Original Article

Mental Health Status among Hospitalized Patients with COVID-19 in Iran


Objective: The recent escalated numbers of subjected COVID-19 patients and mortality rates have alerted the general population and authorities to its effects not only on physical health but also on different aspects of the society such as mental health. This study assesses the general mental health and immediate psychological impacts in hospitalized patients with COVID-19.

Method: In this cross-sectional study, 88 patients from two tertiary hospitals in Tehran agreed to complete the surveys. The Impact of Event Scale-Revised (IES-R) and 12 item General Health questionnaire (GHQ-12) were used to evaluate mental health and impact of disease. Epidemiological and sociodemographic information entailing underlying diseases was assess by a researcher-made questionnaire.

Results: We found that the psychological impact of the current pandemic is mild to moderate. During the initial phase of the pandemic, the intellectual engagements, inducing post event stress is not yet entirely developed. However, patients had a moderate to high probability of psychiatric morbidity with 63.6% and 28.4%, respectively.

Conclusion: The effect of such viral pandemic on mental health is inevitable. As we conducted the study in the dire times of the outbreak, patients showed a high probability of psychiatric morbidity. On the other hand, since the study was done in the initial phase of the epidemic, we detected mild effects of the epidemic on PTSD in COVID-19 patients. Furthermore, several psychosocial protective programs should be implicated to address the mental complications.

1. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433.
2. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-207.
3. Taghrir MH, Akbarialiabad H, Ahmadi Marzaleh M. Efficacy of Mass Quarantine as Leverage of Health System Governance During COVID-19 Outbreak: A Mini Policy Review. Arch Iran Med. 2020;23(4):265-7.
4. Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Ann Intern Med. 2020;172(9):577-82.
5. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. 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. 2020;17(5): 1-25.
6. Tang W, Hu T, Hu B, Jin C, Wang G, Xie C, et al. Prevalence and correlates of PTSD and depressive symptoms one month after the outbreak of the COVID-19 epidemic in a sample of home-quarantined Chinese university students. J Affect Disord. 2020;274:1-7.
7. Mak IW, Chu CM, Pan PC, Yiu MG, Ho SC, Chan VL. Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors. Gen Hosp Psychiatry. 2010;32(6):590-8.
8. Kinsman J. "A time of fear": local, national, and international responses to a large Ebola outbreak in Uganda. Global Health. 2012;8:15.
9. Delamou A, Camara BS, Kolie JP, Guemou AD, Haba NY, Marquez S, et al. Profile and reintegration experience of Ebola survivors in Guinea: a cross-sectional study. Trop Med Int Health. 2017;22(3):254-60.
10. Torjesen I. Covid-19: Mental health services must be boosted to deal with "tsunami" of cases after lockdown. Bmj. 2020;369:m1994.
11. Pfefferbaum B, North CS. Mental Health and the Covid-19 Pandemic. N Engl J Med. 2020 Aug 6;383(6):510–2.
12. Weiss DS. The impact of event scale: revised. In Wilson JP, So-kum Tang C. Cross-cultural assessment of psychological trauma and PTSD. Springer.2007;219-38.
13. Brewin CR. Systematic review of screening instruments for adults at risk of PTSD. J Trauma Stress. 2005;18(1):53-62.
14. Peters M, Passchier J. Translating instruments for cross-cultural studies in headache research. Headache. 2006;46(1):82-91.
15. L. Panaghi, M. Hakim shooshtari, J. Atari Mogadam. Persian version validation in impact of event Scale-Revised. Tehran Univ Med J. 2006; 64 (3) :52-60.
16. Werneke U, Goldberg DP, Yalcin I, Üstün BT. The stability of the factor structure of the general health questionnaire. Psychol Med 2000, 30: 823-9.
17. Sánchez-López Mdel P, Dresch V. The 12-Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population. Psicothema. 2008;20(4):839-43.
18. Hankins M. The reliability of the twelve-item general health questionnaire (GHQ-12) under realistic assumptions. BMC Public Health. 2008;8:355.
19. Rahmati Najarkolaei F, Raiisi F, Rahnama P, Gholami Fesharaki M, Zamani O, Jafari MR, et al. Factor structure of the Iranian version of 12-item general health questionnaire. Iran Red Crescent Med J. 2014;16(9):e11794.
20. Lau JT, Yang X, Pang E, Tsui HY, Wong E, Wing YK. SARS-related perceptions in Hong Kong. Emerg Infect Dis. 2005;11(3):417-24.
21. Lee AM, Wong JG, McAlonan GM, Cheung V, Cheung C, Sham PC, et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. Can J Psychiatry. 2007;52(4):233-40.
22. Wu KK, Chan SK, Ma TM. Posttraumatic stress after SARS. Emerg Infect Dis. 2005;11(8):1297-300.
23. Sun L, Sun Z, Wu L, Zhu Z, Zhang F, et al. Prevalence and risk factors of acute posttraumatic stress symptoms during the COVID-19 outbreak. J Affect Disord. 2021 ; 283: 123–29.
24. Rubin GJ, Brewin CR, Greenberg N, Simpson J, Wessely S. Psychological and behavioural reactions to the bombings in London on 7 July 2005: Cross sectional survey of a representative sample of Londoners. Br Med J. 2005 ;331(7517):606–11.
25. Drury J, Cocking C, Reicher S. The Nature of Collective Resilience: Survivor Reactions to the 2005 London Bombings. Int J Mass Emerg Disasters. 2009; 27(1): 66–95.
26. Fathian M, Akhavan P, Hoorali M. E-readiness assessment of non-profit ICT SMEs in a developing country: The case of Iran. Technovation. 2008;28(9):578-90.
27. Houshangi T, Woods P, Tee SH. A conceptual model for behavioral intention of the elderly to use internet services in Iran. 2016 22nd International Conference on Virtual System & Multimedia (VSMM). 2016; 1-4.
28. Gao J, Zheng P, Jia Y, Chen H, Mao Y, Chen S, et al. Mental health problems and social media exposure during COVID-19 outbreak. PLoS One. 2020;15(4):e0231924.
29. Plomecka MB, Gobbi S, Neckels R, Radziński P, Skórko B, Lazerri S, Almazidou K, Dedić A, Bakalović A, Hrustić L, Ashraf Z. Mental Health Impact of COVID-19: A global study of risk and resilience factors. MedRxiv. 2020 Jan 1.
30. Farhoudian A, Sharifi V, Amini H, Basirnia A, Mesgarpour B, Mansouri N, et al. Prevalence of psychiatric disorders in Iran: A systematic review. Iran J Psychiatry. 2007; 2:137-50.
31. Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020;52:102066.
32. Xiao H, Zhang Y, Kong D, Li S, Yang N. The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit. 2020;26:e923549.
33. Tomlinson B, Cockram C. Sars: Experience at prince of wales hospital, hong kong. Lancet. 2003; 361(9368):1486-7.
34. Jeong H, Yim HW, Song YJ, Ki M, Min JA, Cho J, et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health. 2016;38:e2016048.
35. Jang SN, Cho SI, Chang J, Boo K, Shin HG, Lee H, et al. Employment status and depressive symptoms in Koreans: results from a baseline survey of the Korean Longitudinal Study of Aging. J Gerontol B Psychol Sci Soc Sci. 2009;64(5):677-83.
36. Ahmad A, Rahman I, Agarwal M. Early psychosocial predictors of mental health among Indians during coronavirus disease 2019 outbreak. 2020;10(2):147-56.
37. Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol Health Med. 2021;26(1):13-22.
38. Jeong H, Yim HW, Song YJ, Ki M, Min JA, Cho J, et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health. 2016;38:e2016048.
39. Carroll BJ, Greden JF, Haskett R, Feinberg M, Albala AA, Martin FIR, et al. NEUROTRANSMITTER STUDIES OF NEUROENDOCRINE PATHOLOGY IN DEPRESSION. Acta Psychiatr Scand. 1980;61(S280):183-99.
40. Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):e21.
41. Meyer CM, Armenian HK, Eaton WW, Ford DE. Incident hypertension associated with depression in the Baltimore Epidemiologic Catchment area follow-up study. J Affect Disord. 2004;83(2-3):127-33.
42. Schulberg HC, McClelland M, Burns BJ. Depression and physical illness: The prevalence, causation, and diagnosis of comorbidity. Clin Psychol Rev.1987; 7(2): 145-167.
43. Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int J Soc Psychiatry. 2020;66(5):504-11.
44. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The Epidemiology of Major Depressive Disorder: Results from the National Comorbidity Survey Replication (NCS-R).JAMA. 2003; 289(23):3095–3105.
45. Lee SA. Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401.
46. Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol Health Med. 2021;26(1):13-22.
47. Kilzieh N, Rastam S, Maziak W, Ward KD. Comorbidity of depression with chronic diseases: a population-based study in Aleppo, Syria. Int J Psychiatry Med. 2008;38(2):169-84.
IssueVol 16 No 3 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijps.v16i3.6263
COVID-19 Coronavirus Mental Health Pandemic SARS-CoV-2

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How to Cite
Kheradmand A, Pirsalehi A, Mahjani M, Khoshgoui B. Mental Health Status among Hospitalized Patients with COVID-19 in Iran. Iran J Psychiatry. 16(3):362-369.