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

Self-Compassion during COVID-19 in Non-WEIRD Countries: A Narrative Review

The coronavirus disease 2019 (COVID-19) pandemic impacted people's mental health negatively worldwide, including in non-WEIRD (Western, Educated, Industrialised, Rich and Democratic) countries. Self-compassion, kindness and understanding towards oneself in difficult times have received increasing attention in the field of mental health. Self-compassion is strongly associated with good mental health in various populations. This narrative review aimed to synthesise the evidence on self-compassion and mental health in non-WEIRD countries during the COVID-19 pandemic. MEDLINE and PsycINFO were searched for empirical studies. Self-compassion was consistently associated with positive mental health in non-WEIRD countries too. However, how, and to what degree, each component of self-compassion impacts mental health remains to be evaluated across different cultures. Future research such as multi-national intervention studies, or component network meta-analysis, is needed to advance our understanding of how self-compassion improves mental health in different populations.

Sleep Quality Aspects in Post-COVID-19 Patients

In this observational cohort study, sleep quality in post-COVID-19 patients was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. This study aimed to examine aspects of sleep quality in patients who have undergone SARS-CoV-2 infection and if there is a pattern of progression or regression over time (6 months). We also observed and analyzed the results in order to identify any possible links between the severity of COVID-19 and sleep quality as measured by the PSQI questionnaire. The study group consisted of 65 adult patients with confirmed SARS-CoV-2 infection who were referred to a pulmonologist for evaluation. Sleep quality was impacted at a high rate in post-COVID-19 patients, quantified by a PSQI score ≥5. Out of 65 patients, 51% of them had scores greater than or equal to 5. Sleep was subjectively reported as unsatisfactory predominantly in mild and moderate COVID-19 patients. According to the PSQI score and a 6-month follow-up, many patients presented persistency in poor sleep quality. Investigation and individualized treatment of sleep disorders in post-COVID-19 patients should be part of the routine pneumological control, as improvement in sleep quality has an impact not only on the health but also on the psychological state of patients. Educating patients about the importance of sleep and sleep quality impairment should be a primary concern.

Mental health symptoms during the COVID-19 pandemic in developing countries: A systematic review and meta-analysis

Background

This systematic review aims to 1) summarize the prevalence of anxiety, depression, distress, insomnia, and PTSD in the adult population during the first year of the COVID pandemic in developing countries and 2) uncover and highlight the uneven distribution of research on mental health in all developing countries across regions.

Methods

Several literature databases were systemically searched for meta-analyses published by September 22, 2021, on the prevalence rates of mental health symptoms in developing countries worldwide. We meta-analysed the raw data of the individual empirical results from the previous meta-analysis papers in developing countries in different regions.

Results

The prevalence rates of mental health symptoms were summarized based on 341 empirical studies with a total of 1 704 072 participants from 40 out of 167 developing countries in Africa, Asia (East, Southeast, South, and West), Europe, and Latin America. Comparatively, Africa (39%) and West Asia (35%) had the worse overall mental health symptoms, followed by Latin America (32%). The prevalence rates of overall mental health symptoms of medical students (38%), general adult students (30%), and frontline health care workers (HCWs) (27%) were higher than those of general HCWs (25%) and general populations (23%). Among five mental health symptoms, distress (29%) and depression (27%) were the most prevalent. Interestingly, people in the least developing countries suffered less than those in emergent and other developing countries. The various instruments employed lead to result heterogeneity, demonstrating the importance of using the well-established instruments with the standard cut-off points (eg, GAD-7, GAD-2, and DASS-21 for anxiety, PHQ-9 and DASS-21 for depression, and ISI for insomnia).

Conclusions

The research effort on mental health in developing countries during COVID-19 has been highly uneven in the scope of countries and mental health outcomes. This meta-analysis, the largest on this topic to date, shows that the mental health symptoms are highly prevalent yet differ across regions. The accumulated systematic evidence from this study can help enable the prioritization of mental health assistance efforts to allocate attention and resources across countries and regions.

Psychosocial predictors of anxiety and depression in a sample of healthcare workers in Botswana during the COVID-19 pandemic: A multicenter cross-sectional study

Objectives:

This study aimed to investigate the psychological impact of the COVID-19 outbreak on healthcare workers across multiple hospitals in different districts in Botswana.

Methods:

We conducted a cross-sectional study in five public-funded hospitals from three districts in Botswana from 1 June 2020 to 30 October 2020. We used the neuroticism subscale of the 44-item Big Five Inventory, Patient Health Questionnaire, the Oslo 3-item Social Support Scale, the Anxiety Rating Scale, and the 14-item Resilience Scale to obtain data from 355 healthcare workers.

Results:

The participants’ mean age (standard deviation) was 33.77 (6.84) years. More females (207, 59%) responded than males (144, 41%). Anxiety and depression were experienced by 14% and 23% of the participants, respectively. After multiple regression analyses, neuroticism predicted depression (B = 0.22; p < 0.01) and anxiety disorder (B = 0.31; p < 0.01). Lower educational status (B = −0.13; p = 0.007) predicted anxiety and younger age (B = −0.10; p = 0.038) predicted depression, while resilience negatively correlated with both disorders.

Conclusion:

There is a need to develop and implement interventions targeted at these identified risk and protective factors that can be easily delivered to healthcare workers during this pandemic.

Meta-analytic evidence of depression and anxiety in Eastern Europe during the COVID-19 pandemic

Objective

To perform a systematic and meta-analysis on the prevalence rates of mental health symptoms including anxiety and depression during the COVID-19 pandemic in the general population in Eastern Europe, as well as three select sub-populations: students, general healthcare workers, and frontline healthcare workers.

Data sources

Studies in PubMed, Embase, Web of Science, PsycINFO, and medRxiv up to 6 February 2021.

Eligibility criteria and data analysis

Prevalence rates of mental health symptoms in the general population and key sub-populations during the COVID-19 pandemic in Eastern Europe. Data were pooled using a random-effects meta-analysis to estimate the prevalence rates of anxiety and depression.

Results

The meta-analysis identifies and includes 21 studies and 26 independent samples in Eastern Europe. Poland (n = 4), Serbia (n = 4), Russia (n = 3), and Croatia (n = 3) had the greatest number of studies. To our knowledge, no studies have been conducted in eleven Eastern European countries including Hungary, Slovakia, and Slovenia. The pooled prevalence of anxiety in 18 studies with 22 samples was 30% (95% CI: 24-37%) pooled prevalence of depression in 18 studies with 23 samples was 27% (95% CI: 21-34%).

Implications

The cumulative evidence from the meta-analysis reveals high prevalence rates of clinically significant symptoms during the COVID-19 pandemic in Eastern Europe. The findings suggest evidence of a potential mental health crisis in Eastern Europe during the ongoing COVID-19 pandemic. Our synthesis also reveals a relative lack of studies in certain Eastern European countries as well as high heterogeneities among the existing studies, calling for more effort to achieve evidence-based mental healthcare in Eastern Europe.

The Relationship Between Age and Mental Health Among Adults in Iran During the COVID-19 Pandemic

The evidence on the predictors of mental health in the COVID-19 pandemic has revealed contradictory findings, which prevent effective screening for mental health assistance. This study aims to identify the predictors of mental health issues, specifically examining age as a nonlinear predictor. Based on a survey of 474 adults using snowball sampling under the COVID-19 pandemic during April 1th-10th, 2020, in Iran, we found that age had a curvilinear relationship with nonsomatic pain, depression, and anxiety. Specifically, it predicted pain, depression, and anxiety disorders, negatively among adults younger than 45 years, yet positively among seniors older than 70 years. Adults who were female, were unsure about their chronic diseases, or exercised less were more likely to have mental health issues. This study, being the first paper to examine age curvilinearly, suggests future research to pay more attention to nonlinear predictors of mental health disorders in the COVID-19 pandemic.

The Psychological Impacts During the Initial Phase of the COVID-19 Outbreak, and its Associated Factors Among Pastoral Community in West Omo Zone, South-West Ethiopia, 2020: A Community-Based Study

BACKGROUND

COVID-19 is a global pandemic and a major health crisis affecting several nations. Such outbreaks are associated with adverse mental health consequences to any group of the population. Despite its negative effects, no study has addressed the potential psychological impacts of the COVID-19 outbreak among the pastoral community. This study aims to assess psychological experiences during the early stages of the COVID-19 outbreak and the factors that contributed to it among pastoral community residents in West Omo, South-West Ethiopia.

METHODS

A community-based cross-sectional study was carried out from May to June 2020. The study subjects were selected through a multistage sampling technique. Data were collected through face-to-face interviews, and entered into EpiData 3.1, then exported to SPSS version 24 for statistical analysis. The psychological impact was assessed by the Depression, Anxiety and Stress Scale (DASS-21). P-value < 0.20 during bi-variable analysis was considered as a candidate for multivariable logistic regression. Independent factors of depression, anxiety, and stress were assessed using adjusted odds ratio with 95% confidence level s at P-value < 0.05 cut-off point.

RESULTS

A total of 845 eligible pastoral residents were interviewed, with a 94.4% response rate. The prevalence of a positive response for anxiety, depression and stress was 30.8%, 26.3% and 24.4%, respectively. Being female was highly associated with developing anxiety and depression. Anxiety was found to be three times more prevalent among the respondents with ≥ 3 family members. Furthermore, participants with a history of mental illness, poor social support, and a high perceived life threat were also at a higher risk of experiencing anxiety, depression, and stress.

CONCLUSION

The prevalence of positive depression, anxiety and stress results were high. As a result, special attention should be paid, by governmental and non-governmental health organizations, to psychosocial and mental health programs for pastoral residentsduring the COVID-19 pandemic.