Prevalence of Anxiety and Depression in the Iranian General Population during the COVID-19 Pandemic: A Web-Based Cross-Sectional Study
-
Saman Maroufizadeh
,
Majid Pourshaikhian
,
Ali Pourramzani
,
Farzaneh Sheikholeslami
,
Mohammad Taghi Moghadamnia
,
Seyed Amirhossein Alavi
Abstract
Objective: This study aimed to determine prevalence of anxiety and depression and associated factors in the general population of Iran during the COVID-19 pandemic.
Method: We conducted this web-based cross-sectional study on 5328 individuals in Iran between 17th and 29th of April 2020. Data were collected using the convenience sampling method through an anonymous online questionnaire via social media like WhatsApp and Telegram. The online survey collected data on demographic variables, COVID-19-related variables, and symptoms of anxiety and depression. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), respectively. Simple and multiple logistic regression analyses were performed to determine independent predictors of anxiety and depression.
Results: The mean GAD-7 and PHQ-9 total scores were 7.17 (SD = 5.42) and 7.80 (SD = 6.68), respectively. Prevalence of anxiety, depression, and comorbid anxiety-depression were 30.1%, 33.4%, and 22.1%, respectively. According to the adjusted analysis, anxiety was significantly associated with female gender, being young and middle-aged, being unemployed or a housewife, having chronic diseases, spending considerable time thinking about COVID-19, having family members, friends, and/or relatives infected with COVID-19, and death of family members, relatives or friends due to COVID-19. Same results were also found for depression. Furthermore, depression was associated with being single, being resident in urban area, and having high risk individual in family.
Conclusion: Prevalence of anxiety and depression were considerably higher in the general population of Iran during the COVID-19 pandemic. In addition, the findings suggest that more attention needs to be paid to vulnerable groups such as women, young/middle-aged adults, the unemployed, and people with chronic disease.
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26. Ueda M, Stickley A, Sueki H, Matsubayashi T. Mental health status of the general population in Japan during the COVID-19 pandemic. Psychiatry Clin Neurosci. 2020;74(9):505-506.
27. Sigdel A, Bista A, Bhattarai N, Chandra Pun P, Giri G, Marqusee H, et al. Depression, Anxiety and Depression-anxiety comorbidity amid COVID-19 Pandemic: An online survey conducted during lockdown in Nepal. medRxiv. 2020; 20086926.
28. Solomou I, Constantinidou F. Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter. Int J Environ Res Public Health. 2020;17(14):4924.
29. Shevlin M, McBride O, Murphy J, Miller JG, Hartman TK, Levita L, et al. Anxiety, depression, traumatic stress and COVID-19-related anxiety in the UK general population during the COVID-19 pandemic. BJPsych Open. 2020;6(6):e125.
30. Hyland P, Shevlin M, McBride O, Murphy J, Karatzias T, Bentall RP, et al. Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic. Acta Psychiatr Scand. 2020;142(3):249-56.
31. Pieh C, Budimir S, Probst T. The effect of age, gender, income, work, and physical activity on mental health during coronavirus disease (COVID-19) lockdown in Austria. J Psychosom Res. 2020;136:110186.
32. Bäuerle A, Teufel M, Musche V, Weismüller B, Kohler H, Hetkamp M, et al. Increased generalized anxiety, depression and distress during the COVID-19 pandemic: a cross-sectional study in Germany. J Public Health (Oxf). 2020;42(4):672-8.
33. Fullana MA, Hidalgo-Mazzei D, Vieta E, Radua J. Coping behaviors associated with decreased anxiety and depressive symptoms during the COVID-19 pandemic and lockdown. J Affect Disord. 2020;275:80-1.
34. Watterson RA, Williams JV, Lavorato DH, Patten SB. Descriptive Epidemiology of Generalized Anxiety Disorder in Canada. Can J Psychiatry. 2017;62(1):24-9.
35. Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119-38.
36. Liu X, Liu J, Zhong X. Psychological State of College Students During COVID-19 Epidemic. SSRN Electron J. 2020. Available at SSRN: https://ssrn.com/abstract=3552814
37. Zhu J, Su L, Zhou Y, Qiao J, Hu W. The effect of nationwide quarantine on anxiety levels during the COVID-19 outbreak in China. Brain Behav. 2021;11(1):e01938.
2. 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.
3. 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.
4. Smith EM. Ethnic minorities: Life stress, social support, and mental health issues. The Counseling Psychologist. 1985;13(4):537-79.
5. Fiorillo A, Gorwood P. The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. Eur Psychiatry. 2020;63(1):e32.
6. Cowling BJ, Ng DM, Ip DK, Liao Q, Lam WW, Wu JT, et al. Community psychological and behavioral responses through the first wave of the 2009 influenza A(H1N1) pandemic in Hong Kong. J Infect Dis. 2010;202(6):867-76.
7. Ko CH, Yen CF, Yen JY, Yang MJ. Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan. Psychiatry Clin Neurosci. 2006;60(4):397-403.
8. Lu YC, Shu BC, Chang YY, Lung FW. The mental health of hospital workers dealing with severe acute respiratory syndrome. Psychother Psychosom. 2006;75(6):370-5.
9. Bai Y, Lin CC, Lin CY, Chen JY, Chue CM, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004;55(9):1055-7.
10. Page LA, Seetharaman S, Suhail I, Wessely S, Pereira J, Rubin GJ. Using electronic patient records to assess the impact of swine flu (influenza H1N1) on mental health patients. J Ment Health. 2011;20(1):60-9.
11. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206-12.
12. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7.
13. Omani-Samani R, Maroufizadeh S, Ghaheri A, Navid B. Generalized Anxiety Disorder-7 (GAD-7) in people with infertility: A reliability and validity study. Middle East Fertil Soc J. 2018; 23(4):446-9.
14. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.
15. Maroufizadeh S, Omani-Samani R, Almasi-Hashiani A, Amini P, Sepidarkish M. The reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with infertility. Reprod Health. 2019;16(1):137.
16. Qian M, Wu Q, Wu P, Hou Z, Liang Y, Cowling BJ, Yu H. Anxiety levels, precautionary behaviours and public perceptions during the early phase of the COVID-19 outbreak in China: a population-based cross-sectional survey. BMJ Open. 2020;10(10):e040910.
17. Liu D, Ren Y, Yan F, Li Y, Xu X,Yu X, et al. Psychological Impact and Predisposing Factors of the Coronavirus Disease 2019 (COVID-19) Pandemic on General Public in China. SSRN Electron J. 2020. Available at SSRN: https://ssrn.com/abstract=3551415
18. 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.
19. Li J, Yang Z, Qiu H, Wang Y, Jian L, Ji J, et al. Anxiety and depression among general population in China at the peak of the COVID-19 epidemic. World Psychiatry. 2020;19(2):249-50.
20. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934.
21. Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C, et al. 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. 2020;17(9):3165.
22. Lv Y, Yao H, Xi Y, Zhang Z, Zhang Y, Chen J, et al. Social support protects Chinese medical staff from suffering psychological symptoms in COVID-19 defense. 2020.
23. Lv Y, Zhang Z, Zeng W, Li J, Wang X, Luo G. Anxiety and depression survey of Chinese medical staff before and during COVID-19 defense. Available at SSRN 3551350. 2020.
24. Ying Y, Ruan L, Kong F, Zhu B, Ji Y, Lou Z. Mental health status among family members of health care workers in Ningbo, China, during the coronavirus disease 2019 (COVID-19) outbreak: a cross-sectional study. BMC Psychiatry. 2020;20(1):379.
25. Banna MHA, Sayeed A, Kundu S, Christopher E, Hasan MT, Begum MR, et al. The impact of the COVID-19 pandemic on the mental health of the adult population in Bangladesh: a nationwide cross-sectional study. Int J Environ Health Res. 2020:1-12.
26. Ueda M, Stickley A, Sueki H, Matsubayashi T. Mental health status of the general population in Japan during the COVID-19 pandemic. Psychiatry Clin Neurosci. 2020;74(9):505-506.
27. Sigdel A, Bista A, Bhattarai N, Chandra Pun P, Giri G, Marqusee H, et al. Depression, Anxiety and Depression-anxiety comorbidity amid COVID-19 Pandemic: An online survey conducted during lockdown in Nepal. medRxiv. 2020; 20086926.
28. Solomou I, Constantinidou F. Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter. Int J Environ Res Public Health. 2020;17(14):4924.
29. Shevlin M, McBride O, Murphy J, Miller JG, Hartman TK, Levita L, et al. Anxiety, depression, traumatic stress and COVID-19-related anxiety in the UK general population during the COVID-19 pandemic. BJPsych Open. 2020;6(6):e125.
30. Hyland P, Shevlin M, McBride O, Murphy J, Karatzias T, Bentall RP, et al. Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic. Acta Psychiatr Scand. 2020;142(3):249-56.
31. Pieh C, Budimir S, Probst T. The effect of age, gender, income, work, and physical activity on mental health during coronavirus disease (COVID-19) lockdown in Austria. J Psychosom Res. 2020;136:110186.
32. Bäuerle A, Teufel M, Musche V, Weismüller B, Kohler H, Hetkamp M, et al. Increased generalized anxiety, depression and distress during the COVID-19 pandemic: a cross-sectional study in Germany. J Public Health (Oxf). 2020;42(4):672-8.
33. Fullana MA, Hidalgo-Mazzei D, Vieta E, Radua J. Coping behaviors associated with decreased anxiety and depressive symptoms during the COVID-19 pandemic and lockdown. J Affect Disord. 2020;275:80-1.
34. Watterson RA, Williams JV, Lavorato DH, Patten SB. Descriptive Epidemiology of Generalized Anxiety Disorder in Canada. Can J Psychiatry. 2017;62(1):24-9.
35. Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119-38.
36. Liu X, Liu J, Zhong X. Psychological State of College Students During COVID-19 Epidemic. SSRN Electron J. 2020. Available at SSRN: https://ssrn.com/abstract=3552814
37. Zhu J, Su L, Zhou Y, Qiao J, Hu W. The effect of nationwide quarantine on anxiety levels during the COVID-19 outbreak in China. Brain Behav. 2021;11(1):e01938.
| Files | ||
| Issue | Vol 17 No 2 (2022) | |
| Section | Original Article(s) | |
| Keywords | ||
| Anxiety COVID-19 Depression Population Iran | ||
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How to Cite
1.
Maroufizadeh S, Pourshaikhian M, Pourramzani A, Sheikholeslami F, Moghadamnia MT, Alavi SA. Prevalence of Anxiety and Depression in the Iranian General Population during the COVID-19 Pandemic: A Web-Based Cross-Sectional Study. Iran J Psychiatry. 2022;17(2):230-239.
