The development and validation of Huaxi emotional-distress index (HEI): A Chinese questionnaire for screening depression and anxiety in non-psychiatric clinical settings

Wang, Jian; Guo, Wanjun; Zhang, Lan; Deng, Wei; Wang, Hui-yao; Yu, Jing; Luo, Shanhong; Huang, Meizhu; Dong, Zaiquan; Li, Dajiang; Song, Jian; Jiang, Yu; Cheng, Nan‐Sheng; Liu, Xiehe; Li, Tao

doi:10.1016/j.comppsych.2017.04.001

Cited by 30 publications

(30 citation statements)

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“…A total score of >8 points indicates that the respondent has clear negative emotions and related mental health problems. The Cronbach's α of HEI was 0.90 (0.915 in this study); sensitivity and specificity were 0.880 and 0.766, respectively [13].…”

Section: Covid-19 Concerns and Coping Methodssupporting

confidence: 46%

The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study

et al. 2020

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Abstract Background. The COVID-19 outbreak required the significantly increased working time and intensity for health professionals in China, which may cause stress signs. Methods. From March 2–13 of 2020, 4,618 health professionals in China were included in an anonymous, self-rated online survey regarding their concerns on exposure to the COVID-19 outbreak. The questionnaires consisted of five parts: basic demographic information and epidemiological exposure; occupational and psychological impact; concerns during the episode; coping strategies; and the Huaxi Emotional-Distress Index (HEI). Results. About 24.2% of respondents experienced high levels of anxiety or/and depressive symptoms since the COVID-19 outbreak. Respondents who worried about their physical health and those who had COVID-19 infected friends or close relatives were more likely to have high HEI levels, than those without these characteristics. Further, family relationship was found to have an independent protective effect against high HEI levels. Their main concerns were that their families would not be cared for and that they would not be able to work properly. Compared to respondents with clear emotional problems, those with somewhat hidden emotional issues adopted more positive coping measures. Conclusions. About a quarter of medical staff experienced psychological problems during the pandemic of COVID-19. The psychological impact of stressful events was related to worrying about their physical health, having close COVID-19 infected acquaintances and family relationship issues. Therefore, the psychological supprot for medical staff fighting in the COVID-19 pandemic may be needed.

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Section: Covid-19 Concerns and Coping Methodssupporting

confidence: 46%

The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study

et al. 2020

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“…The HEI is a preliminary screening tool for emotional disorders (anxiety and depression) in non-psychiatric clinical settings [15]. It is mainly used for rapid screening and grading of emotional disorders and related mental health problems.…”

Section: Huaxi Emotional-distress Indexmentioning

confidence: 99%

“…In addition, these scales are rarely used in routine clinical practice due to their disadvantages, which include too many items, time consumption and cultural or language barriers. Therefore, based on the Chinese population and culture, Wang et al [15] developed a new psychometrically solid and concise screening tool for identifying emotional disorders (anxiety, depression and/ or suicidal ideation). The questionnaire was named as "Huaxi Emotional-Distress Index (HEI)".…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and association of anxiety and depression among orthopaedic trauma inpatients: a retrospective analysis of 1994 cases

et al. 2020

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Background Patients with traumatic injuries are often accompanied by emotional disorders, which seriously impede functional gains. The objective of this study was to identify the prevalence and risk factors associated with underlying anxiety and depression in orthopaedic trauma patients. Methods From July 2015 to December 2017, all orthopaedic trauma patients were included in the retrospective study. Patients with conditions that might affect cognitive impairment were excluded from the study. Basic demographic data were collected. All patients were screened for emotional disorders on admission using a simple questionnaire called “Huaxi Emotional-Distress Index” (HEI). Bivariate analyses and logistic regression were used to identify the factors associated with a HEI score of > 8. Results One hundred and sixty-two patients (8.1%) had a HEI score of > 8. About 1.0% of enrolled patients had severe emotional disorders (HEI score ≥ 17). The reasons caused by emotional disorders in patients with orthopaedic trauma were a higher Injury Severity Score (ISS), a higher visual analogue score (VAS) and type of surgery. On logistic regression, marital status was a protective factor for emotional disorders, while VAS and ISS were the risk factors for emotional disorders. Conclusions Although a significantly low percentage of orthopaedic trauma patients in our setting have emotional disorders, traumatic orthopaedic surgeons still need to pay attention to the risk of emotional disorders and integrate effective screening tools into clinical practice to screen for these factors and stratify emotional disorders. Appropriate targeted psychological intervention and treatment should be adopted according to the stratification of emotional disorders.

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“…Second, some papers use other terminologies, such as “extremely severe” (Ozamiz-Etxebarria et al, 2020), “very severe” (Moghanibashi-Mansourieh, 2020), or “very high” (Temsah, 2020), “moderate-severe” e.g., (Guiroy et al, 2020), “moderate to severe” (Moccia et al, 2020; Wang et al, 2020a), “moderately severe” e.g., (Xiaoming et al, 2020), and “poor” (Wang et al, 2020f), which often is not clear in terms of the cutoff points used to categorize those symptoms. We opted to recode all the papers that indicate their cutoff scores manually(Antony et al, 1998; Beusenberg et al, 1994; Blevins et al, 2015; Buysse et al, 1989; Cheng et al, 2002; Cheung et al, 2007; Creamer et al, 2003; Dai, 2020; Dobie et al, 2002; Guo et al, 2017; Health; Kessler et al, 2010; Kroenke et al, 2001; Kroenke et al, 2009; Lee et al, 2018; Matza et al, 2010; Morin et al, 2011; Prins et al, 2016; Qiu et al, 2020; Schlenger et al, 2002; Soldatos et al, 2000; Spitzer et al, 2006; Thoresen et al, 2010; Tsai et al, 2005; Wang et al, 2017; Wang et al, 2011; Wilberforce et al, 2010; Wu et al, 2003; Zigmond and Snaith, 1983; Zimmerman et al, 2013; Zung, 1965, 1971; 王春芳 et al, 1986); however, these terminologies may contribute to the heterogeneity and confusion in accumulating evidence.…”

Section: Resultsmentioning

confidence: 99%

One Year of Evidence on Mental Health Disorders in China during the COVID-19 Crisis - A Systematic Review and Meta-Analysis

Chen¹,

Chen

Zhang³

et al. 2021

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Objective: This paper provides a systematic review and meta-analysis on the prevalence rate of mental health issues of the major population, including general population, general healthcare workers (HCWs), and frontline healthcare workers (HCWs), in China over one year of the COVID-19 crisis. Design: A systematic review and meta-analysis. Data sources: articles in PubMed, Embase, Web of Science, and medRxiv up to November 16, 2020, one year after the first publicly known confirmed COVID-19 case. Eligibility criteria and data analysis: any COVID-19 and mental disorders relevant English studies with frontline/general healthcare workers, general adult population sample, using validated scales. We pooled data using random-effects meta-analyses to estimate the prevalence rates of anxiety, depression, distress, general psychological symptoms (GPS), insomnia, and PTSD and ran meta-regression to tease out the heterogeneity. Results: The meta-analysis includes 131 studies and 171 independent samples. The overall prevalence of anxiety, depression, distress, GPS, insomnia, and PTSD are 11%, 13%, 20%, 13%, 19%, and 20%, respectively. The meta-regression results uncovered several predictors of the prevalence rates, including severity (e.g., above severe vs. above moderate, p<0.01; above moderate vs. above mild, p<0.01) and type of mental issues (e.g., depression vs. anxiety, p=0.04; insomnia vs. anxiety p=0.04), population (frontline HCWs vs. general HCWs, p<0.01), sampling location (Wuhan vs. non-Wuhan, p=0.04), and study quality (p=0.04). Limitations: First, we only focus on China population, which may limit the generalizability of the results. Second, 96.2% studies included in this meta-analysis were cross-sectional. Last, since we only included studies published in English, we expect to have a language bias. Conclusion: Our pooled prevalence rates are significantly different from, yet largely between, the findings of previous meta-analyses, suggesting the results of our larger study are consistent with, yet fine-tune, the findings of the smaller, previous meta-analyses. Hence, this meta-analysis not only provides a significant update on the mental health prevalence rates in COVID-19 but also suggests the need to update meta-analyses continuously to provide more accurate estimates of the prevalence of mental illness during this ongoing health crisis. While prior meta-analyses focused on the prevalence rates of mental health disorders based on one level of severity (i.e., above mild), our findings also suggest a need to examine the prevalence rates at varying levels of severity. The one-year cumulative evidence on sampling locations (Wuhan vs. non-Wuhan) corroborates the typhoon eye effect theory. Our finding that the prevalence rates of distress and insomnia and those of frontline healthcare workers are higher suggest future research and interventions should pay more attention to those mental outcomes and populations. Keywords: systematic review; meta-analysis; COVID-19; mental health; epidemic; general population; healthcare workers; frontline healthcare workers

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The development and validation of Huaxi emotional-distress index (HEI): A Chinese questionnaire for screening depression and anxiety in non-psychiatric clinical settings

Cited by 30 publications

References 42 publications

The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study

The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study

Prevalence and association of anxiety and depression among orthopaedic trauma inpatients: a retrospective analysis of 1994 cases

One Year of Evidence on Mental Health Disorders in China during the COVID-19 Crisis - A Systematic Review and Meta-Analysis

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