An investigation of depression, anxiety, and stress and its relating factors during COVID-19 pandemic in Iran.

BACKGROUND: The COVID-19 (SARS-CoV-2) is an emerging epidemic caused by the new Coronavirus. It has affected more than 200 countries, infected 5,939,234 people, and killed 367,255 in the world until 1 June 2020. While the disease epidemic could affect population mental health, this study aimed to investigate stress, anxiety, and depression during the Corona pandemic in Iran. METHODS: An online survey was designed using the depression, anxiety, and stress scale (DASS-21) questionnaire. The questionnaire was available for all Iranian population from 18 to 28 April 2020. Finally, 1498 participants filled the questionnaire using snowball sampling. Data were analyzed using multivariate regression models. RESULTS: Findings showed that most participants had experienced a normal level of stress (36.6%), anxiety (57.9%) and depression (47.9%). About 2.5% of respondents report an extremely severe level of stress. This amount of anxiety and depression was 6.3 and 7.9%, respectively. Regression model showed being female (CI: - 1.299; - 0.248), living with a high risk family member (CI: 0.325; 1.400), health status (CI: - 0.857; - 0.595), economic status (CI: - 0.396; - 0.141), social capital (CI: - 0.475; - 0.244), risk of disease (CI: 0.081; 0.729), and following COVID-19 news (CI: 0.111; 0.551) have a relation with stress level. Education level (CI: - 0.252; - 0.017), living with a high risk family member (CI: 0.0301; 1.160), health status (CI: - 0.682; - 0.471), social capital (CI: - 0.236; - 0.048), risk of disease (CI: 0.154; 0.674), and following COVID-19 news (CI: 0.046; 0.401) have a relation with anxiety score. Depression score was in relation with education level (CI: - 0.263; - 0.022), having a high-risk family member (CI: 0.292; 1.155), health status (CI: - 0.687; - 0.476), social capital (CI: - 0.235; - 0.048), risk of disease (CI: 0.144; 0.667), and following Covid-19 news (CI: 0.053; 0.408). CONCLUSIONS: Most of the factors related to depression, anxiety, and stress are related to COVID-19, such as having a vulnerable person in the family, risk of disease, and following COVID-19 news. The findings suggest the factors that should be taken into consideration for improving population mental health during pandemics.

Efficacy of a web application for stress management among Iranian college students during COVID-19 outbreak: a study protocol for randomized controlled trials.

BACKGROUND: The prevalence of mental health disorders is increasing globally, and the prevalence of COVID-19 has made it worse. Evidence has indicated a major mental health burden and elevated anxiety associated with the new coronavirus outbreak in the general population. This study aims to evaluate an evidence-based web application (Naranj) for stress management among Iranian college students. METHODS AND DESIGN: This study aims to present a protocol related to a randomized controlled trial among Iranian college students. The study will be conducted on 100 students from two colleges of Shiraz University of Medical Sciences in Iran. The participants will be randomly assigned to the intervention and control groups. The intervention group participants will be provided with a web application, whereas the control group ones will be provided with an app unrelated to stress management. The primary outcome for this study will be the Perceived Stress Scale, and the two groups will be compared with respect to stress level and sleep quality. DISCUSSION: A web application will be developed according to psychological theories and will be scientifically approved for managing college students' stress and improving their sleep quality during the COVID-19 outbreak. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20160427027647N2 . Registered on 14 May 2020.