Prevalence and predictors of post-traumatic stress symptoms and depressive symptoms among Bangladeshi students during COVID-19 mandatory home confinement: A nationwide cross-sectional survey

Depression, anxiety, and help-seeking among Slovenian postsecondary students during the COVID-19 pandemic

Introduction

The COVID-19 pandemic has faced students with many challenges, contributing to their mental distress. This article explores the role of demographic characteristics, psychological status, year of study, and social support during the COVID-19 pandemic in explaining Slovenian university students' mental health problems and help-seeking behavior.

Methods

In February and March 2021, data were collected on 5,234 full-time Slovenian postsecondary students who were enrolled in public and concessionary independent higher education institutions. Participants completed a questionnaire, which included The Patient Health Questionnaire (PHQ-9), General Anxiety Disorder questionnaire (GAD-7), Oslo Social Support Scale (OSSS-3), and items measuring psychological status, help-seeking behavior and demographics. Data were analyzed using multiple linear regression and hypothesis testing for differences.

Results

Factors, such as gender, age, psychological status and social support, contributed to experiencing anxiety and depression among Slovenian students during the COVID-19 pandemic, with year of study additionally contributing to experiencing depression. Similarly, gender, age, psychological status and social support contributed to help-seeking behavior. Higher levels of depression and anxiety were reported by female students, students with prior mental disorders, and students with lower social support levels. Female students and students with lower social support levels reported more frequent help-seeking behaviors.

Conclusion

The results provide insight into the mental state of the Slovenian student population in the context of imposed public health measures at the end of the second COVID-19 wave in Slovenia. The findings can help identify vulnerable groups within the student population to whom we must be particularly attentive in times of crisis.

Depression, anxiety, stress, and fear of COVID-19 among Bangladeshi medical students during the first wave of the pandemic: a mixed-methods study

Aim

This study aims to investigate depression, anxiety, stress, and fear of the COVID-19 pandemic and the associated risk factors among Bangladeshi medical students. It also explored qualitative insights on mental health from medical students during the first wave of the pandemic.

Methods

This mixed-methods study was conducted online in Bangladesh from June 2020 to September 2020. Participants were Bangladeshi medical students from the first year to the final year. The quantitative part included a structured online survey. One focus group discussion (FGD) was organized using the Zoom platform to collect qualitative insights from the students. To determine levels of stress, anxiety, and depression, the Bangla-validated version of the Depression, Anxiety, and Stress Scale 21 (DASS-21) was used. A 7-item and Bangla-validated Fear of COVID-19 Scale, also known as FCV-19S, was used to explore the COVID-19-specific fear of the students. A semi-structured topic guide was used for exploring the qualitative insights of medical students' perceptions of fear of COVID-19, mental health impacts during COVID-19, overall recommendations to support students, and the impact of the pandemic on the future of the medical curriculum.

Results

The study reported that 51.20%, 59.40%, and 64% of the 406 respondents had moderate to severe stress, anxiety, and depressive symptoms, respectively, according to the DASS-21. The mean fear score for the COVID-19 scale was 19.4 (SD 6.4). Respondents with family members aged 50 years or older (B = 2.1; CI: 0.3-3.9) and those who had infected family members (B = 1.9; 95% CI: 0.1-3.7) exhibited a higher level of fear of COVID-19. Moreover, depression was associated with a history of having cancer among family members (AOR = 2.9, CI: 1.1-7.5), anxiety was strongly associated with having symptoms of COVID-19 (AOR = 2, CI: 1.3-3.2), and stress was associated with having symptoms of COVID-19 infection among family members (AOR = 1.9, CI: 1.3-3). Altered sleep was a potential risk factor for developing stress, anxiety, and depression symptoms. Manual thematic analysis of qualitative data generated four major themes, including the perception of fear of COVID-19, the perception of mental health impacts during COVID-19, the change in the medical curriculum along with the pandemic, and recommendations from the medical students to support the mental health concerns of medical students during public health crises like this pandemic. Qualitative findings showed that the participants experienced fear of their parents becoming infected by COVID-19, and this fear was more prominent in those who had their loved ones hospitalized. They were also stressed and anxious, with thoughts of death. Their fear also extended to their thoughts on academic progress and the effectiveness of online classes.

Conclusion

A substantial proportion of medical students experienced mental health difficulties in Bangladesh. Appropriate interventions should be designed, and adequate support should be provided to the medical students to protect their mental health and wellbeing, considering their potential impact on the future health system in a low-resource setting like Bangladesh.

The prevalence of post-traumatic stress disorder in college students by continents and national income during the COVID-19 pandemic: a meta-analysis

Introduction

The present study aimed to provide a more accurate representation of post-traumatic stress disorder (PTSD) in college students during COVID-19 by performing meta-analyses by continents, national income, and study majors, and comparing the results with estimated pooled prevalence.

Methods

Based on the guideline of PRISMA, literature was searched in PubMed, Web of Science, and Embase. The prevalence of PTSD was estimated through a random model based on the different continents and levels of national income, as well as study majors, and compared with the pooled prevalence of PTSD among college students.

Results

Totally 381 articles were retrieved from electronic databases and 38 articles were included in the present meta-analysis. The results showed that the pooled prevalence of college students' PTSD was 25% (95% CI: 21-28%). Prevalence estimates of PTSD among college students were statistically significant (p < 0.00001) when stratified with geographical regions, income levels, and study majors. In comparison with the pooled prevalence of PTSD (25%), subgroups of Africa and Europe, lower-middle-income countries, and medical college students possessed higher prevalence estimates.

Discussion

The findings of the study showed that the prevalence of PTSD in college students worldwide during COVID-19 was relatively high and varied in different continents and countries with different income levels. Therefore, healthcare providers should pay attention to the psychologically healthy condition of college students during COVID-19.

Psychological disorders among Spanish Nursing students three months after COVID-19 lockdown: A cross-sectional study

The COVID-19 pandemic had a notable impact on the psychological well-being of a large part of the population, putting them at risk of developing depressive symptoms, different levels of anxiety disorders, and posttraumatic stress disorder (PTSD). One group considered to be at high risk are Nursing students; they were affected as learning strategies changed and clinical practices were cancelled. This study attempts to assess the psychological impact COVID-19 pandemic had on Nursing students and to explore the sociodemographic differences that can be risk factors for mental health disturbance. The psychological impact was evaluated using the Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). The study took place 4 months after the state of alarm was declared over in Spain. From a total sample of 304 Nursing students, 26.7%, 39.8%, and 15.5% showed PTSD, anxiety, and depression symptoms, respectively. Severe levels of psychological impact have been associated with being a female, a smoker, and feeling fear and stress. Having a relative test positive has been linked to lower anxiety levels while being afraid or stressed to higher anxiety levels. Being a female, co-habit with friends and feeling stress have been associated with higher depression levels.

Investigating posttraumatic stress disorder among COVID-19 recovered patients: A cross-sectional study

Background

During the 21st century, pandemics have emerged frequently and become more challenging. Coronavirus disease (COVID-19) is among the most prominent examples. A considerable public health issue following the pandemic is posttraumatic stress disorder (PTSD). COVID-19-recovered patients are highly susceptible to developing PTSD. Earlier epidemic studies showed a high prevalence of trauma-exposed people as a result of infectious diseases. This research aimed to quantify the estimated prevalence of PTSD and its contributing variables among COVID-19-recovered patients in Bangladesh.

Methods

This was a cross-sectional research carried out through an e-survey comprising 326 individuals (69.0% male; mean age = 37.97 ± 13.02 years; age range = 18-76 years) and conducted between September 2020 to January 2021. The online survey included a section for gathering participant's informed permission as well as sections on key demographics and way of life, and social supports during the suffering period from acute COVID-19, as well as a PTSD Checklist for DSM-5 (PCL-5) to examine PSTD. Descriptive statistics and multiple regression analyses were performed. Results: The prevalence estimates of PTSD ranged between 36 and 41% based on three predefined cut-offs. As per multiple linear regression analysis, PTSD was much more common among those who took part and reported being middle-aged/older adults (≥40 years), having lower S.E.S., and who slept more (>9 h/day). In addition, PTSD was negatively associated (p <0.05) with the social support of family members/friends/relatives, and colleagues in working settings; while positively correlated with health care providers. Conclusion: The current investigation revealed a considerably higher level of PTSD among COVID-19-recovered patients. The findings suggest extending the mental health services, other covariates, and immediate intervention among national and international COVID-19 recovered patients.

Are older teens more frustrated than younger teens by the covid-19 restrictions? The role of psychological maturity, personality traits, depression and life satisfaction

Many studies have shown the negative impact of lockdowns on adolescents, but there is less evidence on how they are affected by other stages of the COVID-19 pandemic, and, especially, whether there are any differences between early and late adolescence. The current study focuses on the frustration felt by adolescents because of the severe COVID-19 restrictions in a non-lockdown situation. We aimed to (a) assess the role of maturity and two personality traits (emotional stability and extraversion) in predicting their frustration, and (b) compare the levels of frustration, depressive symptoms, and life satisfaction in older and younger adolescents. The sample of older adolescents was also compared with a paired sample of the same age collected in 2018, before the pandemic. The results suggest that maturity, extraversion and emotional stability are predictors of frustration in both older and younger adolescents, although older adolescents reported higher levels of frustration and depressive symptoms, and lower levels of life satisfaction. Older adolescents also reported higher levels of depressive symptoms than adolescents of the same age before the pandemic. These results show the negative impact of the pandemic, especially on older adolescents, and the important role of maturity and some personality traits in predicting their frustration.

Investigating problematic uses of Facebook and other Internet activities among university students in Bangladesh during the COVID-19 pandemic

Problematic use of Internet (PUI) and problematic use of Facebook (PUF) has been linked to escalating behavioral health issues among university students and has increased during the COVID-19 pandemic. This study estimated the prevalence of and explored associated factors for PUI and PUF among Bangladeshi university students during the COVID-19 pandemic. A cross-sectional online survey was undertaken among 1101 Bangladeshi university students between November and December 2020. The Internet Addiction Test and Facebook Addiction Scale were used to assess PIU and PUF, respectively. A multiple linear regression analysis was performed to adjust for confounders. Among the participants, PUI and PUF were found in 39.3% and 37.1%, respectively. The multiple linear regression model indicated PUI was significantly associated with participants residing in a village, arts majors, those unsatisfied with their major, having mediocre parental relationships, failure in romantic relationships, physical comorbidities, longer use of the Internet, using the Internet for purposes other than education, using social media, and downloading movies/TV series. PUF was significantly associated with village residence, lower income, arts majors, failure in romantic relationships, longer use of the Internet, using the Internet for purposes other than education, and downloading movies/TV series. Both PUI and PUF have been prevalent among Bangladeshi university students during the COVID-19 pandemic. Longitudinal & exploratory studies are warranted in the future to identify causal factors for PUI and PUF and appropriate interventions should be designed quickly for this population.

Psychosocial health of school-going adolescents during the COVID-19 pandemic: Findings from a nationwide survey in Bangladesh

BACKGROUND

Common psychosocial health problems (PHPs) have become more prevalent among adolescents globally during the COVID-19 pandemic. However, the psychosocial health of school-going adolescents has remained unexplored in Bangladesh due to limited research during the pandemic. The present study aimed to estimate the prevalence of PHPs (i.e., depression and anxiety) and assess associated lifestyle and behavioral factors among school-going adolescents in Bangladesh during the COVID-19 pandemic.

METHODS

A nationwide cross-sectional survey was conducted among 3,571 school-going adolescents (male: 57.4%, mean age: 14.9±1.8 years; age range: 10-19 years) covering all divisions, including 63 districts in Bangladesh. A semi-structured e-questionnaire, including informed consent and questions related to socio-demographics, lifestyle, academics, pandemic and PHPs, was used to collect data between May and July 2021.

RESULTS

The prevalence of moderate to severe depression and anxiety were 37.3% and 21.7%, respectively, ranging from 24.7% in the Sylhet Division to 47.5% in the Rajshahi Division for depression, and from 13.4% in the Sylhet Division to 30.3% in the Rajshahi Division for anxiety. Depression and anxiety were associated with older age, reports of poor teacher cooperation in online classes, worries due to academic delays, parental comparison of academic performance with other classmates, difficulties coping with quarantine situations, changes in eating habits, weight gain, physical inactivity and having experienced cyberbullying. Moreover, being female was associated with higher odds of depression.

CONCLUSIONS

Adolescent psychosocial problems represent a public health problem. The findings suggest a need for generating improved empirically supported school-based psychosocial support programs involving parents and teachers to ensure the well-being of adolescents in Bangladesh. School-based prevention of psychosocial problems that promote environmental and policy changes related to lifestyle practices and active living should be developed, tested, and implemented.

Psychological Effect of the COVID-19 Pandemic on Nursing Students: Palestinian Perspective

Introduction

COVID-19 has had an important effect on nursing students, with some having their clinical practice cancelled or suspended and others suffering from the virus.

Objective

The purpose of this study was to assess the psychological status in terms of stress, anxiety, and depression of nursing students during COVID-19 pandemic.

Methods

The study was cross-sectional, carried out by a convenience sample of 320 participants of nursing students between May and June 2020. Data collection was performed by "Depression Anxiety Stress-21 Scale" (DASS-21).

Results

The results revealed that 78 (24.3%) of participants reported stress; 121 (37.8%) reported anxiety; and 72 (22.5%) reported depression. Also, grade and socioeconomic status had statistically significant effect on anxiety, stress, and depression. In addition, age had statistically significant effect on depression, place of residence had statistically significant effect on anxiety, and gender had statistically significant effect on stress.

Conclusion

The study confirmed an alarming number of nursing students who experienced anxiety, stress, and depression. This study serves as an evidence concerning nursing students' mental health issues as a consequence of the COVID-19 pandemic.

Post-traumatic stress disorders and coping strategies of health professionals during COVID-19 pandemic in Bangladesh: Findings of a countrywide cross-sectional study

Background

COVID-19 pandemic imposed a devastating effect on the psychological health of health professionals as they worked nonstop to withstand the hardship of the pandemic. The present study intended to determine the post-traumatic stress disorders (PTSD) and coping strategies among health professionals during the COVID-19 pandemic in Bangladesh.

Methods

This country-wide cross-sectional study was conducted from July to December 2021 among 1394 health professionals (596 physicians, 713 nurses, 85 medical technologists) who served COVID-19 patients at the secondary, tertiary, and specialized government healthcare facilities in Bangladesh and completed at least one month after exposure to COVID-19 patient-care. Data were collected through face-to-face interviews using a semi-structured questionnaire and analyzed by SPSS software. All the ethical issues were maintained strictly.

Findings

Most of the participants, 877(62∙9%) [95% CI: 60∙3-65∙5], were female, and 327(23∙5%) [95% CI: 21∙3-25∙8] developed PTSD. Females (AOR:1∙42 [95% CI: 1∙083-1∙868] p=0∙011), having an elderly family member (AOR:1∙515 [95% CI: 1∙173-1∙956] p=0∙0014), working in specialized hospitals (AOR:2∙685 [95% CI: 1∙928-3∙739] p<0∙001), and working ≥8 hours/day (AOR:1∙897 [95% CI: 1∙350-2∙666] p=0∙0002) had higher odds of developing PTSD. Most of the participants adopted spiritual approaches 96(29∙4%) [24∙5-34∙6] and distraction by watching TV/YouTube 59(18∙0%) [14∙0-22∙6] as coping strategies.

Interpretation

The study findings would be helpful for health policymakers and managers to develop comprehensive measures for restoring the mental well-being of health professionals by alleviating PTSD induced by a pandemic like COVID-19.

Funding

The study got funding from the Directorate General of Medical Education under the Ministry of Health and Family Welfare, Bangladesh.

An analysis of business students’ stressors and their coping strategies in the post-pandemic era

The COVID-19 pandemic has brought a dramatic change in teaching–learning practices in higher education across the world. The post-pandemic era with a new shift of teaching–learning phase raises the concern of students' psychological well-being, especially the novice, i.e., first-year undergraduate students, as first-year students often struggle to adjust to the new environment of higher institutions, thereby depressive symptoms are more prevalent among them. In this regard, a qualitative study was conducted followed by a dyadic approach to explore the symptoms of students’ psychological stressors, their causes, and provide essential remedies for coping with such behaviors in the post-pandemic era. The findings show that students’ stressors were commonly reported due to the academic workload, institutional regulations, lack of resources, and financial constraints. Regarding indications, unusual behavior, lack of confidence, improper sleep, and lack of motivation were identified as the primary symptoms of students’ stress. However, participants reported a lack of understanding regarding stress-related matters. Yet, students and faculty members try to adopt several strategies for reducing such stressors. By examining the perceived psychological stress, indications, and coping behaviors, this study enriches the literature by bridging pragmatic and theoretical gaps regarding students’ stressors of business management. Furthermore, the study mainly suggests that adequate institutional support should be provided to deal with students’ problems that cause stress. Also, universities should organize workshops or seminars to cultivate psychological health awareness among students and faculty members.

Trauma and stressor-related disorders among health care workers during COVID-19 pandemic and the role of the gender: A prospective longitudinal survey

INTRODUCTION

Health-care Workers (HCW) are facing a critical situation caused by Coronavirus Disease 2019 (COVID-19) which could impact on their mental health status. In addition, HCW women have been identified as a group at high-risk of developing psychological distress, although no previous longitudinal studies have explored this issue in a sample of HCW.

AIMS

The main aim of the study was to observe the temporal pattern of the stress reactions among HCW as well as to explore its potential predictors of poor outcome. Moreover, we analyzed possible gender differences in stress reaction responses.

METHODS

One thousand for hundred and thirty-two HCW responded an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Bivariate and multivariate analyses as well as repeated measures analyses were used to achieve the aims of the study.

RESULTS

The proportion of HCW who fulfilled Acute Stress Disorder criteria did not change over the follow-up period, although we observed a significant improvement in stress reactions responses among HCW. Proximal factors were the most salient predictors of traumatic reactions. Repeated analyses revealed significant gender differences in acute stress reactions. In addition, women showed significantly greater improvement than men in re-experiencing the traumatic event and hyperarousal dimensions.

CONCLUSIONS

Monitoring of working conditions as well as emotional reactions in HCW facing major disasters should be carried out to prevent the development of peritraumatic stress reactions. In addition, HCW women are characterized by a different pattern of progression in stress responses.

Prevalence and correlates of diabetes distress and depressive symptoms among individuals with type-2 diabetes mellitus during Ramadan fasting: A cross-sectional study in Bangladesh amid the COVID-19

AIMS

Psychological concerns relating to "diabetes distress" (DD) and depressive symptoms (DS) in individuals with type-2 diabetes mellitus (T2DM) may negatively impact adherence to medical treatments and overall mental health. Thus, this study was undertaken to investigate DS and DD in relation to fasting during the month of Ramadan.

METHODS

A cross-sectional survey was conducted among 735 patients with T2DM in 2021. DD and DS were measured by the Problem Areas in Diabetes scale and Patient Health Questionnaire-9, respectively. Logistic regression and correlation analyses were executed.

RESULTS

More than one-third of the participants (41.2%) had DD and DS (36.9%). DS was significantly higher in participants who did not fast (p = 0.027). Participants who had higher dietary diversity were less likely to have DD (p = 0.004) and DS (p = 0.001). Females (AOR = 1.89, 95% CI: 1.25-2.85) and those who lived alone (AOR = 1.89, 95% CI: 1.25-2.85) were more likely to have DS. Participants with diabetes-related complications were more likely to experience DS (AOR = 2.17; 95% CI: 1.5-3.13) and DD (AOR = 3.46; 95% CI: 2.42-4.95). DD was also associated with being younger (p = 0.003), having hypertension (p = 0.030), having heart disease (p = 0.012), and taking insulin (p = 0.010).

CONCLUSIONS

Individuals with T2DM who were not fasting experienced more mental health concerns. Psychosocial support and other interventions from health professionals should be examined and empirical interventions should be implemented to promote the mental health and well-being of individuals with T2DM.

Generalized anxiety disorder among Bangladeshi university students during COVID-19 pandemic: gender specific findings from a cross-sectional study

In the current COVID-19 pandemic there are reports of deteriorating psychological conditions among university students in lower-middle-income countries (LMICs), but very little is known about the gender differences in the mental health conditions on this population. This study aims to assess generalized anxiety disorder (GAD) among university students using a gender lens during the COVID-19 pandemic. A cross-sectional study was conducted using web-based Google forms between May 2020 and August 2020 among 605 current students of two universities in Bangladesh. Within the total 605 study participants, 59.5% (360) were female. The prevalence of mild to severe anxiety disorder was 61.8% among females and 38.2% among males. In the multivariable logistic regression analysis, females were 2.21 times more likely to have anxiety compared to males [AOR: 2.21; CI 95% (1.28-53.70); p-value: 0.004] and participants' age was negatively associated with increased levels of anxiety (AOR = 0.17; 95% CI = 0.05-0.57; p = 0.001). In addition, participants who were worried about academic delays were more anxious than those who were not worried about it (AOR: 2.82; 95% CI 1.50-5.31, p = 0.001). These findings of this study will add value to the existing limited evidence and strongly advocate in designing gender-specific, low-intensity interventions to ensure comprehensive mental health services for the young adult population of Bangladesh.

The relationship between schizotypal personality features and mind wandering among college students during COVID-19 pandemic: A moderator of depression

INTRODUCTION

Although the impact of the COVID-19 pandemic on people's mental health has been well documented in many studies, the schizotypal personality features in the general population have not received sufficient attention.

METHODS

Study 1 is a longitudinal study tracking changes in schizotypal personality features among college students during the COVID-19 pandemic. A total of 153 Chinese college students were assessed using the Schizotypal Personality Questionnaire. Study 2 explored the relationship between schizotypal personality features, mind wandering, and depression. A total of 557 college students completed the Schizotypal Personality Questionnaire, the Beck Depression Inventory, and the Mind-Wandering Questionnaire during the COVID-19 pandemic.

RESULTS

Study 1 results showed that the scores from later stages in the pandemic were significantly higher than those from the initial stages on each dimension of schizotypal personality, which means that the schizotypal personality features became more obvious during the COVID-19 pandemic. Study 2 results showed that there was a positive correlation between schizotypal personality features, depression, and mind wandering.

DISCUSSION

Depression played a moderating role in the relationship between schizotypal personality features and mind wandering. The schizotypal personality features of college students increase during COVID-19; it has a positive relationship with mind wandering; depression moderates the relationship. We discussed these findings and provided some suggestions about future research.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

Financial Difficulties Correlate With Mental Health Among Bangladeshi Residents Amid COVID-19 Pandemic: Findings From a Cross-Sectional Survey

Background: The COVID-19 pandemic is a global threat which has challenged mental resilience and impacted the psychological well-being of people across all age groups globally. The present study aimed to investigate how financial difficulties during the pandemic correlate with mental health among residents of Bangladesh. Methods: A cross-sectional survey was conducted on 4,020 residents from different parts of Bangladesh between July and September 2020, during a period of elevated risk of COVID-19 infection. A self-reported online questionnaire comprising socio-demographic, financial difficulties and psychometric measures (to assess depression, anxiety and stress) was used to gather information from participants. Multivariable logistic regression analysis was performed to determine the factors associated with mental health consequences. Results: The prevalence of depression, anxiety, and stress in the sample were 71.1%, 62.3%, and 56.7%, respectively. Levels of depression, anxiety, and stress were significantly higher among participants who reported female sex, being unmarried, smaller families, higher monthly family income, poor self-perceived health status, living near people who had been infected by COVID-19, probability of decreased income, food scarcity (both during the pandemic and in the future) and the possibility of unemployment. However, due to the nature of the cross-sectional study performed with a convenience sampling method, the causal relationship between variables cannot be justified. Conclusions: After several months of the COVID-19 pandemic in Bangladesh, more than half of the respondents rated their mental health concerns as moderate to severe. The findings highlight the contributing factors of poor mental health which warrant the creation of interventions that address the economic, financial and mental health impacts of the pandemic.

Mental health difficulties in students with suspected COVID-19 symptoms and students without suspected COVID-19 symptoms: A cross-sectional comparative study during the COVID-19 pandemic

INTRODUCTION

Mental health problems are taking a heavy toll on students during the COVID-19 pandemic. The purpose of this study was to compare the level of anxiety symptoms, depressive symptoms, post-traumatic stress symptoms (PTSS), and fear of COVID-19 between students with suspected COVID-19 symptoms and students without any suspected symptoms during the pandemic in Bangladesh.

METHODS

This cross-sectional comparative study was conducted online among Bangladeshi students from May to July 2020. Anxiety symptoms, depressive symptoms, PTSS, and fear of COVID-19 were assessed by using the Generalized Anxiety Disorder scale, Patient Health Questionnaire, the Impact of Event Scale, and Fear of COVID-19 Scale, respectively. College and University students were the participants of the study.

RESULTS

Among 3777 students, 1259 had suspected COVID-19 symptoms and 2518 had no suspected COVID-19 symptoms. Students who experienced suspected COVID-19 symptoms had higher prevalence (moderate to severe) of depressive symptoms (61.15% vs. 47.62%), anxiety symptoms (44.96% vs. 36.97%), and PTSS (48.3% vs. 39.75%) compared to those who had no such symptoms. The study identified having suspected COVID-19 symptoms as a significant associated factor for anxiety symptoms (β1' = 1.39; 95% CI: 1.03-1.74), depressive symptoms (β1' = 1.88; 95% CI: 1.43-2.32), PTSS (β1' = 3.66; 95% CI: 2.66-4.65), and fear of COVID-19 (β1' = 0.48; 95% CI: 0.02 to 0.94). Students with suspected COVID-19 symptoms thought more that they would be better off dead, or of hurting themselves (P < 0.01) and felt more afraid as if something awful might happen (P < 0.01) than their counterparts.

CONCLUSION

Mental health difficulties are more prevalent among students with suspected COVID-19 symptoms than the students without having such symptoms. This finding suggests that public health practitioners should deploy a rapid diagnostic system and consider psychological intervention in addition to clinical management for those who have COVID-19 like symptoms during the pandemic.

Impact of the COVID-19 Pandemic on Higher Education: Characterizing the Psychosocial Context of the Positive and Negative Affective States Using Classification and Regression Trees

Our aim is to analyze the extent to which the psychosocial aspects can characterize the affective states of the teachers, administrative staff, and undergraduate and postgraduate students during the quarantine. A questionnaire was answered by 1,328 people from the community of the Universitat de Barcelona (UB), Spain. The survey was partially designed ad hoc, collecting indicators related to sociodemographic variables, the impact of COVID on the subjects or in their personal context, the psychosocial context of coexistence and perceived social support, characteristics related to the physical context during the quarantine, and labor conditions. Additionally, it included two validated instruments: the Survey Work-Home Interaction-Nijmegen for Spanish Speaking Countries (SWING-SSC) validated in Spanish and PANAS, the Positive and Negative Affect Schedule. Classification and Regression Trees (CART) were performed to identify which variables better characterize the participants' level of positive and negative affective states. Results according to groups showed that students are the ones who have suffered the most as a result of this situation (temporary employment regulation, higher scores in negative work-home and home-work interaction, lower scores in positive home-work interaction, and negative effects of teleworking). Additionally, they reported a higher mean score in interpersonal conflict and worse scores with regard to negative affective states. Based on sex, women were the ones whose environment was shown to be more frequently affected by the pandemic and who exhibited more negative effects of teleworking. In general terms, participants with the highest scores in negative affective states were those who perceived an increase in conflict and a high negative effect from work spilling over into their personal lives. On the contrary, participants with the highest levels of positive affective states were those with medium to low levels of negative home-work interaction, over 42.5 years old, and with medium to high levels of positive work-home interaction. Our results aim to help higher education to reflect on the need to adapt to this new reality, since the institutions that keep pace with evolving trends will be able to better attract, retain, and engage all the members of the university community in the years ahead.

Financial and Mental Health Concerns of Impoverished Urban-Dwelling Bangladeshi People During COVID-19

Background: The COVID-19 pandemic has impacted the physical, mental and financial health of many individuals. Individuals living in impoverished crowded settings may be particularly vulnerable to COVID-19-related stressors. How substantially marginalized groups like impoverished urban-dwelling individuals have been impacted during this pandemic is poorly understood. The present study aimed to investigate the associated factors of financial concerns and symptoms of depression and posttraumatic stress disorder (PTSD) during the COVID-19 pandemic among impoverished urban-dwelling individuals residing in Dhaka, Bangladesh. Methods: A cross-sectional survey was conducted between August and September 2020 using face-to-face interviews in six disadvantaged neighborhoods ("slums") in Dhaka. Individuals were interviewed using a semi-structured questionnaire consisting of questions assessing socio-demographics, lifestyle, financial well-being relating to the COVID-19 pandemic, depression, and PTSD. Results: Four-hundred-and-thirty-five individuals (male = 54.7%; mean age = 45.0 ± 12.0 years; age range = 18-85 years) participated. Most (96.3%) reported that their household income decreased due to the COVID-19 pandemic. Factors associated with decreased household incomes included female gender, primary education, joblessness, food scarcity and depression. Depression symptoms were linked to female gender, joblessness, divorce, living in a joint family, excessive sleep and smoking. Low incomes, excessive sleep, joblessness and food scarcity were positively associated with PTSD symptoms. In contrast, less sleep appeared protective against PTSD. Conclusions: Public health initiatives, in particular mental health services that target stress and biocentric approaches that consider how humans interact with multiple facets of nature, should be introduced to mitigate against potential financial and psychological effects of the pandemic on impoverished urban-dwelling individuals in Bangladesh.

Fear and depressive symptoms amid COVID-19: A cross-sectional pilot study among adult population in Bangladesh

BACKGROUND

Fear is a primary emotional reaction to the deadly coronavirus disease which might be an associated factor for developing depressive symptoms. This study aimed to assess the level and associated factors of fear and depression amid the COVID-19 pandemic among the adult population of Bangladesh.

METHODS

After providing informed consent, 1050 participants completed the cross-sectional online survey tool. Depressive symptoms and fear were assessed through the PHQ-9 and validated fear of COVID-19 scale (FCV-19S), respectively. Linear regression analysis was performed to predict potential factors of fear and depression.

RESULTS

The study finds that females had higher scores for fear of COVID-19 scale (β1' = 1.81; 95% CI: 1.15 to 2.47) and Patient Health Questionnaire (β2' = 1.92; 95% CI: 0.95 to 2.88) than their male counterpart. Respondents considering the virus to be extremely dangerous had higher scores for FCV-19S (β1' = 1.55; 95% CI: 0.66 to 2.44) and PHQ-9 (β2 = 1.59; 95% CI: 0.25 to 2.92). Similarly, respondents considering themselves unsafe and very worried about the virus had increased scores for both FCV-19S and PHQ-9. On other hand, people those were reluctant to use masks (β1' = -1.58; 95% CI: -3.12 to -0.04) or seek doctors' advice (β1' = -0.93; 95% CI: -1.83 to -0.02) if COVID-19 symptoms appear, had comparatively lower scores for FCV-19S.

CONCLUSIONS

Fear of COVID-19 and depression were found to be associated with some specific knowledge, attitude & preparedness towards COVID-19 which should be adequately addressed in public health strategies to prevent the virus.