ABSTRACT
Background Amid the ongoing COVID-19 pandemic and its global health and socioeconomic aftereffects, the enduring state of crisis is increasingly impacting the coping capacity of the populations. In this study, we aimed to characterize the levels of psychological distress after the lifting of COVID-19 lockdown. Results The Impact of Event Scale (IES-R) and Depression, Anxiety, and Stress Scales-21 items (DASS-21) were used to screen for post-traumatic stress syndrome (PTSD), depression, anxiety, and stress. The prevalence of PTSD was 41.6% and was associated with severe or extremely severe stress (27.8%), anxiety (31.4%), and depression (39.0%). All disorders were strongly correlated with one another. The risk of developing PTSD was independently associated with residence in high COVID-19 prevalence region (OR = 2.25, p = 0.004), poor (OR = 3.98, p = 0.002), or moderate (OR = 1.63, p = 0.048) self-assessed overall physical health, psychiatric comorbidity (OR = 1.87, p = 0.036), number of COVID-19-like symptoms (OR = 1.94, p = 0.039), and severe COVID-19 morbidity in the acquaintances (OR = 1.54, p = 0.026). Four theories were proposed to explain these high figures, with a discussion of their practical implications. Conclusions The lifting of lockdown measures was associated with a substantial increase in psychological distress among the Saudi population, referring to figures reported during the lockdown. This may indicate a decline in the overall population's coping capacity with the enduring crisis.