 related worries (main effect F 1,3054 = 134.9 p < 0.00001, covarying for confounders). Participants significantly endorsed more distress about family contracting COVID-19 (48.5%) and unknowingly infecting others (36%), than getting COVID-19 themselves (19.9%), p 10, 22.2%) and depression (PHQ2 > 2, 16.1%) did not differ between healthcare providers and non-healthcare providers. Totally, 3042 participants ( n = 1964 females, age range 18–79, mean age = 39) completed the resilience and COVID-19-related stress survey and 1350 of them (mean age = 41, SD = 13 n = 997 females) completed GAD7 and PHQ2.
Tools have been established to estimate resilience, broadly conceptualized as healthy and adaptive functioning in the aftermath of adversity 2. In addition to physical health, coping with the pandemic requires mental resilience. The COVID-19 pandemic is impacting humankind in unprecedented and monumental ways and data is needed to plan for next steps following the acute outbreak 1. Seizures are a comorbid disorder with Autism Spectrum Disorders and there have been two published reports of lowered seizure activity after using DMG ( New England Journal of Medicine , 1982, 307, 1081-1082. Findings provide empirical evidence on mental health associated with COVID-19 outbreak in a large convenience sample, setting a stage for longitudinal studies evaluating mental health trajectories following COVID-19 pandemic.The recommended daily dose of DMG is between between two to eight 125mg tablets for adults and one to four 125 mg tablets for children. ![]() Participants were asked to rate how much they worried on a 5-item scale (0—not at all 1—a little 2—a moderate amount 3—a lot 4—a great deal). We also explored differences in COVID-19 related stress and resilience between participants from US and Israel.On April 6th 2020, we launched a website ( ) that included an interactive 21-item resilience survey and assessment of COVID-19-related stress (worries) regarding: (1) getting (contracting), (2) dying from, (3) currently having, (4) family member getting, (5) unknowingly infecting others, and (6) experiencing significant financial burden following COVID-19. We hypothesized that (1) COVID-19 related stress (estimated by subjective worries) will be associated with generalized anxiety and depression (2) higher resilience scores would correlate with less worries, generalized anxiety and depression (3) healthcare providers will report higher levels of COVID-19 related concerns, anxiety and depression. Here, we applied an interactive online platform to measure resilience in a population enriched for healthcare providers. We previously developed and applied a tool to measure resilience using self-report items 8. The Distress Management Guideline DMG 12 to address the psychosocial.The internet has transformed our ability to collect large-scale data through crowdsourcing, with rapid outreach to large samples complying with social distancing 7. ![]() Resilience items included in the survey and their corresponding scores are described in Supplementary Table 1. For the sake of brevity and scalability of the online survey, we use five of the seven factors, resulting in a 21-item abbreviated version: self-reliance (3 items) 11 emotion regulation (5 items) 12 positive (4 items) and negative (5 items) 13 relationship characteristics and neighborhood characteristics (4 items) 14, 15. The 212 items were reduced, using factor analysis followed by computerized adaptive test simulation, to a 47-item battery comprising seven factors 8. The items included were identified following administration of 212 items to >250 participants. Resilience surveyThe survey was based on questions associated with resilience that were recently compiled into a single battery 8. The study was approved by the Institutional Review Board of the University of Pennsylvania. The key dependent variable was item response (5-point scale indicating level of COVID-19-related worry), and we addressed the following questions: (1) Are certain types of worry more common than others? (2) Are there sex differences or age-related effects on the type of worry? (3) Is resilience associated with lower worry? (4) Does the effect of resilience depend on the type of worry? (5) Do the pattern of effects differ in healthcare providers? All models included the following potential confounders: age, gender, race (white/non-white), education, income, occupation (healthcare, engineering/computers and other), marital status (married, single or other), country of residence (US, Israel or other), number of people in household, date at which the survey was taken (days and (days squared) since study launch), and exposures related directly to COVID-19 including getting tested for COVID-19, knowing someone who tested positive for COVID-19 and knowing someone who died from COVID-19. The mixed model treated the 6 items of COVID-19 worry/stress (evaluated at the same time in this cross-sectional study) as repeated measures within individual. Data analysisFor COVID-19 related worries, all main and interaction effects were investigated using mixed models to account for within-person variance across items. GAD7 score > 10 was considered a case of probable generalized anxiety 19, PHQ2 score > 2 was considered a case of probable depression 20. Based on reports of overall higher scoring in anxiety 17 and depression 18 in web-based compared to paper and pencil surveys, we chose more conservative cutoffs to capture moderate and above anxiety or depression. The key dependent variable was either a dichotomized measure of meeting screening levels of GAD and depression (binary logistic regression) or continuous GAD7 and PHQ2 score (linear regression). Siedler 3 gold edition iso downloadFemales had overall higher COVID-19-related worries than males, except for the financial burden, where they were comparable to males (Fig. Participants worried to a similar extent about financial burden following COVID-19 as about getting COVID-19 worried less about dying from COVID-19 and worried least about currently having COVID-19. 1a, item main effect F 5,15205 = 1536.0, p < 0.00001, model included age, gender, education, income, marital status, number of people in household and country of residence). Models included all covariates listed above.All regression analyses were conducted in SPSS version 26 (IBM).Participants were significantly more worried about a family member contracting COVID-19 or about unknowingly infecting others than about getting COVID-19 themselves (Fig. Effects of gender, age, and being a healthcare provider were tested in separate models including interaction terms of all of the above with resilience overall score.In an exploratory analysis we compared participants from the US and Israel using regression models with US/Israel as a binary independent variable and COVID-19 worries/stress, resilience, anxiety, and depression as the dependent variables. All models included multiple co-variates as described above.
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