The COVID-19 pandemic is a global public health problem affecting mental health, and basic data are required for evidence-based mental health interventions. This study aimed to identify the prevalence of psychological impacts, anxiety, depression, stress, and any associated risk factors in individuals living in Turkey during the COVID-19 pandemic.
The population of this descriptive study consisted of individuals over the age of 18 living in Turkey. The data were collected between July–September 2020 using the snowball sampling method. The study was completed with 1733 participants. The data were collected using the Impact of Events Scale-Revised and the Depression Anxiety Stress Scale. Statistical analyses included percentage, mean, standard deviation, a Chi-square test, a Mann Whitney U test, Kruskal Wallis and Tamhane's T2 post hoc, and Spearman's correlation. P < 0.05 was considered statistically significant.
45.1% had moderate or severe psychological effects; 42.7% had a moderate or severe depression, 31.7% had moderate or severe anxiety, and 28.5% had moderate or severe stress levels. Being a woman, being single, unemployment, smoking, the presence of chronic diseases, being young (<35), being a university graduate, having a household size of 5 or more, a low income, having poor health, and being underweight were significantly correlated with some psychological impact, depression, anxiety, and stress levels of people.
During the pandemic period, almost half of the respondents were found to experience some psychological impact of the pandemic and have negative moderate to severe mental health levels. Risk groups for mental health were identified.
Citation: Bahar Kefeli Çol, Ayşe Gümüşler Başaran, Hilal Pekmezci. COVID-19 pandemic: Evaluating its psychological impact and individuals' depression, anxiety, and stress levels[J]. AIMS Public Health, 2023, 10(3): 507-523. doi: 10.3934/publichealth.2023036
The COVID-19 pandemic is a global public health problem affecting mental health, and basic data are required for evidence-based mental health interventions. This study aimed to identify the prevalence of psychological impacts, anxiety, depression, stress, and any associated risk factors in individuals living in Turkey during the COVID-19 pandemic.
The population of this descriptive study consisted of individuals over the age of 18 living in Turkey. The data were collected between July–September 2020 using the snowball sampling method. The study was completed with 1733 participants. The data were collected using the Impact of Events Scale-Revised and the Depression Anxiety Stress Scale. Statistical analyses included percentage, mean, standard deviation, a Chi-square test, a Mann Whitney U test, Kruskal Wallis and Tamhane's T2 post hoc, and Spearman's correlation. P < 0.05 was considered statistically significant.
45.1% had moderate or severe psychological effects; 42.7% had a moderate or severe depression, 31.7% had moderate or severe anxiety, and 28.5% had moderate or severe stress levels. Being a woman, being single, unemployment, smoking, the presence of chronic diseases, being young (<35), being a university graduate, having a household size of 5 or more, a low income, having poor health, and being underweight were significantly correlated with some psychological impact, depression, anxiety, and stress levels of people.
During the pandemic period, almost half of the respondents were found to experience some psychological impact of the pandemic and have negative moderate to severe mental health levels. Risk groups for mental health were identified.
| [1] | World Health Organization (WHO)Situation reports (2020). Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. |
| [2] | J GroganImpact of COVID-19 measures on democracy and fundamental rights-Best practices and lessons learned in the Member States and third countries, European Parliament Study (2020). Available from: https://www.europarl.europa.eu/RegData/etudes/STUD/2022/734010/IPOL_STU(2022)734010_EN.pdf. |
| [3] | Within the Scope of Combating Coronavirus - Circulars of Restrictions and Measures. Available from: https://www.icisleri.gov.tr/koronavirus-ile-mucadele-kapsaminda-sokaga-cikma-kisitlamalari---yeni-kisitlama-ve-tedbirler-genelgeleri. |
| [4] | TC Sağlik BakanliğiMinistry of Health, COVID-19 Information Platform, Covıd-19 Outbreak Management And Study Guide (2020). Available from: https://covid19.saglik.gov.tr/Eklenti/40340/0/covid-19salginyonetimivecalismarehberipdf.pdf. |
| [5] | Khachfe HH, Chahrour M, Sammouri J, et al. (2020) An epidemiological study on COVID-19: a rapidly spreading disease. Cureus 12: e7313. https://doi.org/10.7759/cureus.7313 |
| [6] | Costa MR, Rocha MF, Santos GCJ, et al. (2020) Mental health and COVID-19 ınfection: Systematic review in human cross-sectional studies. Health Sci J 2020: 1-7. |
| [7] |
Bueno-Notivol J, Gracia-Garcí P, Olaya B, et al. (2021) Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. Int J Clin Health Psychol 21: 100196. https://doi.org/10.1016/j.ijchp.2020.07.007 
|
| [8] |
Salari N, Hosseinian-Far A, Jalali R, et al. (2020) Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Global Health 16: 57. https://doi.org/10.1186/s12992-020-00589-w
|
| [9] |
Van Bortel T, Basnayake A, Wurie F, et al. (2016) Psychosocial effects of an Ebola outbreak at individual, community and international levels. Bull World Health Organ 94: 210. https://doi.org/10.2471/BLT.15.158543
|
| [10] |
Ambrosetti J, Macheret L, Folliet A, et al. (2021) Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study. Int J Environ Res Public Health 18: 1174. https://doi.org/10.3390/ijerph18031174
|
| [11] |
Amerio A, Lugo A, Stival C, et al. (2021) COVID-19 lockdown impact on mental health in a large representative sample of Italian adults. J Affect Disord 292: 398-404. https://doi.org/10.1016/j.jad.2021.05.117
|
| [12] |
Yamamoto T, Uchiumi C, Suzuki N, et al. (2020) The psychological impact of ‘mild lockdown’ in Japan during the COVID-19 pandemic: a nationwide survey under a declared state of emergency. Int J Environ Res Public Health 17: 9382. https://doi.org/10.3390/ijerph17249382
|
| [13] |
Qiu J, Shen B, Zhao M, et al. (2020) A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatr 33: e100213. https://doi.org/10.1136/gpsych-2020-100213
|
| [14] |
Fullana MA, Hidalgo-Mazzei D, Vieta E, et al. (2020) Coping behaviors associated with decreased anxiety and depressive symptoms during the COVID-19 pandemic and lockdown. J Affect Disord 275: 80-81. https://doi.org/10.1016/j.jad.2020.06.027
|
| [15] |
Stanton R, To QG, Khalesi S, et al. (2020) Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults. Int J Environ Res Public Health 17: 4065. https://doi.org/10.3390/ijerph17114065
|
| [16] |
Odriozola-González P, Planchuelo-Gómez Á, Irurtia MJ, et al. (2020) Psychological symptoms of the outbreak of the COVID-19 confinement in Spain. J Health Psychol 27: 825-835. https://doi.org/10.1177/1359105320967086
|
| [17] |
Zhao H, He X, Fan G, et al. (2020) COVID-19 infection outbreak increases anxiety level of general public in China: involved mechanisms and influencing factors. J Affect Disord 276: 446-452. https://doi.org/10.1016/j.jad.2020.07.085
|
| [18] | Le XTT, Dang KA, Toweh J, et al. (2020) Evaluating the psychological impacts related to COVID-19 of Vietnamese people under the first nationwide partial lockdown in Vietnam. Front Psychiatry 11: 824. https://doi.org/10.3389/fpsyt.2020.00824 |
| [19] |
Traunmüller C, Stefitz R, Gaisbachgrabner K, et al. (2020) Psychological correlates of COVID-19 pandemic in the Austrian population. BMC Public Health 20: 1395. https://doi.org/10.1186/s12889-020-09489-5
|
| [20] | Larionov PM, Mudło-Głagolska K (2020) Mental Health Risk Factors during COVID-19 Pandemic in the Polish Population. Psychiatr Pol 56: 289-296. https://doi.org/10.31234/osf.io/3ku8w |
| [21] |
Rodríguez-Rey R, Garrido-Hernansaiz H, Collado S (2020) Psychological impact and associated factors during the initial stage of the coronavirus (COVID-19) pandemic among the general population in Spain. Front Psychol 11: 1540. https://doi.org/10.3389/fpsyg.2020.01540
|
| [22] |
El-Zoghby SM, Soltan EM, Salama HM (2020) Impact of the COVID-19 Pandemic on Mental Health and Social Support among Adult Egyptians. J Community Health 45: 689-695. https://doi.org/10.1007/s10900-020-00853-5
|
| [23] |
Varshney M, Parel JT, Raizada N, et al. (2020) Initial psychological impact of COVID-19 and its correlates in Indian Community: An online (FEEL-COVID) survey. PLoS One 15: e0233874. https://doi.org/10.1371/journal.pone.0233874
|
| [24] |
Ramírez LPG, Arriaga RJM, Hernández-Gonzale MA, et al. (2020) Psychological distress and signs of post-traumatic stress in response to the COVID-19 health emergency in a Mexican sample. Psychol Res Behav Manag 13: 589-597. https://doi.org/10.2147/PRBM.S259563
|
| [25] |
Wang C, Pan R, Wan X, et al. (2020) Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health 17: 1729. https://doi.org/10.3390/ijerph17051729
|
| [26] |
Mazza C, Ricci E, Biondi S, et al. (2020) A nationwide survey of psychological distress among italian people during the COVID-19 pandemic: Immediate psychological responses and associated factors. Int J Environ Res Public Health 17: 3165. https://doi.org/10.3390/ijerph17093165
|
| [27] |
Alkhamees AA, Alrashed SA, Alzunaydi AA, et al. (2020) The psychological impact of COVID-19 pandemic on the general population of Saudi Arabia. Compr Psychiatry 102: 152192. https://doi.org/10.1016/j.comppsych.2020.152192
|
| [28] | Devilly GJ, Assessment Devices, The University of Melbourne, Forensic Psychology & Victim Services. Available from: http://www.criminology.unimelb.edu.au/victims/resources/assessment/assessment.html. |
| [29] | Çorapçioğlu A, Yargiç İ, Geyran P, et al. (2006) This study was designed to determine the validity and reliability of Turkish version of Impact of Event Scale-Revised (IES-R). Yeni Symposium 44: 14-22. |
| [30] | Lovibond SH, Lovibond PF (1995) Manual for the Depression Anxiety Stress Scales. Syd Psychol Found . https://doi.org/10.1037/t01004-000 |
| [31] | Sariçam H (2018) The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. Bilişsel Davranişçi Psikoterapi ve Araştirmalar Dergisi 7: 19-30. https://doi.org/10.5455/JCBPR.274847 |
| [32] | Lök N, Bademli K (2017) Determination of the relationship between physical activity and depression in adult individuals. Mustafa Kemal Univ J Soc Sci Inst 14: 101-110. |
| [33] |
Hsu TL, Barrett AE (2020) The association between marital status and psychological well-being: variation across negative and positive dimensions. J Fam Issues 41: 2179-2202. https://doi.org/10.1177/0192513X20910184
|
| [34] |
Soulsby LK, Bennett KM (2015) Marriage and psychological wellbeing: The role of social support. Psychology 6: 1349-1359. https://doi.org/10.4236/psych.2015.611132
|
| [35] | Bhat MA, Joshi J (2020) Impact of Unemployment on the Mental Health of Youth in the Kashmir Valley. J Psychol Psychother 10: 373. |
| [36] |
Bosmans MW, Van der Velden PG (2018) The effect of employment status in postdisaster recovery: a longitudinal comparative study among employed and unemployed affected residents. J Trauma Stress 31: 460-466. https://doi.org/10.1002/jts.22282
|
| [37] |
Newby J, O'Moore K, Tang S, et al. (2020) Acute mental health responses during the COVID-19 pandemic in Australia. PLoS One 15: e0236562. https://doi.org/10.1371/journal.pone.0236562
|
| [38] |
Zuelke AE, Luck T, Schroeter ML, et al. (2018) The association between unemployment and depression–Results from the population-based LIFE-adult-study. J Affect Disord 235: 399-406. https://doi.org/10.1016/j.jad.2018.04.073
|
| [39] |
Feldner MT, Babson KA, Zvolensky MJ (2007) Smoking, traumatic event exposure, and post-traumatic stress: A critical review of the empirical literature. Clin Psychol Rev 27: 14-45. https://doi.org/10.1016/j.cpr.2006.08.004
|
| [40] |
Fluharty M, Taylor AE, Grabski M, et al. (2016) The association of cigarette smoking with depression and anxiety: a systematic review. Nicotine Tob Res 19: 3-13. https://doi.org/10.1093/ntr/ntw140
|
| [41] |
Moylan S, Jacka FN, Pasco JA, et al. (2013) How cigarette smoking may increase the risk of anxiety symptoms and anxiety disorders: a critical review of biological pathways. Brain Behav 3: 302-326. https://doi.org/10.1002/brb3.137
|
| [42] |
Taylor AE, Fluharty ME, Bjørngaard JH, et al. (2014) Investigating the possible causal association of smoking with depression and anxiety using Mendelian randomisation meta-analysis: the CARTA consortium. BMJ Open 4: e006141. https://doi.org/10.1136/bmjopen-2014-006141
|
| [43] | Ahmed N, Maqsood A, Abduljabbar T, et al. (2020) Tobacco Smoking a Potential Risk Factor in Transmission of COVID-19 Infection. Pak J Med Sci 36: S104-S107. https://doi.org/10.12669/pjms.36.COVID19-S4.2739 |
| [44] |
Zhou F, Yu T, Du R, et al. (2020) Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 395: 1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3
|
| [45] |
Wang B, Li R, Lu Z, et al. (2020) Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging 12: 6049. https://doi.org/10.18632/aging.103000
|
| [46] | Sun L, Sun Z, Wu L, et al. (2020) Prevalence and Risk Factors of Acute Posttraumatic Stress Symptoms during the COVID-19 Outbreak in Wuhan, China. MedRxiv 10: 06.20032425. https://doi.org/10.1101/2020.03.06.20032425 |
| [47] |
Wang D, Hu B, Hu C, et al. (2020) Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 323: 1061-1069. https://doi.org/10.1001/jama.2020.1585
|
| [48] |
DeJesus RS, Breitkopf CR, Ebbert JO, et al. (2016) Associations between anxiety disorder diagnoses and body mass index differ by age, sex and race: a population based study. Clin Pract Epidemiol Ment Health 12: 67-74. https://doi.org/10.2174/1745017901612010067
|
| [49] | Moghimi-Dehkordi B, Safaee A, Vahedi M, et al. (2011) Association between perceived depression, anxiety and stress with Body Mass Index: results from a community-based cross-sectional survey in Iran. Ital J Public Health . https://doi.org/10.2427/5655 |
| [50] |
Zhao G, Ford S, Dhingra S, et al. (2009) Depression and anxiety among US adults: associations with body mass index. Int J Obes 33: 257-266. https://doi.org/10.1038/ijo.2008.268
|
| [51] | OECDCOVID-19: Protectıng people and societies (2020). Available from: https://www.oecd.org/inclusive-growth/resources/COVID-19-Protecting-people-and-societies.pdf. |
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Bahar Kefeli Çol, Ayşe Gümüşler Başaran, Hilal Pekmezci. COVID-19 pandemic: Evaluating its psychological impact and individuals' depression, anxiety, and stress levels[J]. AIMS Public Health, 2023, 10(3): 507-523. doi: 10.3934/publichealth.2023036
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