ABSTRACT
This study compared the coronavirus disease 2019 (COVID-19)-related stress, fear of infection, loneliness, and depression between patients with schizophrenia and the general population. A face-to-face survey was administered to 1340 patients with a schizophrenia spectrum disorder and online survey of the general population (n = 2000) was conducted. The information gathered included the level of COVID-19-related stress, fear of infection, the Patient Health Questionnaire-9 score, and the three-item UCLA Loneliness Scale score. Structural equation modeling revealed a significant effect of fear of COVID-19 infection on depression among the general population and on loneliness among patients with schizophrenia. Loneliness experienced during COVID-19 exacerbated depression in both groups. In the COVID-19-related stress-loneliness-depression pathway, the partial mediating effect of loneliness was significant in both groups. Conversely, in the COVID-19-related fear-loneliness-depression pathway, the full mediating effect of loneliness was only significant in patients with schizophrenia. In conclusion, the loneliness associated with COVID-19-related stress and fear of infection was an important factor influencing depression, and the impact was greater in patients with schizophrenia compared with the general population. Thus, different mental health intervention plans are needed for patients with schizophrenia during the COVID-19 pandemic. During the long-lasting COVID-19 pandemic, social support and provision of mental health services to prevent loneliness and consequent depression are required in patients with schizophrenia.
ABSTRACT
The dramatic changes in people's daily lives caused by the 2019 coronavirus (COVID-19) pandemic have had a huge impact on their emotions and behaviors. This study aimed to examine psychosocial responses to COVID-19 using network analysis. A total of 1,500 urban residents of South Korea, selected from an online public panel, were surveyed using self-rating questionnaires addressing daily life changes, fear of infection, and distress related to COVID-19. Participants also completed a 10-item Perceived Stress Scale survey. We constructed regularized partial correlation networks, estimated global and local network metrics, tested network accuracy and stability, and compared the estimated networks between men and women. The network of the psychosocial responses consisted of 24 nodes that were classified into five groups: 'fear of infection', 'difficulty with outside activities', 'economic loss', 'altered eating and sleeping', and 'adaptive stress'. The node centralities indicated that 'distress in obtaining daily necessities' and 'concern about harming others' were the most important issues in people's responses to COVID-19. These nodes were connected by a negative edge, reflecting individual- and community-level issues, respectively. The overall level of perceived stress was linked to the network by the connection node 'anger toward others or society', which was associated with economic problems in men, but with distress from changes in daily activities in women. The results suggest that two contrasting feelings - personal insecurity regarding basic needs and a collectivistic orientation - play roles in the response to unusual experiences and distress due to COVID-19. This study also showed that public anger could arise from the psychological stress under the conditions imposed by COVID-19.
ABSTRACT
Objectives: This study aimed to compare psychosocial distress in areas in Korea with different prevalence of coronavirus disease 2019 (COVID-19) after validating a questionnaire on psychological experiences and stress associated with the disease outbreak. Methods: Using an online-based survey, psychosocial distress associated with COVID-19 was investigated in three regions, which were selected according to their prevalence of COVID-19. A total of 1,500 people from an online public panel in the three regions participated in the study. The questionnaire included sociodemographic information, psychosocial experience and stress related to COVID-19, and the perceived stress scale (PSS), patient health questionnaire-9 (PHQ-9), and generalized anxiety disorder-7 (GAD-7). Those questionnaires and scales were compared by level of prevalence of COVID-19 after validating the questionnaire on psychosocial distress associated with COVID-19. Results: The 19 items on psychosocial experience associated with COVID-19 comprised 5 subscales, with favorable Cronbach's α ranging from 0.69 to 0.88. Six stress items related to COVID-19 had a Cronbach's α of 0.79. Disturbance in eating and sleeping, difficulty with outside activities, stress from COVID-19, and PSS scores were greater in the areas where COVID-19 was highly prevalent. Economic problems, daily activity changes, and anger toward society were higher in the higher-prevalence regions. Discussion: Psychosocial distress associated with COVID-19 was closely related to the prevalence of the disease in the areas where participants lived. Psychosocial interventions for distress associated with COVID-19 should be developed and prepared for people during this lengthy pandemic.