Psychosocial Aspects During the First Wave of COVID-19 Infection in South Africa

Impacts of Covid-19 on mental health service provision in the Western Cape, South Africa: The MASC study

In the context of an already large treatment gap in South Africa, this study aimed to examine how Covid-19 and the related lockdown measures affected the availability, accessibility, quality, and continuity of mental health services in the Western Cape province in South Africa. A mixed-methods design was employed, using narrative surveys, quantitative surveys, and qualitative semi-structured interviews, with 17 public mental health providers, and secondary data from the District Health Information System. We analysed and combined the data using descriptive statistics, template analysis and methodological triangulation. Results showed that Covid-19 and the lockdowns had negative impacts on mental health service provision at all levels of care, such as reduced access to services, increased stigma and discrimination, disrupted medication supply, increased workload and stress for providers, and the closure of psychosocial and therapeutic services. Innovations used by providers to mitigate these impacts included telehealth, online training, peer support groups, and community outreach. The study concludes that Covid-19 and the lockdowns exposed and exacerbated the existing gaps and challenges in mental health service provision in South Africa. Key recommendations for policy formation and response to future pandemics in the public mental health sector include: classifying psychological treatments as essential services, establishing an intersectoral mental health emergency response plan, involving mental health care users in the development of pandemic responses, creating policies for managing health emergencies in psychiatric facilities, and increasing resources for the mental health sector in South Africa. These recommendations are relevant for South Africa and other LMICs in ensuring adequate mental health care during public health emergencies.

A meta-analytic review of the associations between dimensions of religious coping and psychological symptoms during the first wave of the COVID-19 pandemic

INTRODUCTION

In the first wave of the COVID-19 pandemic, the unknown etiology and treatment of the highly transmissible coronavirus posed considerable threats to public mental health. Many people around the globe turned to religion as an attempt to mitigate their heightened psychological distress, but mixed findings have been obtained regarding the association between the use of religious coping and two psychological symptoms-anxiety and depressive symptoms-widely reported in the initial wave.

OBJECTIVE

The present meta-analysis was conducted to resolve the empirical inconsistency by synthesizing this body of studies and identifying both individual and national-level factors that accounted for the inconsistent findings.

METHODS

Following PRISMA guidelines, the literature search and data screening procedures yielded 42 eligible studies, with 25,438 participants (58% females, average age = 36.50 years) from 24 countries spanning seven world regions.

RESULTS

Overall, the results showed that only negative religious coping was positively associated with psychological symptoms (r = 0.2886, p < 0.0001). Although the associations of both general and positive religious coping with psychological symptoms were non-significant (rs = 0.0425 and -0.0240, ps > 0.39), the moderation analysis revealed significant positive associations between positive religious coping and psychological symptoms in two demographic groups who experienced greater pandemic distress than their counterparts: younger participants and female participants.

DISCUSSION

This meta-analysis provides a nuanced understanding of the complex nature of religious coping in the initial wave of the COVID-19 pandemic when the levels of public anxiety and stress were heightened. The exclusive use of religious coping may not be associated with low levels of psychological symptoms, implying the importance of supplementing the deployment of this strategy with an array of other strategies. Therapists of mental health interventions should show their clients how to make good use of positive religious coping together with other strategies, and how to avoid the use of negative religious coping, to handle their psychological problems.

SYSTEMATIC REVIEW REGISTRATION

https://osf.io/shb32/.

Association between recent COVID-19 diagnosis, depression and anxiety symptoms among slum residents in Kampala, Uganda

BACKGROUND

Despite the known link between poor living conditions and mental health, there has been little research on the mental health of slum dwellers worldwide. Although the Coronavirus disease 2019 (COVID-19) pandemic has led to an increase in mental health issues, little focus has been given to the impact on slum dwellers. The study aimed to investigate the association between recent COVID-19 diagnosis and the risk of depression and anxiety symptoms among people living in an urban slum in Uganda.

METHODS

A cross-sectional study was conducted among 284 adults (at least 18 years of age) in a slum settlement in Kampala, Uganda between April and May 2022. We assessed depression symptoms and anxiety using validated Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder assessment tool (GAD-7) questionnaires respectively. We collected data on sociodemographic characteristics, and self-reported recent COVID-19 diagnosis (in the previous 30 days). Using a modified Poisson regression, adjusted for age, sex, gender and household income, we separately provided prevalence ratios and 95% confidence intervals for the associations between recent COVID-19 diagnosis and depressive and anxiety symptoms.

RESULTS

Overall, 33.8% and 13.4% of the participants met the depression and generalized anxiety screening criteria respectively and 11.3% were reportedly diagnosed with COVID-19 in the previous 30 days. People with recent COVID-19 diagnosis were more likely to be depressed (53.1%) than those with no recent diagnosis (31.4%) (p<0.001). Participants who were recently diagnosed with COVID-19 reported higher prevalence of anxiety (34.4%) compared to those with no recent diagnosis of COVID-19 (10.7%) (p = 0.014). After adjusting for confounding, recent diagnosis with COVID-19 was associated with depression (PR = 1.60, 95% CI 1.09-2.34) and anxiety (PR = 2.83, 95% CI 1.50-5.31).

CONCLUSION

This study suggests an increased risk of depressive symptoms and GAD in adults following a COVID-19 diagnosis. We recommend additional mental health support for recently diagnosed persons. The long-term of COVID-19 on mental health effects also need to be investigated.

Psychosocial and Physical Predictors of Stress in University Students during the COVID-19 Pandemic: An Observational Study

Currently, university students are at a high risk of stress due to university adjustment, educational interruption, and alterations in daily life because of the COVID-19 pandemic. This study examined the relationship of psychosocial and physical factors with stress in university students during the pandemic. Demographic, psychosocial, physical, and self-perceived stress level information were obtained from 409 Thailand university students. A multiple regression analysis was performed, with stress level as the dependent variable and gender, age, study period, study program, social support, self-esteem, health literacy, health behavior score, sedentary behavior, and physical activity (PA) as independent variables. Most participants had moderate stress levels (68.9%), high self-esteem (83.9%) and social support (66.5%), fair health literacy (41.1%) and health behavior (32%), sedentary lifestyle (85.3%), and PA-levels lower than 600 min per week (57.46%). The regression analysis showed that 45.7% of the variability in stress level was predicted by self-esteem, study period, social support, travel domain of PA, and health behavior. COVID-19 and the attendant restrictions resulted in moderate levels of stress in Thailand university students. High self-esteem, long duration of study, great social support, and having healthy behavior may contribute to the prevention of stress in this population.

Impact of COVID-19 Pandemic on Sleep Quality, Stress Level and Health-Related Quality of Life-A Large Prospective Cohort Study on Adult Danes

The everyday lives of Danish inhabitants have been affected by the COVID-19 pandemic, e.g., by social distancing, which was employed by the government in March 2020 to prevent the spread of SARS-CoV-2. Moreover, the pandemic has entailed economic consequences for many people. This study aims to assess changes in physical and mental health-related quality of life (MCS, PCS), in stress levels, and quality of sleep during the COVID-19 pandemic and to identify factors that impact such changes, using a prospective national cohort study including 26,453 participants from the Danish Blood Donor Study who answered a health questionnaire before the pandemic and during the pandemic. Descriptive statistics, multivariable linear and multinomial logistic regression analyses were applied. A worsening of MCS and quality of sleep was found, and an overall decrease in stress levels was observed. PCS was decreased in men and slightly increased in women. The extent of health changes was mainly affected by changes in job situation, type of job, previous use of anti-depressive medication and the participants’ level of personal stamina. Thus, living under the unusual circumstances that persisted during the COVID-19 pandemic has had a negative impact on the health of the general population. This may, in time, constitute a public health problem.