COVID-19-Related Suicides in Bangladesh Due to Lockdown and Economic Factors: Case Study Evidence from Media Reports

Predictive factors of insomnia during the COVID-19 pandemic in Bangladesh: a GIS-based nationwide distribution

Background

In a densely populated country like Bangladesh, mental health-related burden and associated adverse outcomes are quite prevalent. However, exploration of sleep-related issues in general, and more specifically of insomnia during the COVID-19 pandemic has been scarce and restricted to a single location. The present study investigated the prevalence of insomnia and its predictive factors in the general population, and included Geographic Information System (GIS) analysis to identify regional heterogeneities of insomnia in Bangladesh.

Methods

This cross-sectional study was conducted during the early period of the COVID-19 pandemic. Information related to socio-demographics, knowledge of COVID-19, behaviors related to COVID-19, fear of COVID-19, and insomnia were included in a questionnaire, and coupled with GIS-based spatial analysis to identify regional susceptibility to insomnia.

Results

Approximately 30.4%, 13.1% and 2.8% of participants reported sub-threshold, moderate, and severe forms of insomnia, respectively. Independent predictive risk factors of insomnia symptoms included female gender, college education, urban residence, presence of comorbidities, using social media, taking naps during daytime, and fear of COVID-19. District-wide variations in the spatial distribution of fear of COVID-19 and insomnia were significantly associated.

Conclusion

Insomnia is frequently present during a pandemic, and exhibits regional variability along with multifactorial determinants. These analytic approaches should enable improved detection and targeting of at-risk sectors of the population, and enable implementation of appropriate measures to ensure improved sleep quality.

Fear of COVID-19 and Mental Health: The Role of Mindfulness in During Times of Crisis

The novel coronavirus disease (COVID-19) has had a significant impact on all aspects of individuals' lives, particularly their mental health due to the fear associated with the pandemic. Thus, the current study explored the relationship between the fear of COVID-19 and aspects of mental health, namely anxiety and depression, and will consider whether this relationship can be mediated by mindfulness. Data were collected from a student sample of 355 participants (71.5% female and 28.5% male) ranging between 18 and 41 years of age (M = 22.41 ± 3.27), with participants completing a fear of COVID-19 scale (FCV-19S), Mindfulness Attention and Awareness Scale (MAAS), and the anxiety and depression subscale of the Symptom Checklist-90-Revised (SCL-90-R). In terms of the results, correlational analyses indicated that fear of COVID-19 is inversely associated with mindfulness, while positive correlations were found with anxiety and depression. Structural equation modeling analyses demonstrated that mindfulness mediated the relationship between fear of COVID-19 and depression and anxiety. Associated implications are further discussed.

Depression, coping skills, and quality of life among Jordanian adults during the initial outbreak of COVID-19 pandemic: cross sectional study

Little is known about the immediate psychological impacts of the national lockdown implemented during the COVID-19 pandemic on the general population in Arab countries like Jordan. The aim of this study was to assess the levels of depression, coping skills, and quality of life and their correlates among a sample of Jordanian adults aged ≥18 years during the COVID-19 lockdown implemented in Jordan. A quantitative, descriptive, correlational, cross-sectional design was conducted using an anonymous online self-report survey to collect data on participants’ demographics, depression, coping skills, and quality of life. This study included a total of 511 participants aged 18–65 years (mean = 30, SD = 10.6), most of whom were female (n = 333, 65.2%). About 65% (n = 332) of the participants were found to be suffering from depressive symptoms and 32% (n = 163) of them had moderate to severe depression levels. Religion, acceptance, and planning were the most frequently reported coping skills. The mean total quality of life score among all of the participants was 73.21 (SD = 16.17). Female participants had significantly higher levels of depression and lower levels of quality of life than male participants. Further, age was not found to be significantly correlated with depression, coping skills, or total quality of life scores. Depression scores were significantly positively correlated with coping skills and negatively correlated with total quality of life scores. No significant correlation was found between coping skills scores and total quality of life scores in this study. Being employed, holding an undergraduate degree, having chronic physical problems, and having mental health problems were found to be significantly associated with higher levels of depression. Holding a graduate degree, being a student, having military health insurance, not having mental health problems, and being a non-smoker were found to be significantly associated with lower coping skills scores. Being female, being educated to high school level or below, having mental health problems, and having family history of chronic physical problems were found to be significantly associated with lower total quality of life scores. This study provides valuable information on the psychological impacts of the national lockdown during the initial outbreak of the COVID-19 pandemic on Jordanian adults. This information may help in the development of appropriate psychological interventions aimed at improving mental health and quality of life among at-risk groups during the COVID-19 pandemic.

Effects of the COVID-19 Emergency and National Lockdown on Italian Citizens' Economic Concerns, Government Trust, and Health Engagement: Evidence From a Two-Wave Panel Study

Policy Points Preventive measures such as the national lockdown in Italy have been effective in slowing the spread of COVID-19. However, they also had psychological and economic impacts on people's lives, which should not be neglected as they may reduce citizens' trust and compliance with future health mandates. Engaging citizens in their own health management and in the collaboration with health care professionals and authorities via the adoption of a collaborative approach to health policy development is fundamental to fostering such measures' effectiveness. Psychosocial analysis of citizens' concerns and emotional reactions to preventive policies is important in order to plan personalized health communication campaigns.

CONTEXT

Because of the COVID-19 pandemic, between February 23 and March 8, 2020, some areas of Italy were declared "red zones," with citizens asked to stay home and avoid unnecessary interpersonal contacts. Such measures were then extended, between March 10 and May 4, 2020, to the whole country. However, compliance with such behaviors had an important impact on citizens' personal, psychological, and economic well-being. This could result in reduced trust in authorities and lowered compliance. Keeping citizens engaged in their own health and in preventive behaviors is thus a key strategy for the success of such measures. This paper presents the results from a study conducted in Italy to monitor levels of people's health engagement, sentiment, trust in authorities, and perception of risk at two different time points.

METHODS

Two independent samples (n = 968 and n = 1,004), weighted to be representative of the adult Italian population, were recruited in two waves corresponding to crucial moments of the Italian COVID-19 epidemic: between February 28 and March 4 (beginning of "phase 1," after the first regional lockdowns), and between May 12 and May 18 (beginning of "phase 2," after the national lockdown was partially dismissed). Respondents were asked to complete an online survey with a series of both validated measures and ad hoc items. A series of t-tests, general linear models, and contingency tables were carried out to assess if and how our measures changed over time in different social groups.

FINDINGS

Although sense of self and social responsibility increased between the two waves, and trust toward authorities remained substantially the same, trust in science, consumer sentiment, and health engagement decreased. Our results showed that while both the level of general concern for the emergency and the perceived risk of infection increased between the two waves, in the second wave our participants reported being more concerned for the economic consequences of the pandemic than the health risk.

CONCLUSIONS

The potentially disruptive psychological impact of lockdown may hamper citizens' compliance with, and hence the effectiveness of, behavioral preventive measures. This suggests that preventive measures should be accompanied by collaborative educational plans aimed at promoting people's health engagement by making citizens feel they are partners in the health preventive endeavor and involved in the development of health policies.

COVID-19 pandemic: A review of the global lockdown and its far-reaching effects

COVID-19, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was declared a pandemic by the World Health Organization (WHO) on the 11th of March 2020, leading to some form of lockdown across almost all countries of the world. The extent of the global pandemic due to COVID-19 has a significant impact on our lives that must be studied carefully to combat it. This study highlights the impacts of the COVID-19 pandemic lockdown on crucial aspects of daily life globally, including; Food security, Global economy, Education, Tourism, hospitality, sports and leisure, Gender Relation, Domestic Violence/Abuse, Mental Health and Environmental air pollution through a systematic search of the literature. The COVID-19 global lockdown was initiated to stem the spread of the virus and 'flatten the curve' of the pandemic. However, the impact of the lockdown has had far-reaching effects in different strata of life, including; changes in the accessibility and structure of education delivery to students, food insecurity as a result of unavailability and fluctuation in prices, the depression of the global economy, increase in mental health challenges, wellbeing and quality of life amongst others. This review article highlights the impacts of the COVID-19 pandemic lockdown across the globe. As the global lockdown is being lifted in a phased manner in various countries of the world, it is necessary to explore its impacts to understand its consequences comprehensively. This will guide future decisions that will be made in a possible future wave of the COVID-19 pandemic or other global disease outbreak.

Suicidal behaviour and the coronavirus (COVID-19) pandemic: Insights from Durkheim's sociology of suicide

Whilst suicide is well established as a critical global public health burden causing around 800,000 deaths annually along with many more attempts, there is a concern that the impact of the coronavirus (COVID-19) pandemic might intensify suicidality. The purpose of this study is to draw attention to the budding correlation between the COVID-19 pandemic and suicidality from the theoretical perspective of Emile Durkheim's sociology of suicide. A review of online newspaper databases (1 January to 30 April 2020) that reported suicide cases and attempts triggered as a result of the disruptions caused by the COVID-19 pandemic were included and analysed. Out of the 28 identified cases, there were three suicide attempts, one homicide-suicide/pact-suicide, and 24 suicides spanning 10 countries. Durkheim explained the social causation of suicide and provided a four-fold suicide typology. The cases were analysed according to their appropriate typology, and classified as egoistic (9), altruistic (3), anomic (8), and fatalistic (8). Durkheim suggests that the rise and fall of suicide rates will depend on the nature of social change. As society is undergoing massive social disruption resulting from the COVID-19 pandemic, suicide rates may increase unless suicide prevention measures align with the current social reconstruction process.

An evaluation of the mental health impact of SARS-CoV-2 on patients, general public and healthcare professionals: A systematic review and meta-analysis

BACKGROUND

The global impact of COVID-19 pandemic continues to affect the lives of billions of people with recurrent waves. Healthcare systems are struggling to manage pre-existing patient care and recurring covid-19 demands. As a result, we evaluated the mental health impact using systematic review and meta-analysis.

METHODS

A comprehensive search was undertaken from April 2020 to 22nd January 2021 using multiple electronic databases. A systematic review protocol was developed and published on PROSPERO registration; CRD42020181481. A random-effects model was used to compute pooled estimates of anxiety, depression, PTSD, insomnia and suicidal thoughts.

FINDINGS

Our search yielded 11,295 studies and of those 287 met the inclusion criteria. The meta-analysis of 206 studies revealed minimal differences in prevalence of anxiety, depression, and PTSD among HCPs compared with the public during the pandemic but higher prevalence of suicidal thoughts/ideation or self-harm (11% vs 5.8%) and lower prevalence of wellbeing (28.2% vs 52.6%) among the public compared to HCPs.

INTERPRETATION

The pandemic has led to a high mental health burden especially amongst HCPs and higher suicidal ideation and lower wellbeing in general public which warrants further investigation and management globally. These findings highlight an emerging critical public health issue that requires urgent solutions.

Validation of the FCV-19 Scale and Assessment of Fear of COVID-19 in the Population of Mozambique, East Africa

PURPOSE

This study aimed to validate the Portuguese version of the Fear of COVID-19 Scale (FCV-19S) and investigate its association with sociodemographic and pandemic-related variables in the population of Mozambique.

PARTICIPANTS AND METHODS

A cross-sectional online survey recruited 387 Mozambicans aged 18 to 70 years. The psychometric properties of the Portuguese version of the FCV-19S were evaluated using confirmatory factor analysis and Rash analysis. Additionally, the association of the FCV-19S with sociodemographic and pandemic-related variables was investigated using the two-sample t-test, one-way analysis of variance, and logistic regression.

RESULTS

The unidimensional factor structure of the Portuguese version of the FCV-19S was confirmed, and the scale showed good internal consistency reliability. The FCV-19S properties tested from the Rasch analysis were satisfactory. Women and those with lower education levels had higher scores of fear. Moreover, significantly higher levels of fear were observed among those being in an at-risk group for COVID-19, having family members or friends diagnosed or with death confirmed by COVID-19, and not being confident that they would receive adequate care from the public health services in case of COVID-19 infection.

CONCLUSION

The Portuguese version of FCV-19S has strong psychometric properties and can be used to assess the fear of COVID-19 in the Portuguese-speaking population of Mozambique. As the adverse impacts of the COVID-19 pandemic on mental health represents a challenge to clinical psychiatry, and information on mental health in African countries is still scarce, our findings may assist in the planning of public mental health policies, aimed mainly at specific segments of the population, such as women and people in extreme poverty.

Impact of COVID-19 on Selected Criminal Activities in Dhaka, Bangladesh

The COVID-19 pandemic had a substantial impact on the historical criminal trend around the world. This study explores the early impact of COVID-19 lockdown on selected crimes in Dhaka, Bangladesh. Based on open data of the total number of arrests reported by Dhaka Metropolitan Police (DMP), an uninterrupted historical time series analysis is applied to evaluate the immediate impact during and after the official stay-at-home order due to COVID-19. Auto-regressive moving average (ARIMA) modeling technique was used to compute 6-month-ahead forecasts of the expected frequency of the total number of arrests for illegal arms dealing, vehicle theft, and narcotics trafficking in the absence of the pandemic. These forecasts were compared with the observed data from April 2020 to September 2020. The results suggest that the observed numbers of total arrests for vehicle thefts and illegal arms dealing are not significantly different from their predicted values. However, the observed frequency of the total number of arrests for illegal drug trafficking shows a steep upward trend, which is 75% more than that of the expected frequencies. Estimated results are used to recognize scopes and suggestions for future research on the relationship between crimes and the pandemic.

Analysing the impact of COVID-19 on the mothers of Bangladesh: hearing the unheard

Aim

The purpose of this empirical study was to understand, explore and analyse how the COVID-19 pandemic has affected the mothers of our society, with particular emphasis on Bangladesh, which has so far been a relatively unexplored area.

Subject and methods

The study adopted qualitative and interpretative methods of social research, including content analysis and a perception study of 223 respondents through a semi-structured questionnaire survey, who were selected using purposive random sampling. The data obtained from the perception study was further complemented through phone interviews.

Results

The study found that the pandemic has not affected all mothers uniformly; rather, the intensity of its impact varied depending on factors such as the occupation of mothers and their husbands and their family pattern. Despite such variation, all mothers experienced a subsequent increase in workload, challenges while availing routine health facilities and higher levels of stress, anxiety, depression and certain behavioural changes.

Conclusion

However, the worst affected have been the mothers belonging to the lower socio-economic strata because the pandemic has made them and their husbands jobless, leading them towards an uncertain future.

Variation in Non-external and External Causes of Death in Peru in Relation to the COVID-19 Lockdown

Introduction: Lockdowns are designed to slow COVID-19 transmission, but they may have unanticipated relationships with other aspects of public health. Assessing the overall pattern in population health as a country implements and relaxes a lockdown is relevant, as these patterns may not necessarily be symmetric. We aimed to estimate the changing trends in cause-specific mortality in relation to the 2020 COVID-19 related lockdowns in Peru. Methods: Based on data from the Peruvian National Death Information System (SINADEF), we calculated death rates per 10 million population to assess the trends in mortality rates for non-external and external causes of death (suicides, traffic accidents, and homicides). We compared these trends to 2018-2019, before, during, and after the lockdown, stratified by sex, and adjusted by Peruvian macro-region (Lima & Callao (capital region), Coast, Highland, and Jungle). Results: Non-external deaths presented a distinctive pattern among macro-regions, with an early surge in the Jungle and a later increase in the Highland. External deaths dropped during the lockdown, however, suicides and homicides returned to previous levels in the post-lockdown period. Deaths due to traffic accidents dropped during the lockdown and returned to pre-pandemic levels by December 2020. Conclusions: We found a sudden drop in external causes of death, with suicides and homicides returning to previous levels after the lifting of the lockdown. Non-external deaths showed a differential pattern by macro-region. A close monitoring of these trends could help identify early spikes among these causes of death and take action to prevent a further increase in mortality indirectly affected by the pandemic.

Fear of COVID-19 and Depression: A Comparative Study Among the General Population and Healthcare Professionals During COVID-19 Pandemic Crisis in Bangladesh

The COVID-19 pandemic affects individuals' mental health that can result in fear of getting COVID-19 infection and depression. As there is no prior study available, we evaluated these mental health outcomes and associated factors among the general population and healthcare professionals (HCPs) in Bangladesh. This nationwide cross-sectional study comprised 3388 individuals including 834 HCPs. The measures included socio-demographics, healthcare, and patient-care related information, the Bangla Patient Health Questionnaire, and the Bangla Fear of COVID-19 Scale. Multiple linear regression analyses were performed to identify risk factors. Just over one-quarter of the participants were depressed, and was significantly associated with COVID-19 fear. Regression analyses showed that, both in general population and HCPs, depression and fear of COVID-19 were strongly predicted by being female; however, depression was inversely associated with being married. Particularly, among the HCPs, being restless while examining a patient with flu-like symptoms and while examining a patient returning from abroad was found to be significant predictor for both depression and fear of COVID-19. HCPs who were using single protective equipment for a week had greater depression and those who felt insecure due to the pandemic had a high level of COVID-19 fear. The findings identified major psychological impacts among the participants, suggesting the urgent need to promote mental wellbeing in both general population and medical professionals.

Risk Factors and Effects of the Morbus: COVID-19 through the Biopsychosocial Model and Ecological Systems Approach to Social Work Practice

Utilizing the biopsychosocial model and the ecological systems theory, this disquisition explores on the risk factors associated with the COVID-19 pandemic. The discourse shows the interconnectedness of biological, psychological, and social domains in expatiating on the COVID-19 pandemic. It calls for the need to strengthen the resilience of the global community in the face of health outbreaks such as COVID-19. It emphasizes on the perspectives that pandemics are managed before they emerge through building systems that are resilient. Thus, it appreciates the need for a therapeutic milieu as a building block to resilience. The article calls for the adoption of a developmental stance to analyzing health outbreaks and clinical issues. The adumbration shows the reciprocity effects of the health outbreak [macrocosms] and individual factors [microcosms]. To its end, the paper implies that COVID-19 is a call for integration toward effective health planning between social policy formulators, urban and rural planners, epidemiologists, development practitioners, clinicians, researchers to mention but a few. Ultimately, the paper calls for social workers to consider a developmental-clinical social work approach which helps foster "health in all policies" so as to build resilience against the morbus and limit the proliferation of diseases.

Quarantine practices and COVID-19 transmission in a low-resource setting: Experience of Kerala, India

INTRODUCTION

Disease transmission patterns of COVID-19 have shown that masking, social distancing, contact tracing and quarantine measures are important strategies for reducing transmission. The effective implementation of quarantine is determined by the commitment of the people and monitoring by the State. The aim of the study was to find out the effectiveness of home quarantine practises and its role in determining SARS CoV2 transmission.

METHODS

Record-based retrospective cohort study was conducted among expatriates of Kerala who were on quarantine at their homes and later tested positive for SARS -CoV-2. Quarantine practises were categorised as strict room quarantine, incomplete room quarantine, home quarantine and no quarantine. Risk of transmission was assessed using risk ratios. Multiple logistic regression analysis was performed to find out the determinants of SARS CoV2 transmission.

RESULTS

The median (IQR) age and duration of quarantine of 95 study participants were found to be 35 (29, 44) years and 7 (3,13) days, respectively. Majority of the participants practised strict room quarantine (57%), whereas 11.6%, 16.8% and 14.7% practiced incomplete room, home and no quarantine, respectively. Home quarantine without room quarantine had 24 times odds for transmitting disease [OR (95%CI)): 24.14 (4.87--119.75), P < 0.001] and not being in quarantine for any duration before being diagnosed was found to be 14 times riskier when compared with strict room quarantine [OR (95%CI)): 14.44 (2.42-86.17), P = 0.003].

DISCUSSION

Low-resource settings successful in the initial phases of COVID-19 pandemic should make periodic revisions in the quarantine guidelines while continually promoting physical distancing strategies.

Suicidal behaviors and suicide risk among Bangladeshi people during the COVID-19 pandemic: An online cross-sectional survey

BACKGROUND

Suicide, a major public health concern, is a leading cause of injury and death worldwide. The present study aims to assess suicidal behaviors and suicide risk among Bangladeshi people during COVID-19.

METHODS

A cross-sectional online survey was conducted from July 10 to July 20, 2020, involving 1,415 Bangladeshi residents ages 18 years or older. Data was collected via an anonymous online questionnaire. The Suicide Behaviors Questionnaire-Revised was used to assess suicide risk. The depression and anxiety subscales of the Depression Anxiety Stress Scale 21 were used to assess depression and anxiety. Logistic regression analyses and Pearson's correlation were performed to examine the association of variables.

RESULTS

The prevalence of suicide ideation and planning among Bangladeshi people during the COVID-19 pandemic was 19.0% and 18.5%, respectively. Having suicidal risk during the COVID-19 pandemic was reported by 33.5% participants. Suicide risk was associated higher with females, divorced or widowed marital statuses and low educational attainment (i.e., secondary or below and higher secondary/diploma). Additionally, living in high COVID-19 prevalent areas, having economic loss due to the COVID-19 pandemic, relatives or acquaintances die from COVID-19, direct contact with COVID-19 patient(s), and fear of COVID-19 infection were associated with suicide risk.

CONCLUSIONS

The COVID-19 pandemic imposes significant psychological consequences on people, thus, concerned authorities should pay attention to people's mental health and focus on suicide prevention and awareness during and after the COVID-19 pandemic.

Impact of COVID-19 lockdown policy on homicide, suicide, and motor vehicle deaths in Peru

Although lockdown measures to stop COVID-19 have direct effects on disease transmission, their impact on violent and accidental deaths remains unknown. Our study aims to assess the early impact of COVID-19 lockdown on violent and accidental deaths in Peru. Based on data from the Peruvian National Death Information System, an interrupted time series analysis was performed to assess the immediate impact and change in the trend of COVID-19 lockdown on external causes of death including homicide, suicide, and traffic accidents. The analysis was stratified by sex and the time unit was every 15 days. All forms of deaths examined presented a sudden drop after the lockdown. The biggest drop was in deaths related to traffic accidents, with a reduction of 12.22 deaths per million men per month (95% CI: -14.45, -9.98) and 3.55 deaths per million women per month (95% CI:-4.81, -2.30). Homicide and suicide presented similar level drop in women, while the homicide reduction was 2.5 the size of the suicide reduction in men. The slope in homicide in men during the lock-down period increased by 6.66 deaths per million men per year (95% CI:3.18, 10.15). External deaths presented a sudden drop after the lockdown was implemented and an increase in homicide in men was observed. Falls in mobility have a natural impact on traffic accidents, however, the patterns for suicide and homicide are less intuitive and reveal important characteristics of these events, although we expect all of these changes to be transient.

Impact of COVID-19 lockdown policy on homicide, suicide, and motor vehicle deaths in Peru

Although lockdown measures to stop COVID-19 have direct effects on disease transmission, their impact on violent and accidental deaths remains unknown. Our study aims to assess the early impact of COVID-19 lockdown on violent and accidental deaths in Peru. Based on data from the Peruvian National Death Information System, an interrupted time series analysis was performed to assess the immediate impact and change in the trend of COVID-19 lockdown on external causes of death including homicide, suicide, and traffic accidents. The analysis was stratified by sex and the time unit was every 15 days. All forms of deaths examined presented a sudden drop after the lockdown. The biggest drop was in deaths related to traffic accidents, with a reduction of 12.22 deaths per million men per month (95% CI: -14.45, -9.98) and 3.55 deaths per million women per month (95% CI:-4.81, -2.30). Homicide and suicide presented similar level drop in women, while the homicide reduction was 2.5 the size of the suicide reduction in men. The slope in homicide in men during the lock-down period increased by 6.66 deaths per million men per year (95% CI:3.18, 10.15). External deaths presented a sudden drop after the lockdown was implemented and an increase in homicide in men was observed. Falls in mobility have a natural impact on traffic accidents, however, the patterns for suicide and homicide are less intuitive and reveal important characteristics of these events, although we expect all of these changes to be transient.

Theoretical Mapping of Suicidal Risk Factors During the COVID-19 Pandemic: A Mini-Review

Suicide prevention in times of COVID-19 pandemic has become more challenging than ever due to unusual circumstances. The common risk factors identified with regard to suicidal behavior are fear of COVID-19, economic instability, poor access to healthcare facilities, pre-existing psychiatric disorders, and social disconnect. The studies done so far have reported either case studies or have made an effort to understand the risk factors. An understanding of the underlying causal pattern from existing theories, behind these risks, will enable adopting appropriate prevention mechanisms. Hence, this review examines evidence related to risk factors of suicides that occurred during COVID 19 and discusses it in the light of three major theoretical approaches: interpersonal model, stress diathesis model, and cognitive model. The insights obtained from the three viewpoints reveal that perceived burdensomeness, thwarted belongingness, stress sensitivity, cognitive errors such as magnification, catastrophic thinking, arbitrary inference, and mind-reading are likely reasons behind these risk factors for suicide. It is suggested that awareness regarding COVID-19 stressors, use of community-based approaches like gatekeeper training, and brief online psychotherapy by using techniques of mindfulness, interpersonal psychotherapy, and cognitive behavior therapy can be useful in reducing suicide risk during COVID-19.

The COVID-19 pandemic and serious psychological consequences in Bangladesh: A population-based nationwide study

BACKGROUND

As with other countries worldwide, lockdown measures during the COVID-19 outbreak in Bangladesh were sudden and unexpected, and have the capacity to elicit serious psychological consequences. The present study examined the psychological consequences of COVID-19 in Bangladesh during the lockdown period.

METHODS

A nationwide online cross-sectional survey study recruited 10,067 individuals covering all 64 districts in Bangladesh via social media (April 1-10, 2020). The survey comprised questions concerning socio-demographics, knowledge of COVID-19, behavior towards COVID-19, fear of COVID-19, insomnia, depression, and suicidal ideation. Logistic regression and structural equation modeling (SEM) analyses were performed to identify the risk factors depression and suicidal ideation. Geographical information system (GIS)-based spatial analysis was used to identify district-wise susceptibility to depression and suicidal ideation.

FINDINGS

The prevalence rate of depression and suicidal ideation related to COVID-19 was 33% and 5%%. Common risk factors for suicidal ideation and depression included being young, being female, being a cigarette smoker, having comorbid diseases, having high scores on the Fear COVID-19 Scale, and having insomnia symptoms. GIS-based maps detected high depression and suicidal ideation in the capital of Bangladesh and the districts near the capital as well as coastal areas where COVID-19 prevalence was high, as compared with districts with no reported cases.

LIMITATIONS

Self-reported scales and cross-sectional design of the study.

CONCLUSION

COVID-19 is associated with major psychological impact across Bangladesh, underlining the need of strategically located psychological support measures and improved access to mental health services, especially among women and younger people.

Mental health problems and social supports in the COVID-19 healthcare workers: a Chinese explanatory study

BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread rapidly in China and other overseas areas, which has aroused widespread concern. The sharp increase in the number of patients has led to great psychological pressure on health care workers. The purpose of this study was to understand their mental health status and needs, so as to provide a scientific basis for alleviating the psychological pressure of health care workers.

METHODS

Using a cross-sectional study design, 540 health care workers were randomly selected from two designated tuberculosis medical institutions in Anhui Province. The basic situation, perceived social support, depression level, loneliness and COVID-19 related knowledge were collected and analyzed by questionnaire.

RESULTS

A total of 511 valid questionnaires were finally retrieved. There were 139 people in epidemic prevention and control positions (27.20%). Depression level: People in isolation ward, fever clinic and pre-check triage were at the level of mild to moderate depression. Female was higher than male; nurse was higher than doctor; middle and junior job titles were higher than senior titles; junior college degree or below were higher than bachelor's degree, master's degree and above; isolation ward, fever clinic and pre-check triage were significantly higher than those of non-prevention and control positions (p < 0.05). Loneliness scores: Doctors were higher than that of medical technicians, and isolation ward, fever clinic and pre-check triage were higher than those of other medical departments (p < 0.05). Social support: Doctors were lower than that of medical technicians, and isolation ward, fever clinic and pre-check triage were significantly lower than those of other departments (p < 0.05). The score of social support was negatively correlated with depression and loneliness (p < 0.001), while depression was positively correlated with loneliness (p < 0.001). Health care workers most want to receive one-to-one psychological counseling (29.75%), and provide crisis management (24.07%). The awareness rate of health care workers on COVID-19's knowledge was relatively high.

CONCLUSIONS

The psychological problems of health care workers, especially women, nurses with low educational background, low professional title, and staff in the epidemic prevention and control positions are relatively serious.

Geospatial dynamics of COVID-19 clusters and hotspots in Bangladesh

The coronavirus disease 2019 (COVID-19) is an emerging and rapidly evolving profound pandemic, which causes severe acute respiratory syndrome and results in significant case fatality around the world including Bangladesh. We conducted this study to assess how COVID-19 cases clustered across districts in Bangladesh and whether the pattern and duration of clusters changed following the country's containment strategy using Geographic information system (GIS) software. We calculated the epidemiological measures including incidence, case fatality rate (CFR) and spatiotemporal pattern of COVID-19. We used inverse distance weighting (IDW), Geographically weighted regression (GWR), Moran's I and Getis-Ord Gi* statistics for prediction, spatial autocorrelation and hotspot identification. We used retrospective space-time scan statistic to analyse clusters of COVID-19 cases. COVID-19 has a CFR of 1.4%. Over 50% of cases were reported among young adults (21-40 years age). The incidence varies from 0.03 - 0.95 at the end of March to 15.59-308.62 per 100,000, at the end of July. Global Moran's Index indicates a robust spatial autocorrelation of COVID-19 cases. Local Moran's I analysis stated a distinct High-High (HH) clustering of COVID-19 cases among Dhaka, Gazipur and Narayanganj districts. Twelve statistically significant high rated clusters were identified by space-time scan statistics using a discrete Poisson model. IDW predicted the cases at the undetermined area, and GWR showed a strong relationship between population density and case frequency, which was further established with Moran's I (0.734; p ≤ 0.01). Dhaka and its surrounding six districts were identified as the significant hotspot whereas Chattogram was an extended infected area, indicating the gradual spread of the virus to peripheral districts. This study provides novel insights into the geostatistical analysis of COVID-19 clusters and hotspots that might assist the policy planner to predict the spatiotemporal transmission dynamics and formulate imperative control strategies of SARS-CoV-2 in Bangladesh. The geospatial modeling tools can be used to prevent and control future epidemics and pandemics.

Effect of COVID-19 Quarantine on the Sleep Quality and the Depressive Symptom Levels of University Students in Jordan During the Spring of 2020

Objectives: This study was designed to assess the effect of COVID-19 home quarantine and its lifestyle challenges on the sleep quality and mental health of a large sample of undergraduate University students in Jordan. It is the first study applied to the Jordanian population. The aim was to investigate how quarantine for several weeks changed the students' habits and affected their mental health. Methods: A cross-sectional study was conducted using a random representative sample of 6,157 undergraduate students (mean age 19.79 ± 1.67 years, males 28.7%) from the University of Jordan through voluntarily filling an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiologic Studies-Depression Scale (CES-D) were used to assess sleep quality and depressive symptoms, respectively. Results: The PSQI mean score for the study participants was 8.1 ± 3.6. The sleep quality of three-quarters of the participants was negatively affected by the extended quarantine. Nearly half of the participants reported poor sleep quality. The prevalence of poor sleep quality among participants was 76% (males: 71.5% and females: 77.8%). Similarly, the prevalence of the depressive symptoms was 71% (34% for moderate and 37% for high depressive symptoms), with females showing higher prevalence than males. The overall mean CES-D score for the group with low depressive symptoms is 9.3, for the moderate group is 19.8, while it is 34.3 for the high depressive symptoms group. More than half of the students (62.5%) reported that the quarantine had a negative effect on their mental health. Finally, females, smokers, and students with decreased income levels during the extended quarantine were the common exposures that are significantly associated with a higher risk of developing sleep disturbances and depressive symptoms. Conclusions: Mass and extended quarantine succeeded in controlling the spread of the COVID-19 virus; however, it comes with a high cost of potential psychological impacts. Most of the students reported that they suffer from sleeping disorders and had a degree of depressive symptoms. Officials should provide psychological support and clear guidance to help the general public to reduce these potential effects and overcome the quarantine period with minimum negative impacts.

The Association Between Financial Hardship and Mental Health Difficulties Among Adult Wage Earners During the COVID-19 Pandemic in Bangladesh: Findings From a Cross-Sectional Analysis

Background: The ongoing COVID-19 pandemic has created several challenges including financial burdens that may result in mental health conditions. This study was undertaken to gauge mental health difficulties during the COVID-19 pandemic and gain an insight into wage earners' mental health. Method: This cross-sectional study was conducted through an online survey. A t total of 707 individual Bangladeshi wage earners were enrolled between 20 and 30 May 2020. The questionnaire had sections on sociodemographic information, COVID-19 related questions, PHQ-9 and GAD-7 scales. STATA version 14.1 program was used to carry out all the analyses. Results: The study revealed that 58.6 and 55.9% of the respondents had moderate to severe anxiety and depressive symptoms, respectively. The total monthly income was <30,000 BDT (353.73USD) and displayed increased odds of suffering from depressive symptoms (OR = 4.12; 95% CI: 2.68-6.34) and anxiety (OR = 3.31; 95% CI: 2.17-5.03). Participants who did not receive salary income, had no income source during the pandemic, had financial problems, and inadequate food supply and were more likely to suffer from anxiety and depressive symptoms (p ≤ 0.01). Perceiving the upcoming financial crisis as a stressor was a potential risk factor for anxiety (OR = 1.91; 95% CI:1.32-2.77) and depressive symptoms (OR = 1.50; 95% CI:1.04-2.16). Limitations: The online survey method used in this study limits the generalizability of the findings and self-reported answers might include selection and social desirability bias as a community-based survey was not possible during the pandemic. Conclusion: Wage earners in a low resource setting like Bangladesh require mental health attention and financial consideration to deal with mental health difficulties.

The Association of Suicidal Ideation With Family Characteristics and Social Support of the First Batch of Students Returning to a College During the COVID-19 Epidemic Period: A Cross Sectional Study in China

Objective: To investigate the prevalence of suicidal ideation among the first batch of students returning to a college during the COVID-19 epidemic, and to explore the correlation of suicidal ideation with family characteristics and social support. Methods: A cluster sampling survey with a self-designed questionnaire was conducted among the first batch of students returning to a college in Wuhu, China. The Positive and Negative Suicidal ideation (PANSI) and Social Support Scale (SSRS) were used to define students' suicidal ideation and social support, respectively. The influence of family characteristics and social support on the students' suicidal ideation was investigated using multivariate unconditional logistic regression analysis. Results: Two thousand seven hundred valid questionnaires were collected, including 673 males (24.9%) and 2,027 females (75.1%), in this study. A total of 146 students (5.4%) showed suicidal ideation. Male respondents reported higher rates (7.9%) than females (4.6%). Multivariate logistic regression analysis showed that a higher risk level of residence before returning to school and lower objective support were the risk factors for suicidal ideation in males. In contrast, a higher level of maternal education, a poorer relationship with the mother, and lower scores for subjective support and support availability had significant effects on females' suicidal ideation. Limitations: This is a cross-sectional study, and lacks comparison to the time point unaffected by COVID-19. Moreover, it was limited by COVID-19 epidemic prevention and control restrictions, and the differences in returning to school in different regions. Only one college was investigated in this study, and all of the respondents were sophomores, so there may be some limitations in the representativeness of the sample and extrapolation of the results. Conclusion: Family characteristics and social support have had an important influence on suicidal ideation among students returning to school during the COVID-19 epidemic. Some gender differences were identified. Targeted interventions are needed for early prevention and control.

Psychological and Livelihood Impacts of COVID-19 on Bangladeshi Lower Income People

The objective of this research is to understand the psychological and livelihood-related impacts of coronavirus disease 2019 (COVID-19) on Bangladeshi lower income group people who depend on daily earnings for their living. Following the convenience sampling method, 576 respondents were interviewed for quantitative data and 30 in-depth interviews for qualitative information in several districts of Bangladesh. To 94.1% respondents, livelihood has been affected by the COVID-19 outbreak with an overall score of 3.20 ± 0.77 on a 4-point Likert-type scale. In comparison to unemployed respondents, daily workers have been hardly affected by the COVID-19 outbreak (odds ratio [OR] = 7.957; P < .01), and so they are going outside more frequently in search of jobs (OR = 9.984, P < .01). Due to fear of COVID-19 infection and lack of livelihood means, respondents (76.6%) have been stressed out (overall score 3.19 ± 0.81 on a 4-point Likert-type scale), and those working in industries (OR = 5.818, P < .01), farmers (OR = 3.029, P < .05), and day laborers (OR = 2.651, P < .05) have been highly stressed.

The Fear of COVID-19 Scale: Psychometric Properties of the Ethiopian Amharic Version

Fear is an adaptive response that alerts individuals to the presence of a danger or threat. However, in the context of the current novel coronavirus disease 2019 (COVID-19) pandemic, the fear experienced could be intense because the number of victims of the virus is continuously increasing globally and is inducing severe mental health concerns. The seven-item Fear of COVID-19 Scale (FCV-19S) assesses the severity of fear related to COVID-19 and has already been validated in many languages. The present study evaluated the psychometric properties of the Amharic (Ethiopian) version of the FCV-19S. An online survey including the Amharic versions of the FCV-19S and the six-item UCLA Loneliness Scale (ULS-6) was administered to 307 Amharic-speaking participants using convenience sampling. The participants' age ranged between 18 and 70 years. In the evaluation process, confirmatory factor analysis, Item Response Theory, concurrent validity, and reliabilities (Cronbach's alpha, McDonald's omega, Guttman's lambda, and composite reliability) of the Amharic version of the FCV-19S were performed. The uni-dimensional structure of the FCV-19S was confirmed and the Amharic version of the FCV-19S had strong psychometric properties. All reliability coefficients of the Amharic FCV-19S were satisfactory, with sound concurrent validity shown by significant and positive correlations with loneliness. The results indicate that the FCV-19S can be used in research to assess the fear of COVID-19 among Amharic-speaking populations.

The first COVID-19 infanticide-suicide case: Financial crisis and fear of COVID-19 infection are the causative factors

BACKGROUND

The global suicide occurrences have been aggravated because of COVID-19 crisis-related issues such as fear of infection, the financial crisis, being infected with COVID-19, loneliness, social boycott, etc. Although two studies reported about the seven dyadic suicidality cases (i.e., suicide pacts), child homicide-suicide has not been studied.

CASE PRESENTATION

On 14 May, two dead bodies (i.e., a 30-years old Indian woman and her six-month-old baby) were found in a Riyadh apartment complex. The perpetrator (a person who kills the others and later commits suicide) - a trained nurse, was in search of a job. The woman's husband was recently retrenched from his technician job at a company in Madinah Airport. Her husband was admitted to a hospital with symptoms related to the COVID-19 infection four days before the suicide incidence. The 70-year-old mother-in-law alerted the neighbors after finding that the apartment is locked from inside and there was no response on knocking the doors. After this, the neighbors gathered and called the police. Police found two dead-bodies after opening the flat and suspected that the child was killed before the woman committed suicide.

CONCLUSIONS

Based on the present findings, further child filicide-suicide possibilities in families with economically distressed and/or positive COVID-19 status are expected. Hence, proper financial supports, providing authentic information (COVID-19), and mental health promotional strategies are suggested for decreasing incidences of COVID-19 related infanticide-suicide cases.

Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal

BACKGROUND

Public health concern is increasing with recent rise in the number of COVID-19 cases in Nepal. To curb this pandemic, Nepal is facing some forms of lockdown, encouraging people to implement social distancing so as to reduce interactions between people which could eventually reduce the possibilities of new infection; however, it has affected the overall physical, mental, social and spiritual health of the people.

METHODS

Published articles related to psychosocial effects due to COVID-19 and other outbreaks were searched and reviewed.

CONCLUSION

While many countries are supporting their citizens with sophisticated health safety-nets and various relief funds, some developing countries have unique challenges with vulnerable populations and limited resources to respond to the pandemic. This review presents the consequences of pandemic and lockdown on socioeconomic, mental health and other aspects in Nepalese society.

Factors related to preventive COVID-19 infection behaviors among people with mental illness

BACKGROUND/PURPOSE

Because of the spread of novel coronavirus disease 2019 (COVID-2019), preventive COVID-19 infection behaviors become important for individuals, especially those who are vulnerable. The present study proposes a model to explain the preventive COVID-19 infection behaviors among people with mental illness in Taiwan.

METHODS

A cross-sectional design was carried out and 414 patients with mental illness (230 males [55.6%]; mean age = 46.32 [SD = 10.86]) agreed to participate in the study. All the participants completed the Preventive COVID-19 Infection Behaviors Scale, Self-Stigma Scale-Short, Believing COVID-19 Information Scale, Fear of COVID-19 Scale, and Depression Anxiety Stress Scale-21. Regression models and structural equation modeling (SEM) were applied to examine the factors associated with preventive COVID-19 infection behaviors.

RESULTS

Both regression models and SEM showed that trust in COVID-19 information sources (standardized coefficient [β] = 0.211 in regression; β = 0.194 in SEM) and fear of COVID-19 (β = -0.128 in regression; β = -0.223 in SEM) significantly explained preventive behaviors among individuals with mental illness. The SEM further showed that fear of COVID-19 was significantly explained by trust in COVID-19 information sources (β = 0.220) and self-stigma (β = 0.454).

CONCLUSION

Based on the results, healthcare providers should help individuals with mental illness reduce self-stigma and fear of COVID-19 which would consequently improve their preventive COVID-19 infection behaviors. Moreover, improving trust in COVID-19 information sources for individuals with mental illness may be another method to improve their preventive behaviors.

Suicidal ideation among Bangladeshi university students early during the COVID-19 pandemic: Prevalence estimates and correlates

Lockdown, social isolation, and interruption of daily life during the COVID-19 period have impacted many lives. University students are particularly vulnerable to such disruptions and may be particularly disposed to suicidal ideation, potentially creating a new public health crisis. This study aimed to assess suicidal ideation and associated factors among university students in Bangladesh during the early stages of the COVID-19 pandemic. A cross-sectional online survey was conducted using the Google form (Google survey tool) from April to May 2020. Initially, 3366 respondents voluntarily completed the survey form. Finally, 3331 surveys were included in the final analyses after removing incomplete surveys. The data ware reviewed, rechecked, and analyzed with SPSS (25.0 version) software. A total of 1979 (59.4%) males and 1352 (40.6%) females participated. Respondents were between the ages of 18 to 28 years (mean age 21.4 years [SD = 1.9]). The prevalence estimate of suicidal ideation was 12.8%. Potential risk factors included less sleep, excess sleep, cigarette smoking, past suicidal thoughts, suicide attempt history, family history of suicidality, depression, anxiety, and stress. Potential protective factors included being male, having lower SES, living in rural areas, regular physical exercise, and satisfactory study. Suicidal ideation was prevalent among Bangladeshi university students during the onset of the COVID-19 pandemic. Understanding the correlates of suicidal ideation may aid to develop targeted strategies to support students during and after the COVID-19 pandemic.

Hospital suicide due to non-treatment by healthcare staff fearing COVID-19 infection in Bangladesh?

The COVID-19 pandemic has led to individuals fearing COVID-19 infection alongside conditions such anxiety, depression, trauma, and stress. For a small minority, such mental health factors can contribute to suicide. Here we report a novel reason for suicide and seemingly COVID-19-related - negligence in getting treatment by Bangladeshi healthcare providers. It was alleged that a woman committed suicide at a hospital because she was not treated and because doctors and nurses suspected she was infected with COVID-19 and did not want to get infected themselves. To help allay the fears among HCPs and the patients they are treating with COVID-19, a number of initiatives are suggested.

Fear of COVID-19, Mindfulness, Humor, and Hopelessness: A Multiple Mediation Analysis

Hopelessness is an important vulnerability factor for depressive symptomology and suicidal ideations. It may also play an important role in the fear of coronavirus 2019 (COVID-19). Therefore, the present study tested the mediating role of mindful awareness and humor (both identified as coping strategies for dealing with stressful situations) in the relationship between fear of COVID-19 and hopelessness. Participants comprised 786 Turkish individuals (562 females and 224 males; aged between 18 and 67 years) from 71 of 81 cities in Turkey. An online convenience sampling method was used to recruit participants. Participants completed surveys including the Fear of COVID-19 Scale, Beck Hopelessness Scale, Mindful Attention Awareness Scale, and Coping Humor Scale. The model was tested using structural equation modeling (SEM) and utilizing bootstrapping. The results of SEM showed that the effect of fear of COVID-19 on hopelessness was partly mediated by mindfulness and humor, and which was supported by bootstrapping. Therefore, higher fear of COVID-19 was associated with lower mindfulness and humor. In turn, lower mindfulness and humor were related with higher hopelessness. Findings are discussed in the context of COVID-19 and the hopelessness literature, and practical implications for counselors are also provided.

Immediate impact of stay-at-home orders to control COVID-19 transmission on socioeconomic conditions, food insecurity, mental health, and intimate partner violence in Bangladeshi women and their families: an interrupted time series

BACKGROUND

Stay-at-home orders (lockdowns) have been deployed globally to control COVID-19 transmission, and might impair economic conditions and mental health, and exacerbate risk of food insecurity and intimate partner violence. The effect of lockdowns in low-income and middle-income countries must be understood to ensure safe deployment of these interventions in less affluent settings. We aimed to determine the immediate impact of COVID-19 lockdown orders on women and their families in rural Bangladesh.

METHODS

An interrupted time series was used to compare data collected from families in Rupganj upazila, rural Bangladesh (randomly selected from participants in a randomised controlled trial), on income, food security, and mental health a median of 1 year and 2 years before the COVID-19 pandemic to data collected during the lockdown. We also assessed women's experiences of intimate partner violence during the pandemic.

RESULTS

Between May 19 and June 18, 2020, we randomly selected and invited the mothers of 3016 children to participate in the study, 2424 of whom provided consent. 2414 (99·9%, 95% CI 99·6-99·9) of 2417 mothers were aware of, and adhering to, the stay-at-home advice. 2321 (96·0%, 95·2-96·7) of 2417 mothers reported a reduction in paid work for the family. Median monthly family income fell from US$212 at baseline to $59 during lockdown, and the proportion of families earning less than $1·90 per day rose from five (0·2%, 0·0-0·5) of 2422 to 992 (47·3%, 45·2-49·5) of 2096 (p<0·0001 comparing baseline with lockdown period). Before the pandemic, 136 (5·6%, 4·7-6·6) of 2420 and 65 (2·7%, 2·1-3·4) of 2420 families experienced moderate and severe food insecurity, respectively. This increased to 881 (36·5%, 34·5-38·4) of 2417 and 371 (15·3%, 13·9-16·8) of 2417 during the lockdown; the number of families experiencing any level of food insecurity increased by 51·7% (48·1-55·4; p<0·0001). Mothers' depression and anxiety symptoms increased during the lockdown. Among women experiencing emotional or moderate physical violence, over half reported it had increased since the lockdown.

INTERPRETATION

COVID-19 lockdowns present significant economic, psychosocial, and physical risks to the wellbeing of women and their families across economic strata in rural Bangladesh. Beyond supporting only the most socioeconomically deprived, support is needed for all affected families.

FUNDING

National Health and Medical Research Council, Australia.

Financial threat, hardship and distress predict depression, anxiety and stress among the unemployed youths: A Bangladeshi multi-city study

INTRODUCTION

Unemployment has a contributory role in the development of mental health problems and in Bangladesh there is increasing unemployment, particularly among youth. Consequently, the present study investigated depression, anxiety, and stress among recent graduates in a multi-city study across the country.

METHODS

A cross-sectional study was conducted among 988 Bangladeshi graduate jobseekers in six major cities of the country between August to November 2019. The measures included socio-demographics and life-style factors, study and job-related information, Economic Hardship Questionnaire, Financial Threat Scale, Financial Well-Being Scale, and Depression Anxiety Stress Scale-21.

RESULTS

Depression, anxiety and stress rates among the present sample were 81.1% (n = 801), 61.5% (n = 608) and 64.8% (n = 640) respectively. Factors related to gender, age, socioeconomic conditions, educational background, lack of extra-curricular activities, and high screen activity were significant risk factors of depression, anxiety, and stress. Structural equation modeling indicated that (while controlling for age, daily time spent on sleep study, and social media use), financial threat was moderately positively related to depression, anxiety, and stress. Financial hardship was weakly positively associated with depression, anxiety, and stress, whereas financial wellbeing was weakly negatively associated with depression, anxiety, and stress.

LIMITATIONS

Due to the nature of the present study (i.e., cross-sectional study) and sampling method (i.e., convenience sampling), determining causality between the variables is not possible.

CONCLUSIONS

The present results emphasized the important detrimental role of financial troubles on young people's mental health by showing that financial problems among unemployed youth predict elevated psychiatric distress in both men and women.

COVID-19: psychological effects on a COVID-19 quarantined population in Bangladesh

BACKGROUND

It had been seven months since the first confirmed case (8th March, 2020) of COVID-19 in Bangladesh and people have now got a more complete picture of the extent of the pandemic. Therefore, it is time to evaluate the effects of COVID-19 on mental health. The current population-based study aimed to assess the prevalence of depression and PTSD of the quarantined people in Bangladesh during COVID-19 outbreak.

METHODS

A total of 5792 individuals comprised the population of this study. Subjects were respondents to an online questionnaire that was administered through social media. The questionnaire included questions on personal information, quarantine related knowledge, items of the Impact of Event Scale-Revised (IES-R) and the Center for Epidemiologic Studies-Depression (CES-D) scale. Data were collected and analyzed by regression utilizing a using IBM SPSS-22 (Statistical Package for Social Science, Chicago, IL, USA).

RESULTS

The most post-traumatic stress disorder (PTSD) symptoms had on the male (n = 1392, 75.7%) who had institutional quarantine. The most depression symptoms were on the female (n = 920, 72.8%) whose income was more than 75000 takas in Bangladeshi currency. 81.8% of respondents had PTSD and their scores ≥24 in the IES-R scale. On the other hand, the respondent's income was 40000-74999 takas in Bangladesh currency had more PTSD symptoms and the odd ratio 19.3 (95% CI: 12.5-27.3), adjusted odds ratio 22.9 (95% CI: 15.6-32.4), after adjusting all personal variables. 85.9% respondents scored 16 ≤ in the CES-D scale, meaning they were depressed. The respondents whose education level grade 10 were most depressed and the odd ratio of 3.8 (95% CI: 3.1-4.65), adjusted odds ratio of 13.19 (95% CI: 9.88-17.62) after adjusting all personal variables.

CONCLUSIONS

The prevalence of depression and PTSD of the quarantined people higher than that of the affected group during the outbreak of COVID-19 in Bangladesh. If the administration and health care workers become conscious of such results, actions and policies can be taken to improve the consequential sufferings.

Perception Toward Quarantine for COVID-19 Among Adult Residents of Selected Towns in Southwest Ethiopia

BACKGROUND

COVID-19 is a global pandemic caused by a transmissible respiratory virus, SARS-Cov-2. Because it is a novel pathogen, limited information is available to characterize the spectrum of clinical illness, transmission efficiency, and the duration of viral shedding for patients with COVID-19. Quarantine is an important component of a multilayered strategy to prevent sustained spread of COVID-19 everywhere. The aim of this study was to assess public perceptions toward quarantine for COVID-19 and associated factors among adult residents of selected towns in Southwest Ethiopia, 2020.

METHODS

The community-based cross-sectional study was conducted from 1 to 15 June 2020 among adult residents of selected towns in south west Ethiopia. Systematic random sampling was used to select 844 participants. A structured and interviewer-administered questionnaire was used to collect data. Descriptive statistics were used to describe different variables. Multiple linear regression was carried out to determine the predictors of outcome variables. In multiple linear regression, variables with p-value <0.05 were taken as statistically significant association with community perception toward quarantine.

RESULTS

The total of 816 study participants were interviewed from which 450 (55.1%) were male. The median age of respondents was 30 years. Four hundred and twenty-seven (52.3%) of the respondents have a positive perception toward quarantine. Factors associated with perception toward quarantine were having training on COVID-19 (β=2.76, p=0.005), educational status of secondary (β=2.73, p=0.001), educational status to above secondary (β=2.24, p=0.011), occupational status of merchant (β=1.73, p=0.020), and knowledge of COVID-19 (β=0.23, p=0.001).

CONCLUSION

Only 52.3% of the respondents have a positive perception toward quarantine. Having training on COVID-19, educational status of secondary and above, being a merchant, knowledge of COVID-19 and knowledge of quarantine were significantly associated with a positive perception toward quarantine. Concerned bodies should work on enhancing the awareness of the community through information education and communication/behavior changing communication materials.

Raising awareness of suicide prevention during the COVID-19 pandemic

Suicide is one of the top 20 leading causes of death worldwide. With the rapid spreading of coronavirus disease 2019 (COVID‐19) crisis around the world, suicide cases induced by the COVID‐19 pandemic have been reported in many countries. Individuals with suspected and confirmed COVID‐19 infection, frontline healthcare workers, bereaved families, elders, children, and adolescents are vulnerable populations who might be at elevated suicide risk. In this micro‐review, a systematic search through PubMed was performed for a comprehensive investigation of suicide risk factors during the pandemic. On this basis, we put forward considerations and advice for preventing pandemic related suicide, including staying socially connected through online platform or apps during period of quarantine, reducing unemployment, dispelling rumors and misinformation in time, and maintaining evidenced‐based management of psychiatric symptoms. More importantly, early detection and timely intervention of individuals with psychiatric disorders and suicide behaviors will be effective to reduce the number of suicides, with specific measurements of using validated scales to perform regular suicide risk screening, improving the availability of mental health services, and providing appropriate and evidence‐based interventions for individuals in demand. Policy makers, psychiatrists, psychologists, and other healthcare professionals need to collaborate to control the possible suicide events during the COVID‐19 pandemic and future possible crisis.

Individuals who are exposed to bio‐disaster might encounter increased suicide risk. Investigation of infectious disease‐related risk factors would facilitate suicide prevention. Early detection and timely intervention can be key and effective way to reduce suicide cases.

Emotional, Behavioral, and Psychological Impact of the COVID-19 Pandemic

The emergence of SARS-CoV-2 in December 2019 prompted consternation in many parts of the world. Due to its fast dissemination, the World Health Organization declared a pandemic in March 2020. Aiming to contain the spread of the virus, leaders of many countries restrained social movement, targeting to flatten the curve of contamination with social distancing. This review aimed to analyze how human behavior has changed throughout this period. We also approached the key components of the emotional reaction to the pandemic, how internal and external factors, such as personality traits, gender, the media, the economy and the governmental response, influence the social perception of the pandemic and the psychological outcomes of the current scenario. Moreover, we explored in depth the groups at increased risk of suffering mental health burden secondary to these circumstances. These include the healthcare professionals, elderly individuals, children, college students, black subjects, latin and LGBTQ+ communities, economically disadvantaged groups, the homeless, prisoners, the rural population and psychiatric patients. We also discussed several measures that might minimize the emotional impact derived from this scenario. It is crucial that the health authorities, the government and the population articulate to assist the vulnerable groups and promote emotional and psychological support strategies. Moreover, it is fundamental that the population is provided with accurate information concerning the COVID-19 pandemic.

Prevalence and risk factors of COVID-19 suicidal behavior in Bangladeshi population: are healthcare professionals at greater risk?

BACKGROUND

Current COVID-19 researches suggest that both general population and health-care providers (HCPs) are at risk of elevated psychological sufferings including suicidality. However, suicidality has not been addressed properly, although mental health problems are studied globally. Besides, the extreme fear of COVID-19 infection is being existed among the Bangladeshi HCPs, that is reported by a recent patients' suicide because of HCPs treatment negligence.

METHODS

A web-based cross-sectional study was administered through the social media platforms. A total 3,388 respondents took part in the survey (mean age 30.1 ± 6.4 years) among them 834 were frontline HCPs (30.7 ± 5.6 years). The measures included socio-demographics, PPE-related and patient-care related information and a question concerned with the COVID-19 suicidal behavior.

RESULTS

About 6.1% of the total participants had suicidal behavior, with no detectable differences within the groups (i.e., general population and HCPs). Regression analysis showed that being female, being divorced, and having no child were emerged as independent predictors for suicidality. There was no significant association between the PPE-related or patient-care related variables and suicidal behavior of the HCPs. Majority of the participants sometimes had fear of death although no significant relation of the factor was found with suicidality.

LIMITATIONS

The study can be limited because of its nature (i.e., cross-sectional self-reporting online survey) and not considering non-COVID-19 related suicide risk factors etc.

CONCLUSIONS

The present findings identified the substantial proportion of the HCPs and general population had COVID 19 related suicidal behavior. It can be used to advocate a large-scale suicide safety plan using a multidisciplinary approach herein.

The mediating effect of the cyberchondria and anxiety sensitivity in the association between problematic internet use, metacognition beliefs, and fear of COVID-19 among Iranian online population

With the rapid growth of the novel coronavirus disease 2019 (COVID-19), individuals may try to find related medical information using the internet to overcome their fears. Under such circumstances, individuals with the features of cyberchondria, anxiety sensitivity, and metacognitive beliefs in negative thoughts may suffer more fears than those without these features. Therefore, the present study proposed a model to understand the associations between problematic internet use (PIU), cyberchondria, anxiety sensitivity, metacognition beliefs, and fear of COVID-19. Utilizing a cross-sectional online survey, 651 Iranians completed the following psychometric scales: Metacognition Questionnaire-30 (MCQ-30), Anxiety Sensitivity Questionnaire (ASI), Cyberchondria Severity Scale-Short Form (CSS-12), Fear of COVID-19 Scale (FCV-19S), and Generalized Problematic Internet Use Scale (GPIUS). Structural equation modeling (SEM) was used to assess the proposed model via several fit indices. The indices include Tucker-Lewis index (TLI), comparative fit index (CFI), standardized root mean square residual (SRMR), and root mean square error of approximation (RMSEA). The fit indices (CFI = 0.948, TLI = 0.938, RMSEA = 0.053, and SRMR = 0.001) indicated the good fit between the data and the proposed model. Moreover, fear of COVID-19 was significantly and directly predicted by cyberchondria (β = 0.479, p < .001) and anxiety sensitivity (β = 0.286, p < .001). The relationship between PIU and cyberchondria with fear of COVID-19 was mediated significantly by anxiety sensitivity and metacognitive beliefs. Because fear of COVID-19 was found to be significantly associated with cyberchondria and anxiety sensitivity, healthcare providers may want to provide additional support for those with cyberchondria and anxiety sensitivity tendencies.

The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: a living systematic review

Background: The COVID-19 pandemic has caused morbidity and mortality, as well as, widespread disruption to people's lives and livelihoods around the world. Given the health and economic threats posed by the pandemic to the global community, there are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review (LSR) focuses on suicide prevention in relation to COVID-19, with this iteration synthesising relevant evidence up to June 7 th 2020. Method:  Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports. Results: Searches identified 2070 articles, 29 (28 studies) met our inclusion criteria, of which 14 articles were research letters or pre-prints awaiting peer review. All articles reported observational data: 12 cross-sectional; eight case series; five modelling; and three service utilisation studies. No studies reported on changes in rates of suicidal behaviour. Case series were largely drawn from news reporting in low/middle income countries and factors associated with suicide included fear of infection, social isolation and economic concerns.   Conclusions:  A marked improvement in the quality of design, methods, and reporting in future studies is needed. There is thus far no clear evidence of an increase in suicide, self-harm, suicidal behaviour, or suicidal thoughts associated with the pandemic. However, suicide data are challenging to collect in real time and economic effects are evolving. Our LSR will provide a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide. PROSPERO registration: CRD42020183326 01/05/2020.

The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review

Background: The COVID-19 pandemic has caused considerable morbidity, mortality and disruption to people's lives around the world. There are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review synthesises findings from emerging literature on incidence and prevalence of suicidal behaviour as well as suicide prevention efforts in relation to COVID-19, with this iteration synthesising relevant evidence up to 19 th October 2020. Method:  Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports. We exclude one-off cross-sectional studies without either pre-pandemic measures or comparisons of COVID-19 positive vs. unaffected individuals. Results: Searches identified 6,226 articles. Seventy-eight articles met our inclusion criteria. We identified a further 64 relevant cross-sectional studies that did not meet our revised inclusion criteria. Thirty-four articles were not peer-reviewed (e.g. research letters, pre-prints). All articles were based on observational studies. There was no consistent evidence of a rise in suicide but many studies noted adverse economic effects were evolving. There was evidence of a rise in community distress, fall in hospital presentation for suicidal behaviour and early evidence of an increased frequency of suicidal thoughts in those who had become infected with COVID-19. Conclusions:  Research evidence of the impact of COVID-19 on suicidal behaviour is accumulating rapidly. This living review provides a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide risk as the longer term impacts of the pandemic on suicide risk are researched.

COVID-19 and addiction

BACKGROUND AND AIMS

2019-coronavirus disease (COVID-19) is causing insurmountable psychosocial impact on the whole mankind. Marginalized community, particularly those with substance use disorders (SUD), are particularly vulnerable to contract the infection and also likely to suffer from greater psychosocial burden. This article analyses the intricate bi-directional relationship between COVID-19 and addiction.

METHODS

Pubmed and Google Scholar are searched with the following key terms- "COVID-19", "SARS-CoV2", "Pandemic", "Addiction", "Opioid", "Alcohol", "Smoking", "Addiction Psychiatry", "Deaddiction", "Substance use disorders", "Behavioral addiction". Few newspaper reports related to COVID-19 and addiction have also been added as per context.

RESULTS

People with SUD are at greater risk of worse COVID-19 outcome. There is surge of addictive behaviors (both new and relapse) including behavioral addiction in this period. Withdrawal emergencies and death are also being increasingly reported. Addicted people are especially facing difficulties in accessing the healthcare services which are making them prone to procure drugs by illegal means.

CONCLUSION

COVID-19 and addiction are the two pandemics which are on the verge of collision causing major public health threat. While every effort must be taken to make the public aware of deleterious effects of SUD on COVID-19 prognosis, the resumption of deaddiction services and easier accessibility of prescription drugs are needs of the hour.

Depression and anxiety among university students during the COVID-19 pandemic in Bangladesh: A web-based cross-sectional survey

The purpose of this study was to investigate the prevalence of depression and anxiety among Bangladeshi university students during the COVID-19 pandemic. It also aimed at identifying the determinants of depression and anxiety. A total of 476 university students living in Bangladesh participated in this cross-sectional web-based survey. A standardized e-questionnaire was generated using the Google Form, and the link was shared through social media-Facebook. The information was analyzed in three consecutive levels, such as univariate, bivariate, and multivariate analysis. Students were experiencing heightened depression and anxiety. Around 15% of the students reportedly had moderately severe depression, whereas 18.1% were severely suffering from anxiety. The binary logistic regression suggests that older students have greater depression (OR = 2.886, 95% CI = 0.961-8.669). It is also evident that students who provided private tuition in the pre-pandemic period had depression (OR = 1.199, 95% CI = 0.736-1.952). It is expected that both the government and universities could work together to fix the academic delays and financial problems to reduce depression and anxiety among university students.

The COVID-19 pandemic and the public health challenges in Bangladesh: a commentary

Purpose

The purpose of this paper is to highlight the current pandemic situation of coronavirus disease 2019 (COVID-19) in Bangladesh, how the Government is managing this unprecedented condition and encountering these increasing public health challenges.

Design/methodology/approach

This paper is a viewpoint of the current COVID-19 pandemic situation in Bangladesh.

Findings

As one of the most densely populated countries, Bangladesh is vulnerable to COVID-19. Currently, the infection of COVID-19 is spreading fast and started to capture all the parts of Bangladesh. The Government of Bangladesh has already taken several preventive measures to overcome the pandemic such as declaring hotspots of COVID-19 and setting lockdowns, increasing mass awareness through social media and satellite TV channels. They are also encouraging private and community healthcare initiatives to increase hospital beds and COVID-19 treatment facilities. Besides, the Government has deployed defence force and additional health workers and increased public holidays to reduce the number of coronavirus infections. However, both the number of infected people and the death toll is rising, and there are growing challenges that the Government and public healthcare professions need to overcome.

Originality/value

This paper delivers information about the present developing situation of COVID-19 in Bangladesh, how the Government is handling and public health challenges that have raised. This paper can be helpful for the policymakers and Government officials for effective public health interventions.