ABSTRACT
Background: The COVID-19 pandemic brings several features that increase the sense of fear, not to mention confusion, quarantine, financial losses, etc., which may lead to adverse psychosocial outcomes. The influence of such stressors takes place within a broader sociocultural context that needs to be considered.Objective: To examine how the psychological response to the pandemic varies across countries and identify which risk/protective factors contribute to this response.Methods : An online survey was conducted from May 29-June 12, 2020, among a multinational sample of 8,806 adults from eight countries/regions (Canada, United States, England, Switzerland, Belgium, Hong Kong, Philippines, New Zealand). Probable generalized anxiety disorder (GAD) and major depression episode (MDE) were assessed. The independent role of a wide range of potential factors was examined using multilevel logistic regression.Findings: Probable GAD and MDE were indicated by 21.0% and 25.5% of the respondents, respectively, with an important variation according to countries/regions (GAD: 12.2%-31.0%; MDE: 16.7%-32.9%). When considered together, 30.2% of the participants indicated probable GAD or MDE. Several factors were positively associated with a probable GAD or MDE, including (in descending order of importance) weak sense of coherence (SOC), lower age, false beliefs, isolation, threat perceived for oneself/family, mistrust in authorities, stigma, threat perceived for country/world, financial losses, being a female, and having high level of information about COVID-19. Having a weak SOC yielded the highest adjusted odds ratio for probable GAD or MDE (3.23; 95% CI: 2.76-3.78).Interpretation: This pandemic is having an impact on psychological health. In some places and under certain circumstances, however, people seem to be better protected psychologically. This is a unique opportunity to evaluate the psychosocial impacts across various sociocultural backgrounds, providing important lessons that could inform all phases of disaster risk management.Funding: This study was funded by the Canadian Institutes of Health Research.Declaration of Interests: All authors declare no competing interest.Ethics Approval Statement: This study takes place within a broader research project funded by the Canadian Institutes of Health Research. It was reviewed and approved by the Research Ethics Board of the CIUSSS de l'Estrie – CHUS (HEC ref: 2020-3674).
Subject(s)
COVID-19 , Anxiety Disorders , Depressive Disorder, MajorABSTRACT
Introduction: Non-pharmaceutical interventions to facilitate response to the COVID-19 pandemic, a disease caused by novel coronavirus SARS-CoV-2, are urgently needed. Using the WHO health emergency and disaster risk management (health-EDRM) framework, behavioural measures for droplet-borne communicable disease, with their enabling and limiting factors at various implementation levels were evaluated. Sources of data: Keyword search was conducted in PubMed, Google Scholar, Embase, Medline, Science Direct, WHO and CDC online publication database. Using OCEBM as review criteria, 105 English-language articles, with ten bottom-up, non-pharmaceutical prevention measures, published between January 2000 and May 2020 were identified and examined. Areas of Agreement: Evidence-guided behavioural measures against COVID-19 transmission for global at-risk communities are identified. Area of Concern: Strong evidence-based systematic behavioural studies for COVID-19 prevention are lacking. Growing points: Very limited research publications are available for non-pharmaceutical interventions to facilitate pandemic response. Areas timely for research: Research with strong implementation feasibility that targets resource-poor settings with low baseline Health-EDRM capacity is urgently need.