The differential mental health impact of COVID-19 in Arab countries

Investigating fear, depressive symptoms and coping mechanisms among Egyptian nursing students amidst the covid-19 pandemic: a cross-sectional study

BACKGROUND

Amidst the ongoing COVID-19 pandemic, nursing students' contribution to combating this global health crisis is becoming more significant. However, we need a more comprehensive understanding of the psychological impact of this crisis on these students. Therefore, this study holds immense importance as it offers valuable insights into the connection between COVID-19 pandemic fear, coping strategies, and depressive symptoms among nursing students.

METHODS

A cross-sectional survey was conducted to collect and analyze data from 319 undergraduate nursing students. They participated in the study by responding to an online questionnaire. The questionnaire consisted of the Fear of the Coronavirus Questionnaire, Brief Coping Orientation to Problems Experienced, and the Beck Depression Inventory-II.

RESULTS

The study revealed that 45.5% of the participants had a severe fear of COVID-19, 21.9% showed severe depressive symptoms, and 64.6% used moderate coping mechanisms. A positive correlation (r = 0.160, p = 0.01) was found between the fear of COVID-19 and depressive symptoms. Interestingly, this correlation turned negative (r = -0.074, p = 0.01) when adaptive coping strategies such as religion, acceptance, planning, positive reframing, instrumental support, emotional support, active coping, and humor were used. However, when participants resorted to maladaptive coping strategies like venting, self-distraction, self-blame, behavioral disengagement, denial, and substance abuse, the correlation between high fear levels and depressive symptoms became positive (r = 0.352, p = 0.01).

CONCLUSION

The study demonstrated that the fear of COVID-19 and depressive symptoms among nursing students are significantly correlated. However, the nature of this correlation is influenced by the type of coping strategies employed. Adaptive coping mechanisms can mitigate the impact of fear on depressive symptoms. In contrast, maladaptive coping can exacerbate the relationship between fear and depressive symptoms. Therefore, promoting adaptive coping strategies could be a crucial approach to managing the psychological impact of the COVID-19 pandemic.

Psychological effect of COVID-19 pandemic on healthcare professionals of Yemen and coping strategies

COVID-19 pandemic has triggered psychological stress such as anxiety and depression among people around the globe. Due to the nature of the job, healthcare professionals (HCPs) are at high risk of infection and are facing social stigma as well. This research was conducted with the objective to evaluate the psychological influence of the COVID-19 pandemic among HCPs in Yemen and the coping strategies adopted thereof. A web-based, as well as face-to-face cross-sectional study was carried out from July to December 2021 among HCPs of Yemen. The generalized anxiety disorder (GAD-7), patient health questionnaire (PHQ-9), and Brief-COPE scales were applied for the evaluation of anxiety, depression, and coping strategies. A total of 197 HCPs participated in the study where 28.4% and 43.1% had anxiety and depression respectively. The prevalence of both anxiety and depression in the majority were found of the minimal to none and mild categories (71.6% vs. 56.9% respectively). The respondents who had received training on COVID-19 had statistically significant lower GAD-7 scores than those who did not (6.32 vs. 8.02 respectively). A significant statistical difference was observed between physicians versus nurses regarding depression based on the working area (p < 0.05). The physician and pharmacist had a significant positive association with brief COPE scores at the 50th centile compared to other HCPs. The female respondents had statistically significant higher mean Brief COPE scores than male respondents (78.11 vs. 69.50 respectively). Our findings illustrate the requirement for efficient policies through administrative, clinical, and welfare perspectives from the regulatory body in preparedness and preventive measures towards such a pandemic that aids HCPs to provide service in a stress-free condition and assurance of a better healthcare system..

COVID-19 in Baghdad, Iraq: adaptive and emotional findings in a household cluster survey

Purpose

The objective of this study was to assess the impact of COVID-19 infection on households in Baghdad, Iraq.

Methods

A cross-sectional household survey was conducted in early 2022; 41 clusters were selected proportional to population size from the districts of the Baghdad governorate. Households were randomly selected for inclusion. The head of household or senior female member present was interviewed to obtain a listing of COVID-19 infections, deaths, and vaccinations among members of the household and to understand if social and economic changes occurred during the pandemic. All analyses incorporated the complex survey design and sample weights for clustering.

Findings

The findings revealed that there were 1,464 cases of COVID-19 (37.1%) and 34 reported fatalities among the 927 households enrolled in this study. One or more COVID-19 immunizations were received by 50.9% of household members. Preventive measures against COVID-19 were widely reported to be being practiced but were not more commonly reported in households having reported a clinical case of infection. While some households where infections had occurred stated that their household expenses were increased, overall, infections were not associated with significantly increased household costs. In households where COVID-19 had occurred, senior members reported a substantial increase in emotional and psychological problems compared with uninfected households.

Implications

COVID-19 deaths were rare, though infections were common, suggesting an effect of vaccination and other efforts. The household economic implications were minimal in houses with and without COVID-19-infected members. COVID-19 had mental health consequences on affected and unaffected populations alike. It is conceivable that the fear and uncertainty generated by the pandemic had an effect on senior household members which was out of keeping with the other effects in the households sampled. This suggests that there may be a persisting need for mental health services for a protracted period to manage the consequences of mental health needs arising from the pandemic.

Dean Y, Kishk RM, Elsaid NMAB, Salem A, Shah J, Aiash H, Eida M. Assessment of post-traumatic stress disorder and health-related quality of life among patients recovered from mild-to-moderate COVID-19 and their close contacts: A cross-sectional study

The pandemic of COVID-19 is a traumatic event with distressing implications for mental health and several aspects of life. This study aimed to assess Post-traumatic Stress Disorder (PTSD) and Health-Related Quality of Life (HRQoL) among patients who experienced mild-to-moderate COVID-19 and their household contacts. This cross-sectional descriptive study was conducted between May 2020 and November 2020, in Ismailia and Suez governorates. A convenient sampling method was used. The sample size was calculated according to the prevalence of PTSD in COVID-19 patients to be 200 adult participants from both sexes, 100 patients with history of recent COVID-19 infection (up to 2 months after recovery) and their close family. COVID-19 was confirmed by a nasal swab sample tested by PCR in addition to suggestive symptoms and/or positive computed tomography lung findings. Data was collected by using the Arabic version of the Post-Traumatic Stress disorder checklist 5 (PCL5-PTSD) and the Arabic version of Health-Related Quality of Life (HRQoL). The questionnaire was collected through interviews at the Endemic and Infectious diseases and Family medicine outpatient clinics. Of the 200 studied participants, evidence of PTSD was found in 112 (56%) participants; all COVID-19 cases and 12 of their close-contact relatives. Impaired HRQoL was evident in 107 (53.5%) participants; all the COVID-19 cases and 7 contacts. The mean values total scores of the PTSD and HRQoL and its domains were significantly higher among cases compared to their contacts. The most frequently impaired domain was social (55%), psychological (54.5%), impairment (53.5%) followed by physical (48.5%) and the least was health perception (33.5%). The mean values of PTSD, HRQoL and their domains were significantly higher among participants who recalled respiratory symptoms and who had comorbid illness. The odds ratio of PTSD and HRQoL was 0.27 (95% CI: 0.2-0.36) and 0.3 (95% CI: 0.23-0.39) in participants who had more than a case of COVID-19 within their families. All the studied COVID-19 participants showed PTSD and impaired HRQoL, compared to 12% and 7% of their contacts, respectively. Past COVID-19 was associated with impairment of all domains of HRQoL and the most affected were the physical, psychological and impairment domains.

Women's Mental Health and Lessons Learnt from the COVID-19 Pandemic

Women are at the highest risk of pandemic adversities as they represent the majority of health and frontline workers in addition to their essential roles at home. We review gender differences during the COVID-19 pandemic by demonstrating risk-exposure during specific situations such as pregnancy, women's mental health fallouts, COVID-19 disease itself and exposure to different forms of violence. We discuss the particularities that women face in developing countries with depicted examples from some countries in Africa and the Middle East. Women mental health care service stands out as an essential component of the national response to pandemics. Women's integration and leadership in the national pandemic response planning is crucial.

The prevalence of post-traumatic stress disorder in college students by continents and national income during the COVID-19 pandemic: a meta-analysis

Introduction

The present study aimed to provide a more accurate representation of post-traumatic stress disorder (PTSD) in college students during COVID-19 by performing meta-analyses by continents, national income, and study majors, and comparing the results with estimated pooled prevalence.

Methods

Based on the guideline of PRISMA, literature was searched in PubMed, Web of Science, and Embase. The prevalence of PTSD was estimated through a random model based on the different continents and levels of national income, as well as study majors, and compared with the pooled prevalence of PTSD among college students.

Results

Totally 381 articles were retrieved from electronic databases and 38 articles were included in the present meta-analysis. The results showed that the pooled prevalence of college students' PTSD was 25% (95% CI: 21-28%). Prevalence estimates of PTSD among college students were statistically significant (p < 0.00001) when stratified with geographical regions, income levels, and study majors. In comparison with the pooled prevalence of PTSD (25%), subgroups of Africa and Europe, lower-middle-income countries, and medical college students possessed higher prevalence estimates.

Discussion

The findings of the study showed that the prevalence of PTSD in college students worldwide during COVID-19 was relatively high and varied in different continents and countries with different income levels. Therefore, healthcare providers should pay attention to the psychologically healthy condition of college students during COVID-19.

The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type

COVID-19 is a new type of trauma that has never been conceptually or empirically analyzed in our discipline. This study aimed to investigate the impact of COVID-19 as traumatic stress on mental health after controlling for individuals' previous stressors and traumas. We utilized a sample of (N = 1374) adults from seven Arab countries. We used an anonymous online questionnaire that included measures for COVID-19 traumatic stress, posttraumatic stress disorder, anxiety, depression, and cumulative stressors and traumas. We conducted hierarchical multiple regression, with posttraumatic stress disorder, depression, and anxiety as dependent variables. In the first step, in each analysis, we entered the country, gender, age, religion, education, and income as independent variables (Kira, Traumatology 7(2):73-86, 2001; Kira, Torture, 14:38-44, 2004; Kira, Traumatology, 2021, https://doi.org/10.1037/trm0000305). In the second step, we entered cumulative stressors and traumas as an independent variable. In the third step, we entered either COVID-19 traumatic stressors or one of its subtypes (fears of infection, economic, and lockdown) as an independent variable. Finally, we conducted structural equation modeling with PTSD, depression, and anxiety as predictors of the latent variable mental health and COVID-19 as the independent variable. Results indicated that COVID-19 traumatic stressors, and each of its three subtypes, were unique predictors of PTSD, anxiety, and depression. Thus, COVID-19 is a new type of traumatic stress that has serious mental health effects.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-021-00577-0.

COVID-19 and Mental Health of Minority Arab Higher-Education Students in Israel: Social, Economic, and Academic Factors

The mental health and well-being of higher-education students is a topic of growing interest. COVID-19 impacted higher education in many ways and the challenges were especially pronounced for minority students. This study examines the impact of COVID-19 on the mental health of Arab minority students in Israel in relation to social, academic, and financial factors. We recruited 420 Arab higher-education students enrolled in academic colleges or universities in Israel who completed a battery of online questionnaires. Mental health status was measured by the Depression, Anxiety, and Stress Scale 21 (DASS-21). Moderate to severe symptoms of depression, anxiety, and stress were reported by 49.3%, 45.2%, and 54% of Arab students, respectively. Analyses indicate that low quality of online learning, academic difficulties, and negative economic effects of COVID-19 predicted stress, anxiety, and depression. Women reported higher levels of depression and stress; job loss predicted depression and anxiety; low income predicted depression; and COVID-19-related health concerns predicted anxiety. This study highlights the unique and multiple challenges faced by minority students from disadvantaged backgrounds. Campus programs are needed to address the emotional needs of students. Longitudinal research is needed to more fully understand the impact of COVID-19 on higher-education students.

Trends in prevalence of depression and anxiety symptoms and effects of sociodemographic variables before and after the first wave of COVID-19 in Qatar

BACKGROUND

Prevalence trends from Arabic speaking countries on psychiatric symptoms before and after the first wave of the COVID-19 pandemic are lacking. We estimated the point prevalence and change in depression and anxiety symptoms scores in relation to sociodemographic variables following the resolution of the first wave in Qatar compared with before the pandemic.

METHODS

We conducted a trend analysis using repeated nationally representative cross-sectional surveys spanning 2017, 2018, 2020/2021 and using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) to assess depressive and anxiety symptoms. Negative binomial regression was used to model changes in these symptoms in relation sociodemographics and survey year.

RESULTS

The two-week prevalence of depressive symptoms (≥10 on the PHQ-9) was 6.6% in 2017 and 6.5% in 2020/2021 (p = 0.986). The two-week prevalence of anxiety symptoms (≥10 on the GAD-7) was 3.6% in 2018 and 5.1% in 2020/2021 (p = 0.062). The data for 2020/21 showed a 35.1% and 29.2% decrease in depression and anxiety symptoms scores compared to pre-pandemic years (2017/2018) after adjusting for sociodemographic factors.

LIMITATIONS

Screening tools rather than structured interviews were used to assess depressive and anxiety symptoms CONCLUSIONS: The prevalence of depression and anxiety after the first COVID wave did not differ significantly to pre-pandemic estimates. The end of the first wave of the pandemic weakened the associations of these symptoms with traditional sociodemographic risk factors. The 2020/21 depression and anxiety symptoms scores remained high for Qataris and Arabs, suggesting that these cultural groups may benefit most from public mental health interventions.

The relationship of COVID-19 traumatic stress, cumulative trauma, and race to posttraumatic stress disorder symptoms

The purpose of this study was to test if coronavirus disease 2019 (COVID-19) traumatic stress predicts posttraumatic stress disorder (PTSD) symptoms after cumulative trauma and whether there is a three-way interaction between COVID-19 traumatic stress, cumulative trauma, and race in the prediction of PTSD. Using a cross-sectional design, a diverse sample of 745 participants completed measures of cumulative trauma, COVID-19 traumatic stress, and PTSD. COVID-19 traumatic stress accounted for a significant amount of the variance in PTSD above and beyond cumulative trauma. A significant interaction effect was found, indicating that the effect of COVID-19 traumatic stress in predicting PTSD varied as a function of cumulative trauma and that the effects of that interaction were different for Asians and Whites. There were generally comparable associations between COVID-19 traumatic stress and PTSD at low and high levels of cumulative trauma across most racial groups. However, for Asians, higher levels of cumulative trauma did not worsen the PTSD outcome as a function of COVID Traumatic Stress but did at low levels of cumulative trauma.

[Anxiety, depression and stress-related disorders in post Covid-19: A Tunisian study]

OBJECTIVES

- Our study aimed to assess anxiety, depression, and post-traumatic stress disorder in post coronavirus disease 2019 (Covid-19) and identify associated factors.

PATIENTS AND METHODS

- Our study is a descriptive and analytical cross-sectional study carried out during the period from March 1 to May 15th 2021 on patients who were hospitalized and discharged from the Covid-19 unit in the pneumology department at the Hedi Chaker hospital in Sfax (Tunisia). Patients who met all of the following criteria were included: aged 18 and over; having a diagnosis of Covid-19 by polymerase chain reaction (PCR) and/or by CT scan; monitored at the Covid-19 unit and who their clinical conditions did not require intensive care; survivors after 3 months of leaving the service; and having given their informed and informal consent to participate in the study.

RESULTS

- Our study included 154 patients. The prevalence of anxiety, depression and post-traumatic stress disorder was 24.7%, 11% and 13.6% respectively. We found an association between depression and female gender (p= 0.025), gastrointestinal involvement (p= 0.002) and stigma (p= 0.002). We found an association between anxiety and grade level (p= 0.034), and between anxiety and asthenia (p= 0.032).

CONCLUSIONS

- Anxiety, depression, and post-traumatic stress disorder were independent of the majority of disease characteristics including the severity of Covid-19.

Psychological Impact in Healthcare Workers During Emergencies: The Italian Experience With COVID-19 First Wave

Background

The COVID-19 outbreak imposed an overwhelming workload as well as emotional burdens on Healthcare workers (HCWs). In May 2020, an online survey was administered to HCWs in Italy to assess the pandemic's psychological impact and to investigate possible predictive factors that led to individual differences.

Methods

The psychological experience was measured based on the prevalence of self-reported feelings during the pandemic, including negative and positive emotional states. We analyzed the relationship between factors of gender, age, geographic region, professional role, and operational unit, and the four-point scale used to rate the frequency of each emotional state experienced by performing several multinomial logistic regressions, one for each emotion.

Results

Our findings suggest that more than half of HCWs experienced psychological distress during the first COVID-19 outbreak in Italy. Female and younger respondents, especially those operating in northern Italy experienced more frequently negative emotional states such as irritability, anxiety, loneliness, and insecurity. However, positive feelings, first of all solidarity, were also reported especially by female and older workers. The majority of the negative as well as positive emotional states were experienced almost equally by both doctors and nurses, and independently of the operational unit in which they operated.

Conclusions

This study can be very useful as a contribution to the current literature on the psychological effects of this pandemic on health workers. Moreover, our findings can provide useful information in planning more tailored psychological interventions to support this category of workers in the ongoing and future emergencies.

"Post-traumatic Stress Disorder and Difficulties in Emotion Regulation Among University Students under the COVID-19 Condition"

"The new global situation of COVID-19 affects the whole world in all aspects of life including mental health. The study’s goal is to detect the relationship between post-traumatic stress disorder (PTSD) and Emotion Regulation (ER) difficulties under the COVID-19 condition. Methods: University students were asked to complete: 1) Emotion Regulation Difficulties Questionnaire (DERS) 2) PTSD Checklist (PCL- 5). 3) Life Events Checklist for DSM-5 (LEC-5). Results: There were 441 students with suspected COVID-19 symptoms out of 1195 students. When compared to students who did not have suspected COVID-19 symptoms, those who did had a greater prevalence of PTSD symptoms (18.2% vs. 4.7%) and DERS (34.5% vs. 23.3%). Additionally, correlation studies demonstrated a significant positive link (Ps< .01) between the PCL, the overall DERS, and all six categories of emotion regulation difficulties. Conclusion: Students with suspected COVID-19 symptoms have more difficulty with emotion regulation and post-traumatic stress disorder than students without such symptoms. This research recommends that during the pandemic, health professionals should implement a suitable psychological intervention for students who exhibit COVID-19 symptoms."

The anxiety of not knowing: Diagnosis uncertainty about COVID-19

The emergence and swift global spread of COVID-19 brought increased anxiety worldwide (Santabárbara et al. (Progress in Neuro-Psychopharmacology & Biological Psychiatry, 109, 110207, 2021)). Research regarding the COVID-19 outbreak addressed factors that contribute to anxiety people experienced as they tried to handle the changes in their lives associated with COVID-19 (Holmes et al. (The Lancet Psychiatry, 7(6), 547-560, 2020)). This paper focuses on diagnosis uncertainty as a particular source of anxiety. We use self-reported anxiety measures to understand how different stressors, and particularly how being sick or being unsure if one or one's close friends or relatives are sick, relate to overall anxiety levels. Five-hundred and thirty-three participants from a country with a stringent COVID-19 testing policy were surveyed in the spring of 2020 on various aspects of their anxiety and risk for depression, as well as on whether they or their friends or family had COVID-19. Analysis of survey results found that anxiety related to uncertainty regarding whether the survey responder or their friends or family were carrying COVID-19 may be even greater than fear of the virus itself. This paper discusses directional issues related to this finding and offers policy implications for decreasing anxiety during pandemics for certain types of communities. In addition to the main findings regarding diagnosis uncertainty and anxiety, this paper's results also indicate the importance of providing participants with an option for "not sure" in closed questions and imply the increased knowledge that can be gained by analyzing an unsure response independently of "yes" or "no".

Coping with COVID-19 Prolonged and Cumulative Stressors: the Case Example of Egypt

The current study aimed to explore how COVID-19-traumatized populations cope using a coping model based on wills to exist, live, and survive (WTELS) that leads to positive coping and posttraumatic growth (PTG). We used data from 11 Arab countries (N = 2732), including Egypt (N = 831), and included measures for COVID-19 stressors (COVID-fear, economic, lockdown, and grief stressors), WTELS, resilience, religiosity, spirituality, social support, and PTG. We conducted ANOVA on the main sample to explore the differences between Arab countries, hierarchical regressions, and path analysis on the Egyptian subsample to test a model of the effects on WTELS. In the path model, WTELS was the independent variable. Other coping strategies were mediating variables, and COVID-19 stressor types were outcome variables. ANOVA on the main sample indicated that Egypt was the highest on COVID-19 stressors (infection fears, economic, lockdown, and grief stressors), actual infection, and WTELS. Hierarchical regression indicated that social support, resilience, and WTELS were positive predictors of PTG, with WTELS had the highest effect size (β = .41) and WTELS being a negative predictor of COVID-19 stressors, while resilience and social support were not. Path analysis indicated that WTELS predicted higher religiosity, spirituality, social support, resilience, and lower COVID-19 stressors. Religiosity predicted higher spirituality, social support, and resilience and lower COVID-19 stressors. Interfaith spirituality predicted higher resilience and lower COVID-19 grief stressors. The results validated the central role of WTELS. Results helped to identify potentially effective interventions with COVID-19 victims that focus on WTELS, spirituality, and religiosity.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11469-021-00712-x.

Factors associated with depression and anxiety in the adult population of Qatar after the first COVID-19 wave: a cross-sectional study

There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, and COVID-19 infection and mortality rates. The main purpose of the study is to identify the factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey in Qatar between July and December 2020 after Qatar’s first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the Patient Health Questionnaire-Anxiety Depression Scale (PHQ-ADS). Of 1138 participants, 71.0% were female, 69.0% Arabs, 70.0% Non-Qataris, and 77.0% were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with moderate-to-severe levels of depression or anxiety on the PHQ-ADS; Arab ethnicity (OR = 1.67, p = 0.026), never married versus married (OR = 1.69, p = 0.015), prior history of psychiatric disorder versus no history (OR = 1.80, p = 0.009), increased worries due to social media use for COVID-related news/updates (OR = 1.72, p = 0.003), a history of COVID-19 (OR = 1.76, p = 0.039), loneliness (OR = 1.91, p < 0.001), and lower levels of religiosity (OR = 0.96, p = 0.039). These associations also pertained in the reduced model, with the exception of religiosity which was only marginally statistically significant (OR = 0.97, p = 0.055). The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, and similar national events, and assist with early intervention to treat sufferers.

Who's more vulnerable? A generational investigation of COVID-19 perceptions' effect on Organisational citizenship Behaviours in the MENA region: job insecurity, burnout and job satisfaction as mediators

BACKGROUND

This paper is an empirical investigation that examines a path model linking COVID-19 perceptions to organisational citizenship behaviour (OCBs) via three mediators: job insecurity, burnout, and job satisfaction. The research examines the path model invariance spanning Generations X, Y, and Z. Three countries in the Middle East and North Africa (MENA) were the focus of the study.

METHODS

The data was collected from a sample of employees in service companies (n = 578). We used a Partial Least Square Structural Equation Modelling (PLS-SEM) to analyse the data.

RESULTS

Our findings reveal that COVID-19 perceptions positively predict job insecurity, which positively impacts burnout levels. Burnout negatively predicts job satisfaction. The findings established that job satisfaction positively predicts OCBs. The mediation analysis determined that job insecurity, burnout and job satisfaction convey the indirect effects of COVID-19 perceptions onto OCBs. Finally, our hypothesised model is non-equivalent across Generations X, Y and Z. In that regard, our multi-group analysis revealed that the indirect effects of COVID-19 perceptions on OCBs were only valid amongst younger generations, i.e., Generation Y and Generation Z. Specifically, younger generations are substantially more vulnerable to the indirect effects of COVID-19 perceptions on their engagement in OCBs than Generation X whose job satisfaction blocks the effects of COVID-19 perceptions on OCBs.

CONCLUSIONS

The present study extends our knowledge of workplace generational differences in responding to the perceptions of crises or pandemics. It offers evidence that suggests that burnout, job attitudes and organisational outcomes change differently across generations in pandemic times.

Mental Health during the COVID-19 Crisis in Africa: A Systematic Review and Meta-Analysis

We aim to provide a systematic review and meta-analysis of the prevalence rates of mental health symptoms among major African populations during the COVID-19 pandemic. We include articles from PubMed, Embase, Web of Science, PsycINFO, and medRxiv between 1 February 2020 and 6 February 2021, and pooled data using random-effects meta-analyses. We identify 28 studies and 32 independent samples from 12 African countries with a total of 15,071 participants. The pooled prevalence of anxiety was 37% in 27 studies, of depression was 45% in 24 studies, and of insomnia was 28% in 9 studies. The pooled prevalence rates of anxiety, depression, and insomnia in North Africa (44%, 55%, and 31%, respectively) are higher than those in Sub-Saharan Africa (31%, 30%, and 24%, respectively). We find (a) a scarcity of studies in several African countries with a high number of COVID-19 cases; (b) high heterogeneity among the studies; (c) the extent and pattern of prevalence of mental health symptoms in Africa is high and differs from elsewhere-more African adults suffer from depression rather than anxiety and insomnia during COVID 19 compared to adult populations in other countries/regions. Hence, our findings carry crucial implications and impact future research to enable evidence-based medicine in Africa.

Mental Health during the COVID-19 Crisis in Africa: A Systematic Review and Meta-Analysis

We aim to provide a systematic review and meta-analysis of the prevalence rates of mental health symptoms among major African populations during the COVID-19 pandemic. We include articles from PubMed, Embase, Web of Science, PsycINFO, and medRxiv between 1 February 2020 and 6 February 2021, and pooled data using random-effects meta-analyses. We identify 28 studies and 32 independent samples from 12 African countries with a total of 15,071 participants. The pooled prevalence of anxiety was 37% in 27 studies, of depression was 45% in 24 studies, and of insomnia was 28% in 9 studies. The pooled prevalence rates of anxiety, depression, and insomnia in North Africa (44%, 55%, and 31%, respectively) are higher than those in Sub-Saharan Africa (31%, 30%, and 24%, respectively). We find (a) a scarcity of studies in several African countries with a high number of COVID-19 cases; (b) high heterogeneity among the studies; (c) the extent and pattern of prevalence of mental health symptoms in Africa is high and differs from elsewhere-more African adults suffer from depression rather than anxiety and insomnia during COVID 19 compared to adult populations in other countries/regions. Hence, our findings carry crucial implications and impact future research to enable evidence-based medicine in Africa.

Effects of positive psychology interventions in Arab countries: a protocol for a systematic review

INTRODUCTION

Despite the growing volume of published studies on the effects of positive psychology interventions (PPIs), little is known about their effectiveness outside of Western countries, particularly in Arab countries. As the effectiveness of PPIs in this region remains unclear, a systematic review focusing on this area of research can offer a valuable contribution. Here, we present a protocol for the first systematic review that aims to examine the effects of PPIs on increasing well-being, quality of life and resilience and decreasing depression, anxiety and stress for both health and clinical, child and adult populations in Arab countries.

METHODS AND ANALYSIS

This protocol is carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. A systematic literature search for studies up to 30 April 2021 will be conducted in the following electronic databases: PsycINFO, PubMed, Scopus, ProQuest, Dar Al Mandumah and Al Manhal. Experimental/quasi-experimental quantitative studies evaluating the effects of PPIs on healthy and clinical participants of all ages in the 22 Arab countries will be included. Outcomes will include psychological effects of PPIs on dimensions related to well-being (eg, happiness), quality of life, resilience, depression, anxiety and stress. The risk of bias will be evaluated using the Cochrane risk-of-bias tool. A narrative synthesis with tables of study characteristics will be provided. A meta-analysis will be included if outcomes allow; in this instance, subgroups analysis will be conducted, depending on the data gathered, to examine differences in effect sizes based on age group, population type, duration of intervention and type of intervention.

ETHICS AND DISSEMINATION

Ethical approval was not required for the performance of this systematic review. We intend to publish the study in a peer-reviewed journal and share the findings at relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42020198092.

Public knowledge, beliefs, psychological responses, and behavioural changes during the outbreak of COVID-19 in the Middle East

Objective:

To evaluate the knowledge, believes, psychological and behavioural impact of COVID-19 on the general population in the Middle East, exploring how it impacted public lives.

Methods:

A descriptive cross-sectional online survey was sent to a convenience sample in the Middle East through social media (Facebook and WhatsApp) between 16^th of June and 30^th of June 2020. The questionnaire was designed to collect the demographic, participant’s source of information regarding COVID-19, knowledge and believes about COVID-19, the psychological consequences of COVID-19, impact of COVID-19 on participant’s behaviour. The final version of the questionnaire was further tested for content validity by experts in the field.

Results:

A total of 2,061 participants completed the survey, with the majority being females (n=1394, 67.6%), from urban areas (n=1896, 92%) and the majority were from countries of The Levant (n=1199, 58.1%), followed by the Arabian Peninsula (n=392, 19.1%), Iraq (n=300, 14.6%) and Egypt (n=138, 6.7%). Few participants (3.0%) reported to have been infected and many (n=1847, 89.6%) were committed to quarantine at home. Social media platforms were the most common sources of information (41.2%). Many (63%) believed that COVID-19 is a biological weapon and were afraid of visiting crowded places (85%). The majority avoided public facilities (86.9%) such as prayer places and believed that the news about COVID-19 made them anxious (49.5%).

The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey

There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown’s stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims.

Anxiety among the Sudanese university students during the initial stage of COVID-19 pandemic

Since the emergence of the novel coronavirus disease 19 (COVID-19), many people were facing daily life changes that could predispose them to anxiety. For the Sudanese university students, the situation is even more complicated because of the limited availability of online learning and the difficult economic situation of the country. The objective of this study is to assess the students' anxiety levels. The method we used was a cross-section of the university students in Sudan using a proportionate stratified random sampling technique to assess their anxiety level using Beck Anxiety Inventory (BAI) during the COVID-19 pandemic through an online self-administered questionnaire. Results indicated that of the 478 participants, 75.1% had a low anxiety level, 15.5% had a moderate anxiety level and 9.4% had a potentially concerning level of anxiety. Experiencing no symptoms during the past 14 days was associated with a low level of anxiety. Moreover, experiencing fever, sore throat, and myalgia or fatigue were associated with low to moderate anxiety levels among the participants. While having a relative or a friend diagnosed or suspected with the disease or having headache were associated with a low anxiety level, Thus the conclusion was that not complying with the curfew measures, and the preventive etiquette of covering mouth while coughing or sneezing were associated with potentially concerning levels of anxiety while experiencing fever, sore throat and myalgia were associated with moderate anxiety levels. More research should be conducted to study the psychological influences of pandemics on students in developing countries.

Research on Posttraumatic Stress Disorder in the Context of the COVID-19 Pandemic: A Review of Methods and Implications in General Population Samples

Increasing concern about the mental health sequelae to the COVID-19 pandemic has prompted a surge in research and publications on the prevalence of posttraumatic stress disorder in general population samples in relation to the pandemic. We examined how posttraumatic stress disorder in the context of the COVID-19 pandemic has been studied to date and found three general themes: (1) assessment of posttraumatic stress disorder and posttraumatic stress disorder symptoms relied on self-report measures and often did not determine direct trauma exposure as required by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criterion A to diagnose posttraumatic stress disorder; (2) inadequate assessment of pre-existing mental disorders and co-occurring stress; and (3) the use of cross-sectional designs in most studies, often relying on snowball sampling strategies to conduct online surveys. Notwithstanding these methodological limitations, these studies have reported moderate to severe posttraumatic symptoms in 25.8% of the general population on average in relation to the pandemic (ranging from 4.6% to 55.3%). Opportunities for advancing future research that will inform public health planning are discussed.