Psychosomatic health and sympathetic nervous adaptation of health professionals and the general population during the second covid-19 wave in Greece. between-group comparisons and regression analysis
Published:
Oct 9, 2021
Keywords:
Greece COVID-19 psychosomatic health sympathetic nervous system health professionals
Abstract
Background: Based on previous COVID-19 global literature, the second COVID-19 outbreak in Greece probably created a stressful environment for health professionals and the general population. It is likely that psychosomatic and sympathetic nervous symptoms increased in both groups.
Aim: The study tests whether health professionals would present significantly higher levels of psychosomatic and sympathetic nervous symptoms, and whether several biopsychosocial criteria would predict psychosomatic symptoms overall.
Material & Methods: 192 participants were recruited though the snowball strategy after the first domestic COVID-19 lockdown in Greece. Participants provided socio-demographic details, while they answered measurements regarding nervous adaptation (DASS-21), psychosomatics (PSSQ-29), resilience (NMRQ), self-efficacy (GSE) and personality (IPIP-50). The researchers performed independent t-tests, one-way ANOVAs, Pearson’s r correlation analysis and a multiple linear regression.
Results: Health professionals experienced significantly less psychosomatic and sympathetic nervous symptoms compared to the general population, while none of the socio-demographic variables show between-groups differences. 10 out of 15 biopsychosocial variables were found significantly correlated with psychosomatic symptoms. The predictive model (Adjusted R2= .586) shows ‘stress’ (β= .242, p= .006), ‘anxiety’ (β= .494, p< .001) and ‘emotional stability’ (β= -.160, p= .004) to be significant predictors, excluding ‘gender’, ‘being a health professional’, ‘resilience’, ‘self-efficacy’ and ‘extraversion’.
Conclusions: The findings contradict to previous studies regarding psychosomatic and sympathetic nervous symptoms in the COVID-19 era. Additionally, the prediction model is not consistent to the theories regarding resilience and self-efficacy. The present study provides much debate in the relevant fields of research.
Article Details
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Pilafas, G., & Lyrakos, G. (2021). Psychosomatic health and sympathetic nervous adaptation of health professionals and the general population during the second covid-19 wave in Greece. between-group comparisons and regression analysis. Health & Research Journal, 7(4), 160–183. https://doi.org/10.12681/healthresj.28160
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References
Pilafas G, Prouzou A, Strongylaki NP, Menti D, Lyrakos G. Predictors of Psychosomatic Health during the first COVID-19 Outbreak in Greece. A Multiple Linear Regression Analy-sis in an Epidemiological Sample of 1,156 Individuals. Inter-national Journal of Health Sciences and Research 2021;11(6):274–89.
Parlapani E, Holeva V, Voitsidis P, Blekas A, Gliatas I, Porfyri GN, et al. Psychological and Behavioral Responses to the COVID-19 Pandemic in Greece. Front Psychiatry 2020; 11:821.
Strongylaki NP, Dermati A, Pilafas G, Menti D, Lyrakos G. Effect of Coping Strategies on Acute Stress during the COVID–19 Pandemic in Greece. Health & Research Journal 2021;7(3):98-108.
World Health Organization. Greece: WHO Coronavirus Dis-ease (COVID-19) Dashboard | WHO Coronavirus Disease (COVID-19) Dashboard [Internet]. 2020 [cited 2020 Dec 23]. Available from: https://covid19.who.int/region/euro/country/gr
Bandyopadhyay S, Baticulon RE, Kadhum M, Alser M, Ojuka DK, Badereddin Y, et al. Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review. BMJ Global Health 2020;5(12):e003097.
International Council of Nurses. ICN confirms 1,500 nurses have died from COVID-19 in 44 countries and estimates that healthcare worker COVID-19 fatalities worldwide could be more than 20,000 [Internet]. ICN - International Council of Nurses. 2020 [cited 2020 Dec 23]. Available from: https://www.icn.ch/news/icn-confirms-1500-nurses-have-died-covid-19-44-countries-and-estimates-healthcare-worker-covid
Surya M, Jaff D, Stilwell B, Schubert J. The Importance of Mental Well-Being for Health Professionals During Complex Emergencies: It Is Time We Take It Seriously. Glob Health Sci Pract 2017;5(2):188–96.
Davey A, Sharma P, Davey S, Shukla A. Is work-associated stress converted into psychological distress among the staff nurses: A hospital-based study. J Family Med Prim Care 2019 Feb;8(2):511–6.
Srinivasan K, Samuel D. Psychological Problem Factors Faced by Staff Nurses Working in Hospitals. IOSR Journal of Humanities and Social Science 2014 ;19:01–4.
Mark G, Smith AP. Occupational stress, job characteristics, coping, and the mental health of nurses. Br J Health Psychol 2012;17(3):505–21.
Choi KW, Shaffer KM, Zale EL, Funes CJ, Koenen KC, Tehan T, et al. Early risk and resiliency factors predict chronic PTSD in caregivers of patients admitted to a neuroscience intensive care unit. Crit Care Med 2018;46(5):713–9.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5. 5th edi-tion. Washington, D.C: American Psychiatric Publishing; 2013. 991 p.
Hefner K, Rosenheck R. Multimorbidity among Veterans Diagnosed with PTSD in the Veterans Health Administration Nationally. Psychiatr Q 2019;90(2):275–91.
Jacob L, Haro JM, Koyanagi A. Post-traumatic stress symp-toms are associated with physical multimorbidity: Findings from the Adult Psychiatric Morbidity Survey 2007. Journal of Affective Disorders 2018;232:385–92.
Kulas JF, Rosenheck RA. A Comparison of Veterans with Post-traumatic Stress Disorder, with Mild Traumatic Brain Injury and with Both Disorders: Understanding Multimor-bidity. Military Medicine 2018;183(3–4):e114–22.
Nievergelt CM, Maihofer AX, Klengel T, Atkinson EG, Chen C-Y, Choi KW, et al. International meta-analysis of PTSD ge-nome-wide association studies identifies sex- and ancestry-specific genetic risk loci. Nat Commun 2019;10(1):4558.
Lyrakos GN, Aslani H, Catopodi A, Papastavrou D, Kouvari S, Batistaki C, et al. 2823 – Stress-related psychological symp-toms among health care professionals in a greek hospital. European Psychiatry 2013;28:1.
Stathopoulou H, Karanikola MNK, Panagiotopoulou F, Papathanassoglou EDE. Anxiety Levels and Related Symp-toms in Emergency Nursing Personnel in Greece. Journal of Emergency Nursing 2011;37(4):314–20.
Huang JZ, Han MF, Luo TD, Ren AK, Zhou XP. [Mental health survey of medical staff in a tertiary infectious disease hospital for COVID-19]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2020;38(3):192–5.
Wang Y, Duan Z, Peng K, Li D, Ou J, Wilson A, et al. Acute stress disorder among frontline health professionals during the COVID-19 outbreak: A structural equation modelling in-vestigation. Psychosomatic Medicine [Internet]. 2020 Dec 4 [cited 2020 Dec 15];Publish Ahead of Print. Available from: https://journals.lww.com/psychosomaticmedicine/Abstract/9000/Acute_stress_disorder_among_frontline_health.98513.aspx
Maciaszek J, Ciulkowicz M, Misiak B, Szczesniak D, Luc D, Wieczorek T, et al. Mental Health of Medical and Non-Medical Professionals during the Peak of the COVID-19 Pandemic: A Cross-Sectional Nationwide Study. Journal of Clinical Medicine 2020;9(8):2527.
Ernsberger U, Rohrer H. Sympathetic tales: subdivisons of the autonomic nervous system and the impact of develop-mental studies. Neural Dev 2018;13:1–21.
Madeira LP, Borghi F, Wilson VD, Souza AL, Pires‐da‐Rocha MC, Ferreira HA, et al. Perceived stress and salivary cortisol on rock climbing. Translational Sports Medicine 2019;2(6):370–5.
Hammond TT, Ortiz-Jimenez CA, Smith JE. Anthropogenic Change Alters Ecological Relationships via Interactive Changes in Stress Physiology and Behavior within and among Organisms. Integr Comp Biol 2020;60(1):57–69.
Nisar H, Srivastava R. Fundamental Concept of Psychoso-matic Disorders: A Review. Psychosomatic Disorders 2018;3(1):7.
Nakao M, Takeuchi T. Alexithymia and Somatosensory Am-plification Link Perceived Psychosocial Stress and Somatic Symptoms in Outpatients with Psychosomatic Illness. Jour-nal of Clinical Medicine 2018;7(5):112.
Asselmann E, Venz J, Pieper L, Wittchen H-U, Pittrow D, Beesdo-Baum K. The role of gender and anxiety in the asso-ciation between somatic diseases and depression: findings from three combined epidemiological studies in primary care. Epidemiology and Psychiatric Sciences 2019;28(3):321–32.
Gica S, Kavakli M, Durduran Y, Ak M. The Effect of COVID-19 Pandemic on Psychosomatic Complaints and Investiga-tion of The Mediating Role of Intolerance to Uncertainty, Biological Rhythm Changes and Perceived COVID-19 Threat in this Relationship: A Web-Based Community Survey. Psy-chiatry and Clinical Psychopharmacology - PCP 2020;30(2):89.
Widjaja FF, Shatri H, Putranto R. Health Issues Among Healthcare Workers During COVID-19 Pandemic: a Psycho-somatic Approach. Acta Med Indones 2020;52(2):172–6.
Pilafas G, Strongylaki NP, Papaioannou D, Menti D, Lyrakos G. Adaptation of ‘Nicholson McBride Resilience Question-naire’ (NMRQ) in Greek. A reliability and validity study in an epidemiological Greek sample. Health & Research Journal 2020;6(4):123–31.
Xu X, Guangyao L, Shunhong H, Bin L, Sibing Z. Investiga-tion, Analysis and Management Application of Mental Resil-ience and Psychosomatic State of The Medical Team Against COVID-19. 2020 Jun 5 [cited 2020 Dec 15]; Availa-ble from: https://www.researchsquare.com/article/rs-29149/v1
Assari S. General Self-Efficacy and Mortality in the USA; Racial Differences. J Racial and Ethnic Health Disparities 2017;4(4):746–57.
Xiao H, Zhang Y, Kong D, Li S, Yang N. The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit 2020;26:e923549.
Frick E, Büssing A, Baumann K, Weig W, Jacobs C. Do Self-efficacy Expectation and Spirituality Provide a Buffer Against Stress-Associated Impairment of Health? A Com-prehensive Analysis of the German Pastoral Ministry Study. J Relig Health 2016;55(2):448–68.
Vagni M, Maiorano T, Giostra V, Pajardi D. Coping With COVID-19: Emergency Stress, Secondary Trauma and Self-Efficacy in Healthcare and Emergency Workers in Italy. Front Psychol 2020;11:1–12.
Ghazanfari E, Kazemnejad A, Feizi A, Fesharaki MG, Dinu I, Keshteli AH, et al. The relationship between personality traits and psychosomatic complaints in a sample of Iranian adults. Journal of Affective Disorders 2020;261:253–8.
Patsali ME, Mousa D-PV, Papadopoulou EVK, Papadopou-lou KKK, Kaparounaki CK, Diakogiannis I, et al. University students’ changes in mental health status and determinants of behavior during the COVID-19 lockdown in Greece. Psy-chiatry Research 2020;292:113298.
Fouda A, Mahmoudi N, Moy N, Paolucci F. The COVID-19 pandemic in Greece, Iceland, New Zealand, and Singapore: Health policies and lessons learned. Health Policy and Technology 2020;9(4):510–24.
Papandreou C, Arija V, Aretouli E, Tsilidis KK, Bulló M. Com-paring eating behaviours, and symptoms of depression and anxiety between Spain and Greece during the COVID-19 outbreak: Cross-sectional analysis of two different confine-ment strategies. European Eating Disorders Review 2020;28(6):836–46.
British Psychological Society. Practice Guidelines. Third edition. Leicester (UK): The British Psychological Society; 2017. 89 p.
British Psychological Society. Code of ethics and conduct. Leicester (UK): The British Psychological Society; 2018.
Goodman LA. Snowball Sampling. Ann Math Statist 1961;32(1):148–70.
Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*Power 3.1: Tests for correlation and re-gression analyses. Behavior Research Methods 2009;41(4):1149–60.
Dancey CP, Reidy J. Statistics Without Maths for Psycholo-gy. 5th edition. Harlow, England ; New York: Prentice Hall; 2011. 620 p.
Field A. Discovering Statistics Using IBM SPSS Statistics. Fourth edition. Los Angeles: SAGE Publications Ltd; 2013. 952 p.
Ruengvirayudh P, Brooks GP. Comparing Stepwise Regres-sion Models to the Best-Subsets Models, or, the Art of Stepwise. General Linear Model Journal 2016;42:14.
Zhang Z. Variable selection with stepwise and best subset approaches. Annals of Translational Medicine 2016;4(7):11–11.
Field A, Miles J, Field Z. Discovering Statistics Using R. 1st edition. London ; Thousand Oaks, Calif: SAGE Publications Ltd; 2012. 992 p.
Pilafas G, Prouzou A, Strongylaki NP, Menti D, Lyrakos G. Introducing the ‘Psychosomatic Screening Questionnaire - 29’ (PSSQ-29): Reliability and Validity in an Epidemiological Sample of 1,158 Participants in Greece during the COVID-19 Domestic Lockdown. Int J Health Sci Res 2021;11(6):52–65.
Pezirkianidis C, Karakasidou E, Lakioti A, Stalikas A, Galana-kis M. Psychometric Properties of the Depression, Anxiety, Stress Scales-21 (DASS-21) in a Greek Sample. Psychology 2018;9(15):2933–50.
Lyrakos GN, Arvaniti C, Smyrnioti M, Kostopanagiotou G. Translation and validation study of the depression anxiety stress scale in the greek general population and in a psychi-atric patient’s sample. European Psychiatry 2011;26(S2):1731–1731.
Glynou E, Schwarzer R, Jerusalem M. Greek [Internet]. Greek Adaptation of the General Self-Efficacy Scale. 1994 [cited 2020 Dec 23]. Available from: http://userpage.fu-berlin.de/~health/greek.htm
Likert R. A technique for the measurement of attitudes. Archives of Psychology 1932;22 140:55–55.
Ypofanti M, Zisi V, Zourbanos N, Mouchtouri B, Tzanne P, Theodorakis Y, et al. Psychometric Properties of the Interna-tional Personality Item Pool Big-Five Personality Question-naire for the Greek population. Health Psychol Res 2015;3(2):2206.
IBM Corp. IBM SPSS Statistics for Windows. Armonk, NY: IBM Corp.; 2020.
Miles J. R Squared, Adjusted R Squared. In: Wiley StatsRef: Statistics Reference Online. American Cancer Society; 2014.
da Silva FCT, Neto MLR. Psychiatric symptomatology asso-ciated with depression, anxiety, distress, and insomnia in health professionals working in patients affected by COVID-19: A systematic review with meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry 2021;104:110057.
Barzilay R, Moore T, Greenberg D, DiDomenico G, Brown L, White L, et al. Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers. Translational Psychiatry 2020;10.
Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, et al. Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown. Communi-ty Ment Health J 2020;1–7.
Zhang W, Wang K, Yin L, Zhao W, Xue Q, Peng M, et al. Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China. PPS. 2020;89(4):242–50.
Yıldız E. The Conflict Between Greece And Turkey In The Mediterranean Sea (International Maritime Law Study). Jurnal Hukum 2020;36(2):126–38.
Zachariades A. The Crisis in the Eastern Mediterranean and the Need for US Leadership. In LSE Ideas; 2020. p. 14. Avail-able from: http://eprints.lse.ac.uk/107573/1/LSE_IDEAS_All_Hands_on_Deck_October_2020.pdf
Tian F, Li H, Tian S, Yang J, Shao J, Tian C. Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to COVID-19. Psychi-atry Research 2020;288:112992.
Shangguan F, Quan X, Qian W, Zhou C, Zhang C, Zhang XY, et al. Prevalence and correlates of somatization in anxious individuals in a Chinese online crisis intervention during COVID-19 epidemic. Journal of Affective Disorders 2020;277:436–42.
Li P, Meng L, Ouyang M. Mental Health Status of Chinese Student Nurses during COVID-19: A Cross-sectional Study. Design Engineering 2020;01–9.
Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A, Orrù G. Mindfulness, Age and Gender as Pro-tective Factors Against Psychological Distress During COVID-19 Pandemic. Front Psychol 2020;11(1900):1–12.
Pieh C, Budimir S, Delgadillo J, Barkham M, Fontaine JRJ, Probst T. Mental health during COVID-19 lockdown in the United Kingdom. Psychosomatic Medicine [Internet]. 2020 Dec 15 [cited 2020 Dec 20];Publish Ahead of Print. Availa-ble from: https://journals.lww.com/psychosomaticmedicine/Abstract/9000/Mental_health_during_COVID_19_lockdown_in_the.98497.aspx
Pieh C, Budimir S, Probst T. The effect of age, gender, in-come, work, and physical activity on mental health during coronavirus disease (COVID-19) lockdown in Austria. Jour-nal of Psychosomatic Research 2020;136:110186.
Franchini L, Ragone N, Seghi F, Barbini B, Colombo C. Men-tal health services for mood disorder outpatients in Milan during COVID-19 outbreak: The experience of the health care providers at San Raffaele hospital. Psychiatry Research 2020;292:113317.
Ran L, Wang W, Ai M, Kong Y, Chen J, Kuang L. Psychologi-cal resilience, depression, anxiety, and somatization symp-toms in response to COVID-19: A study of the general population in China at the peak of its epidemic. Social Sci-ence & Medicine 2020;262:113261.
Hou T, Zhang R, Song X, Zhang F, Cai W, Liu Y, et al. Self-efficacy and fatigue among non-frontline health care work-ers during COVID-19 outbreak: A moderated mediation model of posttraumatic stress disorder symptoms and nega-tive coping. PLOS ONE 2020;15(12):e0243884.
Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Ra-soulpoor S, Mohammadi M, et al. Prevalence of stress, anxi-ety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Globalization and Health 2020;16(1):57.
Majumdar P, Biswas A, Sahu S. COVID-19 pandemic and lockdown: cause of sleep disruption, depression, somatic pain, and increased screen exposure of office workers and students of India. Chronobiology International 2020;37(8):1191–200.
Monterrosa-Castro A, Redondo-Mendoza V, Mercado-Lara M. Psychosocial factors associated with symptoms of gen-eralized anxiety disorder in general practitioners during the COVID-19 pandemic. Journal of Investigative Medicine 2020;68(7):1228–34.
Wielgus B, Urban W, Patriak A, Cichocki Ł. Examining the Associations between Psychological Flexibility, Mindful-ness, Psychosomatic Functioning, and Anxiety during the COVID-19 Pandemic: A Path Analysis. International Journal of Environmental Research and Public Health 2020;17(23):8764.
Smirni P, Lavanco G, Smirni D. Anxiety in Older Adolescents at the Time of COVID-19. Journal of Clinical Medicine 2020;9(10):3064.
Shevlin M, Nolan E, Owczarek M, McBride O, Murphy J, Miller JG, et al. COVID-19-related anxiety predicts somatic symptoms in the UK population. British Journal of Health Psychology 2020;25(4):875–82.
Stanton R, To QG, Khalesi S, Williams SL, Alley SJ, Thwaite TL, et al. Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, To-bacco and Alcohol Use in Australian Adults. International Journal of Environmental Research and Public Health 2020;17(11):4065.
Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, et al. A longitudinal study on the mental health of general popula-tion during the COVID-19 epidemic in China. Brain, Behav-ior, and Immunity 2020;87:40–8.
Lee SA, Jobe MC, Mathis AA, Gibbons JA. Incremental validi-ty of coronaphobia: Coronavirus anxiety explains depres-sion, generalized anxiety, and death anxiety. Journal of Anx-iety Disorders 2020;74:102268.
Nikčević AV, Marino C, Kolubinski DC, Leach D, Spada MM. Modelling the contribution of the Big Five personality traits, health anxiety, and COVID-19 psychological distress to generalised anxiety and depressive symptoms during the COVID-19 pandemic. Journal of Affective Disorders 2021;279:578–84.
Qian K, Yahara T. Mentality and behavior in COVID-19 emergency status in Japan: Influence of personality, morali-ty and ideology. PLOS ONE 2020;15(7):e0235883.
Hyland P, Shevlin M, Murphy J, McBride O, Fox R, Bondjers K, et al. A longitudinal assessment of depression and anxiety in the Republic of Ireland during the COVID-19 pandemic [Internet]. PsyArXiv; 2020 [cited 2020 Dec 22]. Available from: https://psyarxiv.com/4avt6/
Becerra-García JA, Giménez Ballesta G, Sánchez-Gutiérrez T, Barbeito Resa S, Calvo Calvo A. [Psychopathological symp-toms during Covid-19 quarantine in spanish general popu-lation: a preliminary analysis based on sociodemographic and occupational-contextual factors.]. Rev Esp Salud Publi-ca 2020;94(9):1–11.
Sfendla A, Hadrya F. Factors Associated with Psychological Distress and Physical Activity During the COVID-19 Pan-demic. Health Security 2020;18(6):444–53.
Louvardi M, Pelekasis P, Chrousos GP, Darviri C. Mental health in chronic disease patients during the COVID-19 quarantine in Greece. Palliative & Supportive Care 2020;18(4):394–9.
