ABSTRACT
BACKGROUND: The COVID-19 pandemic has led to a notable increase in psychological distress, globally. Oman is no exception to this, with several studies indicating high levels of anxiety and depression among the Omani public. There is a need for adaptive and effective interventions that aim to improve the elevated levels of psychological distress due to the COVID-19 pandemic. OBJECTIVE: This study aimed to comparatively assess the efficacy of therapist-guided online therapy with that of self-help, internet-based therapy focusing on COVID-19-induced symptoms of anxiety and depression among individuals living in Oman during the COVID-19 pandemic. METHODS: This was a 6-week-long pragmatic randomized controlled trial involving 60 participants who were recruited from a study sample surveyed for symptoms of anxiety or depression among the Omani public amid the COVID-19 pandemic. Participants in the intervention group were allocated to receive 1 online session per week for 6 weeks from certified psychotherapists in Oman; these sessions were conducted in Arabic or English. The psychotherapists utilized cognitive behavioral therapy and acceptance and commitment therapy interventions. Participants in the control group received an automatic weekly newsletter via email containing self-help information and tips to cope with distress associated with COVID-19. The information mainly consisted of behavioral tips revolving around the principles of cognitive behavioral therapy and acceptance and commitment therapy. The primary outcome was measured by comparing the change in the mean scores of Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scale from the baseline to the end of the study (ie, after 6 sessions) between the two groups. The secondary outcome was to compare the proportions of participants with depression and anxiety between the two groups. RESULTS: Data from 46 participants were analyzed (intervention group n=22, control group n=24). There was no statistical difference in the baseline characteristics between both groups. Analysis of covariance indicated a significant reduction in the GAD-7 scores (F1,43=7.307; P=.01) between the two groups after adjusting for baseline scores. GAD-7 scores of participants in the intervention group were considerably more reduced than those of participants in the control group (ß=-3.27; P=.01). Moreover, a greater reduction in mean PHQ-9 scores was observed among participants in the intervention group (F1,43=8.298; P=.006) than those in the control group (ß=-4.311; P=.006). Although the levels of anxiety and depression reduced in both study groups, the reduction was higher in the intervention group (P=.049) than in the control group (P=.02). CONCLUSIONS: This study provides preliminary evidence to support the efficacy of online therapy for improving the symptoms of anxiety and depression during the COVID-19 crisis in Oman. Therapist-guided online therapy was found to be superior to self-help, internet-based therapy; however, both therapies could be considered as viable options. TRIAL REGISTRATION: ClinicalTrials.gov NCT04378257; https://clinicaltrials.gov/ct2/show/NCT04378257.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is a global, virulent pandemic disease that emerged in December 2019, with both short- and long-term psychological repercussions being inevitable. This study aimed to investigate the prevalence and predictors of psychological distress, defined by the presence of either depression or anxiety, among the public in Oman during the COVID-19 pandemic. This was a web-based, cross-sectional study conducted using governmental and private institutional e-mail systems and social media platforms. Anxiety and depression were assessed using both the Generalized Anxiety Disorder-7 Scale and the Patient Health Questionnaire-9. Logistic regression analysis was used to assess the independent predictors. There were a total of 1538 participants in this study (75% female). The prevalence of psychological distress was 30%. Being female, having financial instability, being treated for mental illness and self-medication for coping with stress were independent predictors of psychological distress among the study sample (Odds ratio [OR] = 1.69, confidence interval [CI] = 1.24-2.29; OR = 2.05, CI = 1.54-2.74; OR = 5.35, CI = 3.50-8.18; OR = 7.23, CI = 3.06-17.09, respectively). The results from this study will help public health officials in Oman to plan for and mitigate psychological repercussions of the current and future pandemics.
