Mental health outcomes during the COVID-19 and perceptions towards the pandemic: Findings from a cross sectional study among Bangladeshi students

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.

A qualitative investigation of stressful life events and mental health disorders: The views of patients and caregivers in Bangladesh

BACKGROUND

Mounting mental health disorders among students has become a significant challenge in producing quality graduates with bright minds. Therefore, it is crucial to investigate the underlying causes of students' mental health-related problems and their experiences while living with mental health disorders. This study investigates the causes and exposures of mental health problems among university students in Bangladesh. For this purpose, a qualitative method was used, and an unstructured in-depth interview schedule was used to collect data from students and caregivers. The students were selected from Khulna University, and data were collected in two consecutive months, i.e., November and December 2021. Using a convenient sampling technique, eight (8) students with mental health issues and five (5) caregivers were interviewed to obtain the necessary data.

RESULTS

The findings showed that the intertwined social circumstances led to mental health problems among university students. The students experienced deep depression following a breakup of their romantic affairs/relationships. The prolonged isolation or social distancing due to the government-imposed strict lockdown during the COVID-19 also produced frustration regarding the possible loss of both academic and professional careers. Furthermore, the growing academic pressure in a form of an unfamiliar approach to teaching and learning-online education-also compelled students to complain about depression and suicidal tendencies as parts of their experiences.

CONCLUSIONS

This study recommends that the government and policymakers prioritize mental health issues in educational institutions, and they should enforce specific strategies, such as introducing age-specific mental health services and student counseling at educational institutions to reduce growing mental health issues. Furthermore, a positive approach from the family and community is also required to battle against mental health disorders. Besides, nationally representative empirical research is recommended to comprehend the growing mental health issues among students in the 21st century to figure out solutions for the present and the future.

Prevalence of suicidal behavior in a northeastern Mexican border population during the COVID-19 pandemic

Introduction

Before the pandemic, suicide was already considered a global public health problem. The outbreak of COVID-19, a coronavirus-related infectious disease, began to impact people's physical and mental health. The factors that either contribute to or mitigate this risk need to be better understood, and this can only be accomplished through research. Therefore, this study aimed to study the prevalence of suicidal ideation and behavior in Tamaulipas, Mexico, during the COVID-19 pandemic.

Methods

A quantitative, descriptive, and cross-sectional study was conducted. The sample consisted of 659 participants, of whom 194 (29.5%) were men and 465 (70.5%) participants were oldwomen, ranging in age between 16 and 68 years (M = 22.56, SD = 7.26). An adapted version of the Spanish version of the Columbia Suicidal Severity Rating Scale was used to assess the seriousness of suicidal ideation and behavior.

Results

The higher rates of suicidal indicators were suicidal ideation with "wish to dead" (39.9%), while the lower was suicidal ideation with a specific plan (8.2%). A total of 18.2% of participants reported "suicidal attempts before COVID-19," of whom 40% reported "suicidal attempts in the last 3 months." Suicidal behavior rates were lower: 13.7% of participants reported "non-specific preparatory behavior" and 13.3% reported "actual suicide attempts." Women were more likely than men to exhibit almost all indicators of suicidal ideation and behavior (OR = 1.63-2.54; 95% CI = 1.11-2.41, 1.76-3.68), as well as confinement (OR = 2.60; 95% CI = 1.73-3.91). Confinement for more than 40 days (OR = 0.55-0.66; 95% CI = 0.40-0.75, 0.47-0.93) and knowing a person infected with COVID-19 (OR = 1.57-2.01; 95% CI = 1.02-2.42, 1.20-3.34) were associated with a higher risk of exhibiting several suicidal indicators and having previously attempted suicide.

Conclusion

Being a woman, knowing a person infected with COVID-19, and being confined, especially for longer than 40 days, are all risk factors for suicidal ideation. Therefore, intervention programs are needed to reduce the suicide risk prevalence, especially these days because of the influence of the pandemic, and should be primarily focused on those who present the risk factors associated with suicidal behavior identified in this study.

An Examination of Barriers to Accessing Mental Health Care, and Their Association with Depression, Stress, Suicidal Ideation, and Wellness in a Bangladeshi University Student Sample

BACKGROUND

The mental health burden is high and rising among Bangladeshi university students. Understanding barriers to mental healthcare and how barriers impact mental health outcomes may inform the development of targeted interventions to decrease barriers and improve access to care.

AIMS

This study identifies barriers to mental healthcare and their association with mental health outcomes in a Bangladeshi university student sample.

METHODS

We conducted a cross-sectional survey (n = 350) on stigma-related, attitudinal, and instrumental barriers to accessing mental healthcare among Bangladeshi university students. We examined the association between stigma and non-stigma (i.e., attitudinal and instrumental) barriers with four mental health outcomes: suicidal ideation, depression, high perceived stress, and wellness.

RESULTS

Attitudinal barriers were the most reported barriers. Stigma-related barriers were significant for individuals who had experienced suicidal ideation (aOR = 2.97, p = 0.001), not for individuals with depression. Non-stigma-related barriers were significant for individuals who had experienced depression (aOR = 2.80, p = 0.011).

CONCLUSIONS

The current work advances our understanding of how to improve access to mental healthcare among university students in Bangladesh. Stigma-related barriers were particularly salient for individuals who experienced suicidal ideation. Further study is needed on how stigma may impact access to care distinctly for different mental health problems among Bangladeshi university students.

Exploring mental health challenges and coping strategies in university students during the COVID-19 pandemic: A case study in Dhaka city, Bangladesh

Background

Mental health challenges have emerged worldwide during the COVID-19 pandemic. University students experienced changes in their lifestyles, academic life, family relationships, earning capacity, and support systems. This study explores the common mental health challenges in university students and their coping strategies using social support in the first wave of lockdowns in Dhaka city in 2020. By learning from young people's impacts and coping responses, we can help build an improved strategy for future events of this magnitude.

Methods

A qualitative study design was employed to conduct 20 in-depth interviews and two focus group discussions with students from purposively selected three public and three private universities in Dhaka city and five key informant interviews with different stakeholders. We used inductive reflexive thematic analysis and applied six phases of the thematic analysis. Codes retrieved from two differently prepared codebooks were merged and compared to identify themes for a fair interpretation of the underlying data. Data were manually indexed, summarized, and interpreted to categorize codes into sub-themes leading to themes.

Results

Financial constraints, academic pressure, learning resources shortages, losing confidence, relationship breakup, excessive internet dependency, and traumatic experiences challenged the mental health conditions of the students unevenly across universities during the COVID-19 pandemic. Expressed mental health well-being impacts ranged from anxiety, stress, and depression to self-harm and suicidal ideation. Family bonding and social networking appeared as robust social support mechanisms to allow students to cope with anxiety, stress, and depression. Partial financial subsidies, soft loans to purchase electronic resources, faculty members' counseling, and sessional health counseling contributed to minimizing the mental health impacts of COVID-19.

Conclusion

Mental health is still not a resourced area of health and well-being in Bangladesh. Concentration on developing strong social support and improving increased financial subsidies, including learning resources, can be effective in assisting students in coping with the common mental health burdens during pandemic periods. A national intervention plan should be immediately designed and implemented by engaging different stakeholders including healthcare professionals and establishing effective mental healthcare support centers at universities to avoid immediate and prolonged negative mental health impacts.

Impact of the COVID-19 pandemic on the mental and physical health and overall wellbeing of university students in Portugal

Throughout the pandemic of COVID-19 caused by SARS-CoV-2, university students were considered a vulnerable risk group for mental health impairment and wellbeing deterioration. This study aimed at evaluating the pandemic's impact on the physical and mental health and wellbeing among students of a Portuguese university. This cross-sectional study included 913 participants and ran from June to October 2020. Data collected included sociodemographics, three mental health self-report questionnaires (Depression Anxiety Stress Scale, Eating Disorder Examination Questionnaire and Brief COPE) and lifestyle practices (eating and sleeping patterns, media, and entertainment habits) during the first months of the pandemic, which included a 72-day full national lockdown. Descriptive and correlational statistical analysis were conducted. Students' food habits changed during the pandemic, namely on the consumption of snacks and fast food and, overall, less balanced meals became more prevalent. Additionally, almost 70% of the students reported Body Mass Index changes, while 59% went through sleep pattern changes-these were more pronounced in women and younger students. Over half (67%) of the inquirees exhibited an increase in their stress, depression, and generalized anxiety symptoms. Also, the study demonstrates that students' lifestyles trended negatively during the pandemic and highlights how important regular psychological, health monitoring and emotional support is, amongst this somehow overlooked population throughout the pandemic. Universities should provide support to overcome challenges in future stressful situations. This study might have an impact on how universities and higher education systems approach their students in terms of mental and physical health monitoring and promotion in future situations, non-related with COVID. Moreover, it has a large sample of students well characterized in terms of mental and physical health, which might be of interest for future comparison with other worldwide group of students throughout stressful situations, such as tragic events, wars, pandemics.

Predicting students’ intention to continue business courses on online platforms during the Covid-19: An extended expectation confirmation theory

The objective of this study was to analyze the intention of a University's business department students to continue their studies on e-learning platforms during the ongoing COVID-19 pandemic. To this end, a questionnaire was developed to collect primary data from students in business fields. The study took into account more than 285 respondents from two different universities and relied on the expectation confirmation model (ECM) theory and the structural equation model. The partial least squares (SEM-PLS) method was used to analyze the data. The results of the study showed that task skills (TS) and task challenges (TC) were significant for the enjoyment (EN) of the students which in turn had a positive effect on the satisfaction levels. Confirmation (CON) had an impact on the post adoption perceived usefulness (PAPU), which was deemed positive for student satisfaction (SAT). The SAT and psychological safety (PS) of online learning platforms were found to positively influence the continuance intention (CI) on e-learning platforms. Finally, both SAT and PS of online learning platforms were observed to positively influence CI on e-learning platforms. Further research in this area could be useful in making decisions about promoting educational programs based on e-learning. The researchers recommend that academicians and policymakers must ensure appropriate arrangements for teaching on e-learning platforms.

Quality of Life, Depressive Symptoms, and Personality Traits in Syrian Refugee Adolescents

Purpose

Refugee adolescents' quality of life (Qol) was not investigated during the Covid-19 pandemic which have a potential impact on refugee adolescents' Qol. In this study, it is planned to investigate refugee adolescents' Qol and its association with depression and quality of life.

Methods

301 refugee adolescents aged between 14 and 18 who immigrated from Syria was included in the study. Personality Inventory for DSM-5 Brief Form (PID-5 BF), Beck Depression Scale, and Life Quality Scale was used as assessment tools. The data were tested using structural equation modeling.

Results

Both depressive symptoms and personality traits are associated with low Qol. Also, depression mediated the relationship between personality disorder and Qol.

Conclusion

This is the first study that investigates Qol in Syrian refugee adolescents during the pandemic. This study draws attention to the importance of depressive symptoms and personality traits management for improvement of Qol in Syrian refugee adolescent population.

Highlights

• Depressive symptoms are associated with low Qol in refugee adolescents.• Personality traits are associated with low Qol in refugee adolescents.• Depressive symptoms have a mediator role between personality traits and Qol.

The mental health information needs of Chinese university students and their use of online resources: a holistic model

Purpose

This research aims to explore the nature of Chinese students' mental health information needs and to identify the online resources they use to meet those needs.

Design/methodology/approach

Data was collected from three Chinese research-oriented universities using semi-structured interviews and a survey. Twenty-five university students with varied backgrounds were selected for semi-structured interviews to explore the triggers and nature of their needs. Then, printed and online questionnaires were distributed to undergraduate and postgraduate students and 541 valid responses were processed for descriptive statistical analysis and variance analysis.

Findings

The following findings were incurred. First, the triggers of university students' mental health information needs mainly are mental health being in the news, personal interest in gaining mental health knowledge, mental health issues, required formal learning and preparation for mental health counselling. Second, eleven types of information are used, with an emphasis on employment pressure, study stress and self-understanding. Third, mental health information needs differ with mental health status and some social-demographic factors (including gender, urban or rural origin and educational stage). Fourth, information needs can be characterized as dynamic; complex and diverse but concentrated on a few types; ambiguous and hard for participants to define; private; stigmatized; self-dependent and substitutable. Fifth, Internet sources used to meet such needs are mainly search engines, Question and Answer platforms, public social media platforms. Finally, a model of mental health information needs was built based on the above findings to map the whole process from what triggers a need, to the content and characteristics of information need, and online resources used to meet those needs.

Practical implications

The paper provides suggestions for university mental health services in developing more tailored knowledge contents via effective delivery methods to meet diverse needs of student groups.

Originality/value

This research is novel in using empirical data to build a holistic model that captures the context and the nature of mental health information needs of university students.

Mental Health Risk Factors and Coping Strategies among Students in Asia Pacific during COVID-19 Pandemic-A Scoping Review

The impact of COVID-19 has forced higher education institutes to go into lockdown in order to curb the situation. This sudden change caused students within the institutions to forgo traditional face to face classroom settings and to attend immediate online classes. This review aims to summarize the evidence of the social demographic mental health impacts of the COVID-19 pandemic on students in higher education institutes within the Asia Pacific region and identify the coping mechanisms adopted during these times. A systematic literature search was conducted using three databases (PubMed, Google Scholar, and Scopus), out of which 64 studies met the inclusion/exclusion criteria. The findings revealed that the social demographic groups most at risk were female students, those who were in the final years of their studies (i.e., students who were almost graduating), and postgraduate students as well as students studying medical fields (nursing, dental, medicine, health sciences etc.). The majority of the studies identified that students were relying on mobile devices and extended screen time to cope with the pandemic. Having proper social support, be it through a network of friends or positive family cohesion, can be a good buffer against the mental impacts of COVID-19. Students in higher education institutes are at risk of mental consequences due to COVID-19. By reducing their screen time, finding a healthier coping system, increasing the availability of support within the family and community, as well as actively engaging in beneficial activities students may be able to alleviate general negative emotions, specifically during the pandemic.

Mental health status of adolescents in-home quarantine: a multi-region, cross-sectional study during COVID-19 pandemic in Bangladesh

Background

The population's mental and physical health worldwide are currently at risk due to the coronavirus pandemic. We evaluated the mental health status of the adolescents trapped indoors because of the precautionary restrictions and prolonged closure of the educational institutions.

Method

A cross-sectional study was conducted on adolescents from multiple urban and semi-urban areas of Bangladesh from 22 January to 3 February 2021. A self-reported online questionnaire containing questions regarding sociodemographic factors, home quarantine-related factors and mental health symptoms was distributed to collect data. Descriptive analysis, bivariate and multivariable logistic regressions were performed to measure the association of the variables. Cronbach's alpha was estimated to present the internal consistency of the scales.

Results

A total of 322 adolescents (aged 12–19) with a mean age of 16.00 years (SD = 1.84) responded to the invitation. 54.97% (n = 177) of them were male, and the participants were predominantly urban residents (87.27%, n = 281). We observed varying degrees of depression in 67.08%, anxiety in 49.38% and stress in 40.68% of the participants according to DASS-21. Age, sex, education, mother's occupation, total monthly income, playing sports, doing household chores, going out of home, watching television, using the internet, attending online classes, changing food habits, and communicating with friends had a positive significant association with mental health burdens.

Conclusion

Home quarantine has a noticeable adverse impact on the mental health of teenagers. Psychological evaluations and counselling via online and offline programs are essential to improve adolescents' declining mental health conditions.

Determinants of anxiety and depression among Bangladeshi adults during COVID-19 lockdown: An online survey

Background

Human health and well-being are adversely affected by the effects of COVID-19. This study examined the prevalence of anxiety and depression during COVID-19 lockdown in Bangladesh, and their association with some less explored factors like perceived and relative health status, having elderly members in the family, fear for own and family future, and others from the Asian context.

Methods

Using an online survey, data were collected from the population aged 18 years and above, on socio-demographic and economic attributes, and two separate standardized twelve-item scales were used to assess the level of anxiety and depression. Both descriptive and multivariate linear regression were used to analyze the factors associated with anxiety and depression scores.

Results

The respondents had an average anxiety score of 21.74 (SD = 8.20) on a scale ranging from 12 to 60 and an average depression score of 24.39 (SD = 10.30) on the same scale. The study findings revealed that respondents' concern for future well-being, perceived physical health status compared to others in the same cohort, and perceived physical health status during the survey compared to prior COVID-19 were significantly associated with anxiety and depression scores during COVID-19 lockdown. In addition, the anxiety score was significantly higher (p = 0.046) for women respondents than men. Moreover, respondents aged 18-24 years had significantly higher (p < 0.001) depression than others.

Conclusions

The increased level of anxiety and depression during COVID-19 of adult people in Bangladesh are associated with several factors of which their greater concern about the future of their own and family members and health-related attributes are important. These findings may lead to developing interventions to reduce the psychological crisis during the pandemic in Bangladesh.

Factors Associated With Underprivileged E-Learning, Session Jam Phobia, and the Subsequent Mental Distress Among Students Following the Extended University Closure in Bangladesh

Severe session jam phobia (SJP), the extent of underprivileged online education, and subsequent mental health disorders among students have emerged as distinguished global problems due to the overwhelming effects of coronavirus disease 2019 (COVID-19). The purpose of this research was to evaluate the impact of extended COVID-19 lockdown and its mediating factors on current e-Learning activities, the prevalence of severe SJP and psychological distress among university students in Bangladesh. A web-based cross-sectional study was conducted to assemble responses through Google Form by applying a simple snowball sampling technique among university students aged 18 years or above in Bangladesh. All ethical considerations were maintained, and univariate, bivariate, and multivariate analyses were employed to analyze the acquired data set. Among the total analyzed data (n = 1,122), the male and female ratio was almost 1:1, and a remarkable segment (63.7%) was aged between 21-24 years. Alarmingly, around 50-60% of the students were suffering from severe SJP, prevailing underprivileged education in the e-Learning platform, and severe mental distress. Logistic regression analyses demonstrated that the students from public universities, lower- and mid-income families, lower-aged, and junior years education groups were significantly (p < 0.05) more underprivileged than their counter groups. Besides, the monthly family income and university type significantly influenced the extent of severe SJP. Finally, the students who were female, rustic, come from low-income families (below 25,000 BDT), who had academic uncertainty, job insecurity, online exam phobia, and dissatisfaction with e-Learning education, were significantly suffering from moderate to severe mental distress. The current evidence demonstrates that a substantial number of Bangladeshi university students are struggling with extreme session jam phobia, underprivileged e-Learning education, and subsequent psychological distress, which need to be immediately addressed through concerted efforts by the government, parents, and university authorities.

Generalized anxiety disorder among Bangladeshi university students during COVID-19 pandemic: gender specific findings from a cross-sectional study

In the current COVID-19 pandemic there are reports of deteriorating psychological conditions among university students in lower-middle-income countries (LMICs), but very little is known about the gender differences in the mental health conditions on this population. This study aims to assess generalized anxiety disorder (GAD) among university students using a gender lens during the COVID-19 pandemic. A cross-sectional study was conducted using web-based Google forms between May 2020 and August 2020 among 605 current students of two universities in Bangladesh. Within the total 605 study participants, 59.5% (360) were female. The prevalence of mild to severe anxiety disorder was 61.8% among females and 38.2% among males. In the multivariable logistic regression analysis, females were 2.21 times more likely to have anxiety compared to males [AOR: 2.21; CI 95% (1.28-53.70); p-value: 0.004] and participants' age was negatively associated with increased levels of anxiety (AOR = 0.17; 95% CI = 0.05-0.57; p = 0.001). In addition, participants who were worried about academic delays were more anxious than those who were not worried about it (AOR: 2.82; 95% CI 1.50-5.31, p = 0.001). These findings of this study will add value to the existing limited evidence and strongly advocate in designing gender-specific, low-intensity interventions to ensure comprehensive mental health services for the young adult population of Bangladesh.

Knowledge, Attitudes, and Practices Toward Coronavirus and Associated Anxiety Symptoms Among University Students: A Cross-Sectional Study During the Early Stages of the COVID-19 Pandemic in Bangladesh

BACKGROUND

University students' knowledge, attitude, and practice (KAP) toward COVID-19 are vital to prevent the spread of the virus, especially in the context of developing countries. Consequently, the present study aimed to determine the KAP levels of university students and associated anxiety during the earlier stage of the pandemic in Bangladesh.

METHODS

A cross-sectional, online study with 544 university students was conducted during April 17-May 1, 2020. The questionnaire incorporated several KAP-related test items aligned with the World Health Organization (WHO) guidelines. Anxiety was measured with the 2-item Generalized Anxiety Disorder scale (GAD-2). Multivariable logistic regression analysis was performed to determine the association between KAP levels and anxiety adjusting for sociodemographic variables. Subgroup analyses included rerunning models stratified by gender and quarantine status.

RESULTS

Approximately 50% of students showed high levels of knowledge about COVID-19 guidelines, 59% reported behavioral practices that aligned with COVID-19 guidelines, and 39% had negative attitudes toward COVID-19 guidelines. Attitudes differed by anxiety (χ² = 23.55, p < 0.001); specifically, negative attitudes were associated with higher anxiety (OR: 2.40, 95% CI = 1.66-3.46, p < 0.001). Associations were significant for male (OR = 2.36; 95% CI = 1.45-3.84, p < 0.001) and female (OR = 2.45; 95% CI = 1.3-4.34; p < 0.001) students. Stratified analyses found non-quarantined students with negative attitudes had three times the chance of experiencing anxiety (OR = 3.14, 95% CI: 1.98-4.98, p < 0.001). Non-quarantined students with low levels of knowledge had half the chance of developing anxiety (OR = 0.49, 95% CI: 0.31-0.78, p < 0.01).

CONCLUSION

Based on these findings, it is recommended that university authorities continue to prioritize proactive and effective measures to develop higher levels of knowledge, more positive attitudes and better behavioral practices regarding COVID-19 for the mental health of their students.

An investigation of the incidence of post-traumatic stress disorder, turnover intention and psychological resilience among medical staff in a public hospital in China during the outbreak of the omicron variant in the COVID-19 pandemic in 2022

OBJECTIVE

To investigate the incidence of post-traumatic stress disorder (PTSD), turnover intention and psychological resilience of medical staff during the Outbreak of the Omicron Variant in the COVID-19 pandemic in 2022 and to provide a basis for adopting relevant psychological interventions to reduce medical staff turnover.

METHODS

Using the PTSD Checklist-Civilian Version (PCL-C) and a total score ranging from 17 to 85 points, a total score ≥ 38 indicates significant PTSD symptoms and a diagnosis of PTSD. The Chinese version of the Turnover Intention Scale (TIS) has a total score of 6 to 24 points; the higher the score, the stronger the turnover intention. The Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) has a total score of 0 to 100 points, with higher scores indicating a better level of psychological resilience. A total of 443 front-line medical staff working in Chinese public hospitals and still treating all patients normally during COVID-19 were invited via the internet to complete a survey from 15 May to 30 May 2022 in China.

RESULTS

The incidence of PTSD was 14.4%, the total turnover intention score was 13.38 ± 4.08, and the total psychological resilience score was 87.16 ± 18.42. The prevalence of PTSD was higher among medical staff who were married, had children, and were worried about being infected; in addition, the PTSD group had a higher level of education, higher turnover intention, and lower psychological resilience than the non-PTSD group. The total scores for turnover intention and fear of being infected were risk factors for PTSD, while a high total psychological resilience score and high education level were protective factors for PTSD; the differences were statistically significant (all P < 0.05).

CONCLUSION

Post-traumatic stress disorder among Chinese medical personnel was associated with the marital status, childbirth, education level, turnover intention, and psychological resilience. Among these factors, psychological resilience might be exploited as a protective factor.

Prevalence and risk factors of the symptoms of depression, anxiety, and stress during the COVID-19 pandemic in Bangladesh: a systematic review and meta-analysis

The COVID-19 pandemic affects people's psychological well-being as well as their risk of physical complications. Under the circumstance, it is essential to synthesize the existing evidence on psychological consequences with a view to fostering policymaking. Thus, a systematic attempt was compiled to review the Bangladeshi literature related to common mental health problems (i.e. depression, anxiety, and stress) during the COVID-19 pandemic. Adhering to the PRISMA guidelines, a systematic literature search was performed using Medline or PubMed, Scopus, PsycINFO, Web of Science, CINAHL, Google Scholar, PsyArxiv, MedRxiv, and ResearchGate, between 20 December 2020 and 5 March 2021, followed by predetermined eligibility criteria. The inclusion criteria for this review were observational studies involving at least one mental health problem (i.e. stress, depression, and anxiety) published in peer-reviewed journals or preprint servers in the English language after the inception of the pandemic in Bangladesh. The pooled prevalence of depression, anxiety, and stress was 47% (95% CI 39-55%, I 2 = 99.14%), 47% (95% CI 39-54%, I 2 = 99.78%), and 44% (95% CI 30-58%, I 2 = 99.36%), respectively. Subgroup analysis revealed that students were experiencing a higher rate of depression, anxiety, and stress than general people and healthcare professionals. The associated risk factors of mental health problems were gender, age, residence area, family size, monthly family income, educational status, marital status, physical exercise, smoking, alcohol use, fear of COVID-19, presence of chronic illness, unemployment status, and exposure to COVID-19-related news and social media. This systematic review provides baseline data on the symptoms of depression, anxiety, and stress across various Bangladeshi cohorts, which are anticipated to be helpful to the respective authorities for implementing cohort-specific mental health strategies.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

Financial Difficulties Correlate With Mental Health Among Bangladeshi Residents Amid COVID-19 Pandemic: Findings From a Cross-Sectional Survey

Background: The COVID-19 pandemic is a global threat which has challenged mental resilience and impacted the psychological well-being of people across all age groups globally. The present study aimed to investigate how financial difficulties during the pandemic correlate with mental health among residents of Bangladesh. Methods: A cross-sectional survey was conducted on 4,020 residents from different parts of Bangladesh between July and September 2020, during a period of elevated risk of COVID-19 infection. A self-reported online questionnaire comprising socio-demographic, financial difficulties and psychometric measures (to assess depression, anxiety and stress) was used to gather information from participants. Multivariable logistic regression analysis was performed to determine the factors associated with mental health consequences. Results: The prevalence of depression, anxiety, and stress in the sample were 71.1%, 62.3%, and 56.7%, respectively. Levels of depression, anxiety, and stress were significantly higher among participants who reported female sex, being unmarried, smaller families, higher monthly family income, poor self-perceived health status, living near people who had been infected by COVID-19, probability of decreased income, food scarcity (both during the pandemic and in the future) and the possibility of unemployment. However, due to the nature of the cross-sectional study performed with a convenience sampling method, the causal relationship between variables cannot be justified. Conclusions: After several months of the COVID-19 pandemic in Bangladesh, more than half of the respondents rated their mental health concerns as moderate to severe. The findings highlight the contributing factors of poor mental health which warrant the creation of interventions that address the economic, financial and mental health impacts of the pandemic.

Mental health difficulties in students with suspected COVID-19 symptoms and students without suspected COVID-19 symptoms: A cross-sectional comparative study during the COVID-19 pandemic

INTRODUCTION

Mental health problems are taking a heavy toll on students during the COVID-19 pandemic. The purpose of this study was to compare the level of anxiety symptoms, depressive symptoms, post-traumatic stress symptoms (PTSS), and fear of COVID-19 between students with suspected COVID-19 symptoms and students without any suspected symptoms during the pandemic in Bangladesh.

METHODS

This cross-sectional comparative study was conducted online among Bangladeshi students from May to July 2020. Anxiety symptoms, depressive symptoms, PTSS, and fear of COVID-19 were assessed by using the Generalized Anxiety Disorder scale, Patient Health Questionnaire, the Impact of Event Scale, and Fear of COVID-19 Scale, respectively. College and University students were the participants of the study.

RESULTS

Among 3777 students, 1259 had suspected COVID-19 symptoms and 2518 had no suspected COVID-19 symptoms. Students who experienced suspected COVID-19 symptoms had higher prevalence (moderate to severe) of depressive symptoms (61.15% vs. 47.62%), anxiety symptoms (44.96% vs. 36.97%), and PTSS (48.3% vs. 39.75%) compared to those who had no such symptoms. The study identified having suspected COVID-19 symptoms as a significant associated factor for anxiety symptoms (β1' = 1.39; 95% CI: 1.03-1.74), depressive symptoms (β1' = 1.88; 95% CI: 1.43-2.32), PTSS (β1' = 3.66; 95% CI: 2.66-4.65), and fear of COVID-19 (β1' = 0.48; 95% CI: 0.02 to 0.94). Students with suspected COVID-19 symptoms thought more that they would be better off dead, or of hurting themselves (P < 0.01) and felt more afraid as if something awful might happen (P < 0.01) than their counterparts.

CONCLUSION

Mental health difficulties are more prevalent among students with suspected COVID-19 symptoms than the students without having such symptoms. This finding suggests that public health practitioners should deploy a rapid diagnostic system and consider psychological intervention in addition to clinical management for those who have COVID-19 like symptoms during the pandemic.

Knowledge, attitudes, and preventive practices toward the COVID-19 pandemic: an online survey among Bangladeshi residents

AIM

The novel coronavirus (SARS-CoV-2) has rapidly infected people worldwide, leading to a massive public reaction. Peoples' knowledge, attitudes, and practices (KAP) toward COVID-19 are the most important for the control and prevention of the infectious disease pandemic. This study aimed to assess the knowledge, attitude, and preventive practices (KAP) toward the COVID-19 among Bangladeshi residents during the lockdown situation.

SUBJECTS AND METHODS

An online-based cross-sectional survey was conducted among 1765 Bangladeshi adults through the social media networks of the authors.

RESULTS

The respondents were older than 18 years, with an average age of 24.88 years (SD 6.30). Approximately 15% of our participants received online training. The mean knowledge score was 14.49 (SD 1.8, range 0-17), and the overall correct response rate on this knowledge test was 85%. Approximately 67.2% scored well (above the mean 4.5, range 1-5) regarding the practices. To avoid the infection, 96.6% wore masks outside the home, and 98.7% washed their hands with soap when they came back. COVID-19 knowledge score was significantly associated with a lower odds of (OR 0.87, 95% CI 0.79-0.92) negative attitudes. Again, the awareness score was associated with a lower likelihood of (OR 0.94, 95% CI 0.87-0.98) poor practices.

CONCLUSION

Online health education programs focusing on young people, housewives, and people with less education may potentially improve the attitudes and practices to control the COVID-19 pandemic in the long term in such a low-resource setting.

The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced significant disruptions to the routines of many higher education students around the world. It also deprived them of in-person counselling services and social support. These changes have put students at a greater risk of developing mental illness. The objective of this review is to assess the prevalence of depressive symptoms, anxiety symptoms and sleep disturbances in higher education students during the pandemic. A systematic search of English and Chinese databases was conducted current to January 1^st, 2021. The quality of included studies was evaluated using a modified Newcastle-Ottawa scale. Prevalence of depressive symptoms, anxiety symptoms and sleep disturbances were pooled using random-effects meta-analysis. Eighty-nine studies (n=1,441,828) were included. The pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances was 34%, 32% and 33%, respectively. The prevalence values differ based on geographical regions, diagnostic criteria, education level, undergraduate year of study, financial situation, living arrangements and gender. Overall, the prevalence of depressive symptoms and anxiety symptoms synthesized in this study was higher compared to pre-pandemic prevalence in similar populations. Evidently, mental health screening and intervention should be a top priority for universities and colleges during the pandemic.

The Role of Adolescents' Personal and Social Resources in Achieving Desired Emotional and Behavioral Outcomes during an Anxiety-Provoking Pandemic Outbreak

Considering adolescents' developmentally driven stressors and social needs, they may be particularly vulnerable to the anxiety associated with the public health and economic crises due to the COVID-19 pandemic. Furthermore, they may have difficulty following the mandated contagion prevention directives. The current study focused on the role of adolescents' positive personal resources (self-control, hope) and environmental resources (peer support) in two desired outcomes during the COVID-19 outbreak: wellbeing (i.e., maintaining/increasing positivity ratio) and contagion prevention behaviors (i.e., increasing handwashing). Path analysis was conducted using online survey data collected from a representative sample of 651 Israeli adolescents (ages 13-17). Positive resources were found to be both positively intercorrelated and negatively correlated with pandemic-related anxiety and positively with increased handwashing. Self-control correlated positively with social support, which, in turn, correlated positively with the positivity ratio (i.e., more positive than negative affects) and pandemic-related anxiety. Self-control and pandemic-related anxiety both correlated positively with increased prevention behavior. This study highlights the vital role of positive resources in achieving desired psychological and behavioral outcomes for adolescents during the anxiety-provoking pandemic. Beyond its theoretical innovation, this study offers practical value by focusing on malleable variables that could be the focus of dedicated interventions.

Mental Disorders of Bangladeshi Students During the COVID-19 Pandemic: A Systematic Review

Background

The unprecedented COVID-19 pandemic has become a global burden disrupting peoples’ quality of life. Students being an important cohort of a country, their mental health during this pandemic has been recognized as a concerning issue. Therefore, the prevalence and associated risk factors of Bangladeshi students’ mental health sufferings (ie, depression, anxiety, and stress) are systematically reviewed herein for the first time.

Methods

Adhering to the PRISMA guideline, a systematic search was performed from 1 to 5 April, 2021 in several databases including PubMed; and finally, a total of 7 articles were included to this review.

Results

The prevalence rates of mild to severe symptoms of depression, anxiety, and stress ranged from 46.92% to 82.4%, 26.6% to 96.82%, and 28.5% to 70.1%, respectively. The risk factors concerning mental health problems included the factors related to (i) socio-demographic (younger age, gender, lower educational grade, urban residence, family size, currently living with family/parents, and having children in the family), (ii) behavior and health (smoking status, lack of physical exercise, more internet browsing time, and dissatisfaction with sleep), (iii) COVID-19 pandemic- (COVID-19 related symptoms, COVID-19 related perceptions, and fear of COVID-19 infection), (iv) miscellaneous (losing part-time teaching job, lack of study concentration, agitation, fear of getting assaulted or humiliated on the way to the hospital or home, financial problems, academic dissatisfaction, inadequate food supply, higher exposure to COVID-19 social and mass media, engaging with more recreational activities, and performing more household chores).

Conclusion

The overall assumption of mental disorders’ prevalence rates can be regarded as problematic to this cohort. Thus, the authorities should consider setting up possible strategies to diminish the pandemic effect on students’ mental health.

Mental health difficulties of adults with COVID-19-like symptoms in Bangladesh: A cross-sectional correlational study

BACKGROUND

The rapid spread of novel corona virus disease (COVID-19) coupled with inefficient testing capacities in Bangladesh has resulted in a number of deaths from COVID-19-like symptoms that have no official test results. This study was the first study that explored the mental health of adults with the most common COVID-19-like symptoms in Bangladesh.

METHODS

This cross-sectional correlational study gathered data via an online survey to explore the mental health of Bangladeshi adults with symptoms akin to COVID-19. Level of stress, anxiety symptoms, and depressive symptoms were measured with the DASS-21. Chi-square tests and multivariate logistic regression was performed to examine the association of variables.

RESULTS

The prevalence rates of anxiety symptoms and depressive symptoms of the overall population were 26.9% and 52.0% respectively and 55.6% reported mild to extremely severe levels of stress. Multivariate logistic regression determined that respondents with COVID-19-like symptoms reported higher odds for stress level (AOR = 2.043, CI = 1.51 to 2.76), anxiety symptoms (AOR = 2.770, CI = 2.04 to 3.77) and depressive symptoms (AOR = 1.482, CI = 1.12 to 1.96) than asymptomatic respondents.

LIMITATIONS

There was a chance of recall bias as it was not possible to validate the information due to the retrospective design of the study. Recruitment methods only captured internet users, which reduces the generalizability of findings.

CONCLUSIONS

Patients with symptoms like those of COVID-19 should be prioritized in the healthcare setting in order to reduce mental health difficulties throughout the pandemic .