Depression, Anxiety, Perceived Stress and Family Support in COVID-19 Patients
Abstract
Objective: Coronavirus disease 2019 (COVID-19) was first reported in Iran in February 2020 and then quickly spread to many cities. Different factors contribute to the numerous psychological problems of this pandemic in patients, healthcare workers and the community. This study investigated the prevalence of perceived stress, anxiety and depression in COVID-19 patients hospitalized between March and April 2020 and revealed associations of these factors with social support received from family.
Method: In this cross-sectional study, patients with COVID-19 admitted between 21st of March and 22nd of April 2020 were evaluated by three questionnaires: Anxiety and depression were evaluated using the hospital anxiety and depression scale (HADS), stress levels were evaluated using the four-item perceived stress scale (PSS-4) and family support was evaluated using the perceived social support scale-family (PSS-Fa). In addition to obtaining prevalence of the noted psychological disorders and their relationship with demographic details, relationship of stress, anxiety and depression with family support was also investigated using the Pearson’s correlation coefficient.
Results: Participants comprised 100 COVID-19 patients (38 females and 62 males). Findings suggested high levels of perceived stress in 26% of the participants, anxiety symptoms existed in 29% and borderline conditions existed in 17%. Moreover, depressive and its borderline symptoms were respectively observed in 17% and 23%. Family support was found to negatively and significantly correlated with anxiety (Pearson correlation = -0.249, P < 0.05) and depression. (Pearson correlation = -0.221, P < 0.05).
Conclusion: Given the high prevalence of anxiety and depression in hospitalized COVID-19 patients, it is recommended to further focus on non-clinical interventions, such as providing psychological first aids, boosting psychological resilience, and enabling greater family support, in efforts to prevent transformation of these psychological symptoms into long-term psychological disorders.
2. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, Zheng J. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry research. 2020 May 1; 287:1129
3. Takian A, Raoofi A, Kazempour-Ardebili S. COVID-19 battle during the toughest sanctions against Iran. Lancet. 2020;395(10229):1035-6.
4. Cascella M, Rajnik M, Aleem A, Dulebohn SC, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus (COVID-19). StatPearls. Treasure Island (FL): StatPearls Publishing
Copyright © 2022, StatPearls Publishing LLC.; 2022.
5. Carvalho PMM, Moreira MM, de Oliveira MNA, Landim JMM, Neto MLR. The psychiatric impact of the novel coronavirus outbreak. Psychiatry Res. 2020;286:112902.
6. Zhou X, Snoswell CL, Harding LE, Bambling M, Edirippulige S, Bai X, et al. The Role of Telehealth in Reducing the Mental Health Burden from COVID-19. Telemed J E Health. 2020;26(4):377-9.
7. Biondi M, Zannino LG. Psychological stress, neuroimmunomodulation, and susceptibility to infectious diseases in animals and man: a review. Psychother Psychosom. 1997;66(1):3-26.
8. Segerstrom SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull. 2004;130(4):601-30.
9. Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851-8.
10. Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020;52:102066.
11. 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):1729.
12. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385-96.
13. Leung DY, Lam TH, Chan SS. Three versions of Perceived Stress Scale: validation in a sample of Chinese cardiac patients who smoke. BMC Public Health. 2010;10:513.
14. Maroufizadeh S, Zareiyan A, Sigari N. Reliability and validity of Persian version of perceived stress scale (PSS-10) in adults with asthma. Arch Iran Med. 2014;17(5):361-5.
15. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica scandinavica. 1983;67(6):361-70.
16. Hinz A, Brähler E. Normative values for the hospital anxiety and depression scale (HADS) in the general German population. J Psychosom Res. 2011;71(2):74-8.
17. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health Qual Life Outcomes. 2003;1:14.
18. Procidano ME, Heller K. Measures of perceived social support from friends and from family: three validation studies. Am J Community Psychol. 1983;11(1):1-24.
19. Bagherian-Sararoudi R, Hajian A, Ehsan HB, Sarafraz MR, Zimet GD. Psychometric properties of the persian version of the multidimensional scale of perceived social support in iran. Int J Prev Med. 2013;4(11):1277-81.
20. Sharifi V, Amin-Esmaeili M, Hajebi A, Motevalian A, Radgoodarzi R, Hefazi M, et al. Twelve-month prevalence and correlates of psychiatric disorders in Iran: the Iranian Mental Health Survey, 2011. Arch Iran Med. 2015;18(2):76-84.
21. Nakhostin-Ansari A, Sherafati A, Aghajani F, Khonji MS, Aghajani R, Shahmansouri N. Depression and Anxiety among Iranian Medical Students during COVID-19 Pandemic. Iran J Psychiatry. 2020;15(3):228-35.
22. Judd LL, Akiskal HS, Paulus MP. The role and clinical significance of subsyndromal depressive symptoms (SSD) in unipolar major depressive disorder. J Affect Disord. 1997;45(1-2):5-17; discussion -8.
23. Goldney RD, Fisher LJ, Dal Grande E, Taylor AW. Subsyndromal depression: prevalence, use of health services and quality of life in an Australian population. Soc Psychiatry Psychiatr Epidemiol. 2004;39(4):293-8.
24. Pouralizadeh M, Bostani Z, Maroufizadeh S, Ghanbari A, Khoshbakht M, Alavi SA, et al. Anxiety and depression and the related factors in nurses of Guilan University of Medical Sciences hospitals during COVID-19: A web-based cross-sectional study. Int J Afr Nurs Sci. 2020;13:100233.
25. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954.
26. Zandifar A, Badrfam R, Yazdani S, Arzaghi SM, Rahimi F, Ghasemi S, et al. Prevalence and severity of depression, anxiety, stress and perceived stress in hospitalized patients with COVID-19. J Diabetes Metab Disord. 2020;19(2):1431-8.
27. Kong X, Zheng K, Tang M, Kong F, Zhou J, Diao L, Wu S, Jiao P, Su T, Dong Y. Prevalence and factors associated with depression and anxiety of hospitalized patients with COVID-19. MedRxiv. 2020 Jan 1.
28. Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont). 2007;4(5):35-40.
29. Abbaszadeh M, Allameh SF, Sadeghniiat Haghighi K, RaeesKarami SR, Karimpour Reihan S. Positive Perspectives of the Predicament of COVID-19. Front Emerg Med. 2020;4(2s):e46.
Files | ||
Issue | Vol 17 No 3 (2022) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijps.v17i3.9725 | |
Keywords | ||
Anxiety COVID-19 Depression Stress Social Support |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |