Psychological states of Bangladeshi people and associated factors during the outbreak of COVID-19: A cross-sectional survey

Child-related factors associated with depressive symptoms among mothers of school-going children in urban Bangladesh: A cross-sectional study

OBJECTIVE

This study aimed to identify the child-related factors associated with depressive symptoms among mothers of school-going children in Dhaka city of Bangladesh.

METHODS

The study followed a cross-sectional design and was conducted between June and December 2019 among mothers of school-going children from Dhaka City, Bangladesh. A multistage sampling technique was adopted, and a total of 324 mothers of school-going children studying in the same school for at least six months were selected. Depressive symptoms of mothers were measured using a 20-item Self-Rating Depression Scale weighted to 100 percent, with 25-49 categorized as no depression and ≥ 50 as having depression. A binary logistic regression model was executed to identify the child-related factors associated with depressive symptoms among mothers. All statistical analyses were performed using the statistical software, Stata (Version 14.0).

RESULTS

More than half of the participants (54.3%) were aged 40 years or above and had up to HSC level education (52.5%). The majority of the participants were homemakers (67.0%), mothers of a girl child (53.1%), and had a family income of 50,000 BDT or more (52.8%). Adjusted analyses revealed that the mother's depressive symptoms were associated with their child's frequent complaints of headaches or stomach aches (aOR = 13.19, 95% CI 3.03-57.37), having an injury (aOR = 4.05, 95% CI 1.44-11.41), and unfriendly relationship with mothers (aOR = 21.46, 95% CI 5.04-91.28).

CONCLUSION

The present study highlighted several child-related factors that are associated with depressive symptoms among mothers that need to be considered while designing any intervention to address depressive symptoms among mothers of school-going children. It is also important to counsel mothers and fathers of the children about the importance of having a sound mother-child relationship while addressing depressive symptoms among mothers.

Psychosocial health of school-going adolescents during the COVID-19 pandemic: Findings from a nationwide survey in Bangladesh

BACKGROUND

Common psychosocial health problems (PHPs) have become more prevalent among adolescents globally during the COVID-19 pandemic. However, the psychosocial health of school-going adolescents has remained unexplored in Bangladesh due to limited research during the pandemic. The present study aimed to estimate the prevalence of PHPs (i.e., depression and anxiety) and assess associated lifestyle and behavioral factors among school-going adolescents in Bangladesh during the COVID-19 pandemic.

METHODS

A nationwide cross-sectional survey was conducted among 3,571 school-going adolescents (male: 57.4%, mean age: 14.9±1.8 years; age range: 10-19 years) covering all divisions, including 63 districts in Bangladesh. A semi-structured e-questionnaire, including informed consent and questions related to socio-demographics, lifestyle, academics, pandemic and PHPs, was used to collect data between May and July 2021.

RESULTS

The prevalence of moderate to severe depression and anxiety were 37.3% and 21.7%, respectively, ranging from 24.7% in the Sylhet Division to 47.5% in the Rajshahi Division for depression, and from 13.4% in the Sylhet Division to 30.3% in the Rajshahi Division for anxiety. Depression and anxiety were associated with older age, reports of poor teacher cooperation in online classes, worries due to academic delays, parental comparison of academic performance with other classmates, difficulties coping with quarantine situations, changes in eating habits, weight gain, physical inactivity and having experienced cyberbullying. Moreover, being female was associated with higher odds of depression.

CONCLUSIONS

Adolescent psychosocial problems represent a public health problem. The findings suggest a need for generating improved empirically supported school-based psychosocial support programs involving parents and teachers to ensure the well-being of adolescents in Bangladesh. School-based prevention of psychosocial problems that promote environmental and policy changes related to lifestyle practices and active living should be developed, tested, and implemented.

A review of common mental health problems in the general population during the COVID-19 pandemic in South Asia

The coronavirus disease (COVID-19) pandemic has negatively impacted people's lives, neurobiological health, and general well-being throughout the world. South Asian countries have experienced high frequencies of psychiatric concerns that have worsened during the pandemic. This review aimed to determine the aggregated prevalence of common mental health problems (e.g., depression, fear, anxiety, stress, insomnia, and suicidal tendencies) and their associated factors among community populations in South Asian countries. Following the PRISMA guidelines, a comprehensive literature search was undertaken using multiple databases, including PubMed, Scopus, Global Health, Google Scholar and ResearchGate to retrieve articles. Overall, 22 articles were included. The prevalence of concerns ranged widely with respect to estimates of symptoms of depression (10.2-85.9%), fear (38.5-88.8%), anxiety (8.1-62.5%), stress (10.56-91.77%), and insomnia (13.32-53.45%). In addition, the prevalence of suicidal ideation was estimated to range between 5% and 8%. Factors associated with mental health concerns included socio-demographic, behavioral and health-related measures, and COVID-19 pandemic-related stressors. The findings suggest poor mental health among general populations in South Asia during the COVID-19 pandemic. Thus, identifying individuals with mental health concerns and implementing interventions including mental health counseling appear warranted among these populations.

Psychological Distress among Bangladeshi Dental Students during the COVID-19 Pandemic

Background: Psychological sufferings are observed among dental students during their academic years, which had been intensified during the COVID-19 pandemic. Objectives: This study assessed the levels and identified factors associated with psychological distress, fear and coping experienced by dental undergraduate students in Bangladesh. Methods: A cross sectional online survey was conducted during October-November, 2021. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used in order to assess psychological distress, fear and coping strategies, respectively. Results: A total of 327 students participated; the majority (72%) were 19-23 years old and females (75%). One in five participants were infected with COVID-19 and 15% reported contact with COVID-19 cases. Negative financial impact (AOR 3.72, 95% CIs 1.28-10.8), recent or past COVID-19 infection, and contact with COVID-19 cases were associated with higher levels of psychological distress; but being a third year student (0.14, 0.04-0.55) and being satisfied about current social life (0.11, 0.03-0.33) were associated with lower levels of psychological distress. Being a third year (0.17, 0.08-0.39) and a fourth year student (0.29, 0.12-0.71) were associated with lower levels of fear. Health care service use and feeling positive about life were associated with medium to high resilience coping. Conclusions: This study identified dental students in Bangladesh who were at higher risk of psychological distress, fear and coping during the ongoing pandemic. Development of a mental health support system within dental institutions should be considered in addition to the academic and clinical teaching.

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.

Investigating Poor Sleep Quality and Associated Factors During the COVID-19 Pandemic: A Population-Based Survey in Bangladesh

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected the sleep quality of individuals, and is a poorly investigated area. This study aimed to investigate the prevalence estimate of poor sleep quality and its associated factors among Bangladeshi residents during the COVID-19 pandemic. Methods: An online cross-sectional survey was carried out from July 20 to August 5, 2020, involving 975 Bangladeshi residents (male: 54.2%; mean age: 26.7 ± 9.4 years; age range: 18-75 years). A self-reported questionnaire was answered by the respondents, covering information on demographic characteristics, perceived physical health status, COVID-19-related factors, COVID-19-induced anxiety assessment, and sleep quality. To assess sleep quality, the Bangla version of the Pittsburgh Sleep Quality Index was used. Logistic regression models were performed to analyze the factors associated with sleep quality. Results: The prevalence estimate of poor sleep quality was 55.1% among the Bangladeshi people during the COVID-19 pandemic. As per the multiple regression analysis, poor sleep quality was significantly higher among respondents who reported female gender, moderate/poor health status, indirect contact with COVID-19 infected patients, decreased household income due to the COVID-19 pandemic, fear of infection, and COVID-19-induced anxiety. Conclusion: Poor sleep quality was slightly prevalent among general people in Bangladesh during the COVID-19 pandemic. The findings indicate an immediate response for this vulnerable group to improve the sleep quality during the public health emergency of COVID-19.

Mental Health Concerns, Insomnia, and Loneliness Among Intern Doctors Amidst the COVID-19 Pandemic: Evidence from a Large Tertiary Care Hospital in Bangladesh

Precisely how intern doctors (or trainee physicians) have been impacted during the COVID-19 pandemic is currently poorly understood. The present study aimed to investigate the mental health consequences (i.e., depression, anxiety, and stress), insomnia, and loneliness among intern doctors in Bangladesh amidst the pandemic. A cross-sectional offline survey of 108 intern doctors (53.7 % female; mean age = 24.80 ± 1.08; age range = 23-29 years) in a large tertiary care hospital in Bangladesh was conducted. The participants were surveyed randomly from respective wards during their duties with an anonymous and self-reported questionnaire assessing socio-demographics, COVID-19-related consideration, mental health, insomnia, loneliness, and other measures. Hierarchical regression analyses were conducted to examine relationships. The prevalence estimates of mild to extremely severe depression, anxiety, and stress were 53.7 %, 63.9 %, and 38.9 %, respectively. Sub-threshold to severe insomnia was acknowledged by 53.7 % and loneliness by 43.5 %. Depression was associated with not receiving mental health counseling during the pandemic, anxiety, stress, and loneliness; anxiety was associated with depression and stress; stress was associated with depression, anxiety, and loneliness; insomnia was associated with being married; and loneliness was associated with poorer quality of life, depression, and stress. Depression, but not anxiety and insomnia, fully mediated the relationship between loneliness and regret regarding choice of profession because of the pandemic and its many unexpected experiences. The findings showed considerable mental health concerns, insomnia, and loneliness among intern doctors in Bangladesh during the COVID-19 pandemic. Future studies should further explore the role of mental health concerns in healthcare providers and perceptions of their profession during the pandemic, and examine interventions to help this vulnerable population.

Depression and anxiety among individuals with medical conditions during the COVID-19 pandemic: Findings from a nationwide survey in Bangladesh

BACKGROUND

Coronavirus disease 2019 (COVID-19) disproportionately impacts individuals with medical conditions, including with respect to their mental health. The present study investigated depression and anxiety and their correlates among individuals with medical conditions in Bangladesh.

METHODS

Subjects were recruited to participate in an internet-based survey. Data were collected from November 2020 to January 2021 using convenience sampling by a semi-structured questionnaire through online platforms. Multiple regression analyses were performed to determine associations applying Bonferroni correction (p < 0.004). The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) measured depression and anxiety, respectively.

RESULTS

Nine-hundred-and-seventy-one participants (50.1% male; mean age = 42.29 ± 15.86 years; age range = 18-80 years) with medical conditions were included in final analyses. The most frequently reported conditions were diabetes, hypertension, obesity, heart disease, asthma, and anemia. Estimates of moderate to severe depression and anxiety were 38.9% and 35.2%, respectively. The mean depression and anxiety scores were significantly higher among participants who reported having hypertension, obesity, heart disease, asthma, anemia, cancer and chronic obstructive pulmonary disease (COPD). Using Bonferroni correction (p < 0.004), depression was associated with being female and a student, having poorer quality of life, poorer health status and greater numbers of co-morbidities, not engaging in physical exercise and tobacco smoking. Anxiety was associated with being female and a student, having lower socioeconomic status, poorer quality of life, poorer health status and greater numbers of co-morbidities, less sleep and tobacco smoking.

CONCLUSIONS

Depression and anxiety are prevalent among individuals with medical conditions and correlate with sociodemographic, quality-of-life and smoking measures. Interventions targeting vulnerable groups should be employed and investigated.