Research Article - (2022) Volume 9, Issue 7
Received: Mar 08, 2022, Manuscript No. JEBMH-22-49224; Editor assigned: Mar 11, 2022, Pre QC No. JEBMH-22-49224 (PQ); Reviewed: Mar 25, 2022, QC No. JEBMH-22-49224; Revised: Mar 30, 2022, Manuscript No. JEBMH-22-49224(R); Published: Apr 07, 2022, DOI: 10.18410/jebmh/2022/09.07.32
Citation: Jothishanmugam A, Abdelgader AAM, Hamid HIA, et al. Psychological Distress among People during COVID - 19 Pandemic: A Cross-Sectional Study. J Evid Based Med Healthc 2022; 9(7):32.
The COVID - 19 pandemic and lockdown have had profound effects on everyday life worldwide. The aim of this study is to examine the anxiety level of the people during initial period of COVID - 19. The cross sectional online survey was done using the zung Self - rating Anxiety Scale (SAS) and zung self - rating depression scale. Out of 250 responders, 19.2 %, 6.4 %, and 0.8 % experienced mild, moderate, marked to severe levels of anxiety. According to analysis, female (OR = 1.3, 95 % CI = 0.55 – 3.3, P = 0.524), above the age of 59 years (OR = 1.6, CI = (0.33 – 7.72), P = 0.555), were experiencing moderate level of anxiety when compared with others. Related to depression, 36.4 %, 16.4 % and 5.2 % experienced mild, moderate, marked to severe levels of depression. The findings show that female (OR = 0.79, 95 %, CI = 0.36 – 1.7, P = 0.845), above the age of 59 years (OR = 4.4, CI = 0.75 – 25.8, P = 0.101) were experiencing marked level of depression than others. The main causes for anxiety and depression among the people is due to financial constraints, dual role of women, work from home, and fear of infection, unemployment and online education.
COVID - 19, Psychological problems, Anxiety, Depression, The Public, COVID - 19
In the city of Wuhan, China, unusual cases of patients with pneumonia were reported. They reported that it was caused by the new coronavirus (COVID - 19) reported and that it quickly spread across the globe posing a threat to global health.1,2 Multiple preventive measures were implemented to halt the rapid spread of this global health crisis. In the context of the virus outbreak, a wide range of emotional outcomes have been observed, at the individual, community, national, and international levels. As individuals, people were affected both at the psychological and emotional level. Their major issues were helplessness, fear of getting sick, and being stereotyped.3 There has been a harmful impact on the public's mental health, including psychological crises associated with the pandemic.4 Health crises, such as the COVID - 19 pandemic, cause psychological changes among medical workers and the masses, and these changes are triggered by dread, anxiety, depression, or insecurity.5 This study aims to assess the psychological distress among people during COVID - 19 pandemic.
The study is being conducted to assess the level of anxiety and depression among people in Saudi Arabia during COVID -19 and lockdown. A cross-sectional descriptive online survey was used to conduct this study. The research occurred between 15 June and 15 July, 2020. The poll was created using Google Forms and distributed to participants via Whatsapp. The survey participants were recruited on a voluntary basis using the show ball technique, and consent was sought prior to the start of the survey. The research instruments utilized in this study contained basic demographic information such as gender, age, education level, and occupation.
Study Instruments
The Zung anxiety self - rating scale and Zung self - rating Depression scale (SDS) were used. In this study, the Zung anxiety self-rating scale (SAS) was used to assess the anxiety level. The scale score is assessed follows
(i) < 50 - ordinary range
(ii) 50 - 59 - mild
(iii) 60 - 69 – moderate
(iv) 70 are classified as severe anxiety.
The Zung Depression self-rating scale (SDS) consists of 20 items and is used to measure the degree of depression. This is a four-point system.
(i) 50 - 59 - mild depression,
(ii) 60 - 69 - moderate depression,
(iii) 60 - 69 - moderate depression,
(iv) 70 points - severe depression.
Data Analysis
IBM SPSS version 20 software was used in the data analysis and a multiple regression procedure was used to assess the psychological distress among people f during COVID - 19 pandemic.6
Ethical Approval
The study has obtained ethical clearance from the Institution review board (IRB) of the university (REC41/5/141).7
The demographic characteristics of the respondents are shown in Table 1. Among the 250 respondents, 85.2 % were women, of which 59.2 % were in 19 - 29, and 4% were above 60 years of age. In regard to the education level of the respondents, almost 36.4 % had no formal education, 41.2 % were undergraduates, 6.8 % were housewives, 31.2 % were unemployed, and 29.6 % were studying.
| Demographic Variables | Frequency | Percentage |
| Age in years | ||
| 19 – 29 | 148 | 59.2 |
| 30 – 30 | - | - |
| 40 – 49 | 89 | 35.6 |
| 50 – 59 | 3 | 1.2 |
| Above 60 | 10 | 4 |
| Sex | ||
| Male | 37 | 14.8 |
| Female | 213 | 85.2 |
| Education | ||
| No formal education | 91 | 36.4 |
| School education | 9 | 3.6 |
| Undergraduate | 103 | 41.2 |
| Post Graduate | 44 | 17.6 |
| Doctorate | 3 | 1.2 |
| Type of occupation | ||
| Unemployed | 78 | 31.2 |
| Housewife / Accompanying person / Retired | 17 | 6.8 |
| Private sector | 74 | 29.6 |
| Teacher / Lecturer / Asst. Professor / Training Specialist | 35 | 14 |
| Nurse / Intern Nurse / Doctor’s Assistant | 10 | 4 |
| Doctor / Dentist / Intern Doctor / Specialist | 12 | 4.8 |
| Administration / School Director / Security Observer / Engineer / Technician / Accountant / Delivery / Soldier | 22 | 8.8 |
| Business / Self Employed | 2 | 0.8 |
As per Table 2, among 250 respondents, 19.2 % had mild anxiety, 6.4 % showed moderate anxiety, and 0.8 % experienced severe anxiety levels. Analyzing the depression levels, 36.4 % had mild depression, 16.4 % showed moderate depression, and 5.2 % of respondents have experienced severe depression.
| Distribution | Anxiety | Depression | ||
| No. | % | No. | % | |
| Normal Range ( < 50) | 184 | 74 | 105 | 42 |
| Mild (50 – 59) | 48 | 19 | 91 | 36 |
| Moderate (60 – 69) | 16 | 6 | 41 | 16 |
| Severe ( ≥ 70) | 2 | 13 | 5.2 | |
Table 3 shows the results of multiple logistic regressions. Women (OR = 1.3, 95 % CI = 0.55 – 3.3, P = 0.524), over 59 years old (OR = 1.6, CI = (0.33 – 7.72), P = 0.555), were experienced anxiety compared with other categories.
| Demographic Variables | Non-Anxiety Group | Anxiety Group | c2 | p value | Multiple Logistic Regression Analysis | |
| (n = 184) | (n = 66) | OR | p-Value | |||
| (95 % CI) | ||||||
| Age in years | 1.2 | 0.76 | ||||
| 19 – 29 | 108 (43.2%) | 40 (16 %) | 1 | 0 | ||
| 30 – 30 | - | - | - | - | ||
| 40 – 49 | 66 (26.4 %) | 23 (9.2 %) | 1.01 | 0.97 | ||
| (0.54 – 1.9) | ||||||
| 50 – 59 | 3 (1.2%) | 0 (0 %) | 0 | 1 | ||
| Above 60 | 7 (2.8%) | 3 (1.2 %) | 1.6 | 0.56 | ||
| (0.33 – 7.72) | ||||||
| Sex | 0.5 | 0.48 | ||||
| Male | 29 (11.6 %) | 8 (3.2 %) | 1 | - | ||
| Female | 155 (62.0 %) | 58 (23.2 %) | 1.3 | 0.52 | ||
| (0.55 – 3.3) | ||||||
| Education | 2.7 | 0.6 | ||||
| No formal education | 64 (25.6 %) | 27 (10.8 %) | 1 | - | ||
| School education | 8 (3.2%) | 1 (0.4 %) | 0.38 | 0.54 | ||
| (0.2 – 8.1) | ||||||
| Undergraduate | 77 (30.8 %) | 26 (10.4 %) | 2 | 0.52 | ||
| (0.25 – 15.8) | ||||||
| Post Graduate | 32 (12.8 %) | 12 (4.8 %) | 2.1 | 0.63 | ||
| (0.11 – 37.4) | ||||||
| Doctorate | 3 (1.2 %) | 0 (0 %) | 0 | 1 | ||
| Type of occupation | 8.8 | 0.27 | ||||
| Unemployed | 51 (20.4 %) | 27 (10.8%) | 1 | - | ||
| Housewife / Accompanying person / Retired | 16 (6.4 %) | 1 (0.4 %) | 0.12 | 0.06 | ||
| (0.01 – 1.04) | ||||||
| Student / Intern student / Private education | 57 (22.8 %) | 17 (6.8 %) | 0.32 | 0.28 | ||
| (0.04 – 2.6) | ||||||
| Teacher / Lecturer / Asst. Prof. / Training Specialist | 25 (10.0%) | 10 (4. 0 %) | 0.43 | 0.57 | ||
| (0.02 – 7.9) | ||||||
| Nurse / Intern Nurse / Doctor’s Assistant | 8 (3.2%) | 2 (0.8 %) | 0.25 | 0.29 | ||
| (0.02 – 3.3) | ||||||
| Doctor / Dentist / Intern Doctor / Specialist | 10 (4.0%) | 2 (0.8 %) | 0.19 | 0.31 | ||
| 4.6) | ||||||
| Private / Administration / School Director / Security Observer / Engineer / Technician / Accountant / Delivery / Soldier | 15 (6.0 %) | 7 (2.8 %) | 0.77 | 0.82 | ||
| (0.08 – 7.8) | ||||||
| Business / Self Employed | 2 (0.8%) | 0 (0 %) | 0 | 1 | ||
Table 4, Related to depression, 36.4 % had mild depression, 16.4 % showed moderate depression, and 5.2 % of respondents have experienced severe depression. According to analysis Females (OR = 0.79,95 % CI = 0.36 – 1.7, P = 0.845), age above 59 years (OR = 4.4, CI = (0.75 – 25.8), P = 0.101) experienced more depression than other groups.
| Demographic Variables | Non-Depression Group(n = 105 ) | Depression Group ( = 145 ) | χ2 | p value | Multiple Logistic Regression Analysis | |
| OR ( 95% CI ) | p Value | |||||
| Age in years | 5 | 0.2 | ||||
| 19 – 29 | 67 ( 26.8 % ) | 81(32.4 %) | 1 | - | ||
| 30 – 30 | - | - | - | - | ||
| 40 – 49 | 36 (14.4 %) | 53 (21.2 %) | 1.2 | 0.45 | ||
| (0.71 – 2.2) | ||||||
| 50 – 59 | 0 (0 %) | 3 (1.2 %) | 0 | 1 | ||
| Above 60 | 2 (0.8 %) | 8 (3.2%) | 4.4 | 0.1 | ||
| (0.75 – 25.8) | ||||||
| Sex | 0 | 0.8 | ||||
| Male | 15 (6 %) | 22 (8.8 %) | 1 | - | ||
| Female | 90 (36.0 %) | 123 (49.2 %) | 0.8 | 0.56 | ||
| ( 0.36 – 1.7 ) | ||||||
| Education | 6 | 0.2 | ||||
| No formal education | 30 (12.0 %) | 61 (24.4 %) | 1 | - | ||
| School education | 3 (1.2 %) | 6 (2.4 %) | 13 | 0.08 | ||
| (0.77 –227.36) | ||||||
| Undergraduate | 49 (19.6 %) | 54 (21.6 %) | 3.3 | 0.29 | ||
| (0.37 – 29.5) | ||||||
| Post Graduate | 22(8.8 %) | 22 (8.8 %) | 2.6 | 0.53 | ||
| (0.13 – 50.0) | ||||||
| Doctorate | 1 (0.4 %) | 2 (0.8 %) | 5.6 | 0.35 | ||
| (0.15 – 203.6) | ||||||
| Type of occupation | 13 | 0.1 | ||||
| Unemployed | 24 (9.6 %) | 54 (21.6 %) | 1 | - | ||
| Housewife / Accompanying person / Retired | 5 (2.0 %) | 12 (4.8 %) | 0.8 | 0.68 | ||
| (0.23 – 2.6) | ||||||
| Student / Intern student / Private education | 36(14.4 %) | 38 (15.2 %) | 0.1 | 0.08 | ||
| (0.015 – 1.3) | ||||||
| Teacher / Lecturer / Asst. Professor / Training Specialist | 16 (6.4 %) | 19 ( 7.6 ) | 0.2 | 0.25 | ||
| (0.01 – 3.4) | ||||||
| Nurse / Intern Nurse / Doctor’s Assistant | 4 (1.6 %) | 6 (2.4 %) | 0.2 | 0.24 | ||
| (0.02 – 2.8) | ||||||
| Doctor / Dentist / Intern Doctor / Specialist | 6 (2.4 %) | 6 (2.4 %) | 0.2 | 0.23 | ||
| (0.01 - 3.3) | ||||||
| Private / Administration / School Director / Security Observer / Engineer / Technician / Accountant / Delivery / Soldier | 14 (5.6 %) | 8 (3.2 %) | 0 | 0.01 | ||
| (0.003 – 0.45) | ||||||
| Business / Self Employed | 0 ( 0 %) | 2 (0.8 %) | 0 | 1 | ||
The study examines anxiety and depression levels among people in Jazan region, Kingdom of Saudi Arabia. The COVID 19 pandemic and lockdown period between 16 March to 21 June, 2020. In these inexorable circumstances, which are beyond the ordinary, people feel stress, anxiety, and a sense of helplessness. It was evidenced by this study finding. Based on the analysis and findings, the anxiety level was higher in women than in men, the results are similar to those of.8 It is believed that women express emotions to a greater extent than men. Many studies show that women have a lower tolerance threshold than men. Women are unable to cope with strategies in times of uncertainty and stressful conditions.9 Among the Australian populations, women were also found to be more exposed to stress, depression, and anxiety than men in this pandemic situation.10 In this study, it was found that the anxiety and depression levels of people of younger age group were high. Well known fact is that the youngsters’ are constantly engaged in using media and the information shared on social media regarding COVID 19 could have played a pivotal role in increasing the anxiety and depression level of the younger ones / students.11 The other contributor to anxiety and depression levels was a sudden shift from face to face class to online classes, which indirectly resulted in academic stress. Similarly, a study conducted among Spanish population revealed that students, women, and people with a lower income and those who do not have the required space per person in their homes, suffer from a higher psychological impact in terms of emotional distress and deteriorating mental health.12 Another recent study found that university students frequently experience academic stress and have poor coping skills overall.13 During the lockdown period, many researches have been carried out and the finding shows that t during the lockdown period, the sudden shift of online education, fear of academic achievement, loneliness, dual role of women, unemployment, economic constraints, unpredicted life, fear of infection, dependency, increased burden over women in the home, induced psychological problems among the people.14-16The present study also implies same. Many of the individuals in their late adulthood (above 60 years) experienced anxiety and depression during the COVID - 19 pandemic.17 Older adults could also experience difficulties in maintaining relationships through new channels of communication in a virtual form during the pandemic due to less experience with new technologies or age-related health problems (e.g. poor eyesight, problems with motor coordination). Thus, keeping relationships with others, especially friends at a similar age, could have been particularly difficult for the oldest group.18 Finally, unemployed person continuity was related to anxiety and depressive symptoms; likewise, another study revealed that women, young people, and those who lost their jobs during the health crisis showed more negative psychological symptoms like higher levels of stress.
According to the findings of this study, age, gender, academic performance, and occupation were all strongly linked to anxiety and depression among those who experienced anxiety and depression. Throughout COVID - 19 and the lockdown phase. Remote online learning was the most common source of stress, which was unrelated to their academic achievement, economic constraints, loneliness, job loss, and a change in their typical routine life style contributes psychological problems among people. The analysis and findings imply that there is an urgent need for online support by health care professionals, and the hospitals should have call centers for 24 hours to provide mental health assistance and that will direct applicants to available community services when needed. It is a necessary and urgent need to plan new strategies to manage the psychological problems of the public and update the public with current information about COVID 19 and psychological support services. These support services might reduce the anxiety and depression levels and will help in the wellbeing of the individual.19
