COVID-19: Psychological distress, fear, and coping strategies among community members across the United Arab Emirates

BACKGROUND

The COVID-19 pandemic impacted the psychosocial well-being of the United Arab Emirates [UAE] population like other communities internationally.

OBJECTIVES

We aimed to identify the factors associated with psychological distress, fear, and coping amongst community members across the UAE.

METHODS

We conducted a cross-sectional online survey across the UAE during November 2020. Adults aged ≥18 years, living in the UAE who were able to respond to an online questionnaire in English or Arabic were considered eligible to participate in the study. We used standard validated tools to measure psychological distress, fear and coping. Kessler Psychological Distress Scale [K10] was used to assess psychological distress, Fear of COVID-19 Scale [FCV-19S] was used to assess the level of fear, and Brief Resilient Coping Scale [BRCS] was used to assess the coping strategies.

RESULTS

A total of 417 individuals participated in this study with a mean age of 29 [± 10.7] years. More than half of the participants experienced high to very high levels of psychological distress [55%] and a quarter experienced high levels of fear of COVID-19 [23.3%] with almost a third of them [36.2%] having low resilient coping. About 37.4% of the participants had work-related mental health impacts and 32.4% were perceived to have moderate to a great deal of distress due to a change of employment status during the pandemic. One in ten participants [9.4%] reported increased smoking. Increased smoking [AOR 8.66, 95% CIs 1.08-69.1,], increased alcohol drinking [AOR 2.39, 95% CIs 1.05-5.47] and higher levels of fear of COVID-19 [AOR 2.93, 95% CIs 1.83-4.67] were associated with moderate to very high levels of psychological distress. Being female [AOR 1.82, p = 0.030], having a pre-existing mental health condition [AOR 9.88, 95% p = 0.027], engaging in high-risk behaviors such as increased smoking [AOR 21.14, p = 0.003], increased alcohol drinking [AOR 1.48, p = 0.359] in the previous four weeks, and higher levels of fear of COVID-19 [AOR 4.18, p <0.001] were associated with moderate to very high levels of psychological distress. Also, being a smoker [AOR, 0.840, p = 0.011], and having a high level of fear [AOR 0.372, p = 0.001] were found to be associated with low resilient coping.

CONCLUSION

Community members in the UAE are at a higher risk of psychosocial distress and fear during the COVID-19 pandemic. Thus, healthcare providers and policymakers would need to be more alert to provide specific mental health support strategies for their wellbeing.

Link between cesarean section scar defect and secondary infertility: Case reports and review

The objective was to study clinical cases and understand the link between cesarean section scar defect with hydrometra and secondary infertility. A retrospective case series from an assisted reproductive center and infertility treatment clinic in the United Arab Emirates. We had five patients with secondary infertility diagnosed with cesarean section scar defect with persistent hydrometra based on high resolution transvaginal ultrasound assessment. The patients underwent surgical repair for the cesarean section scar defect followed by infertility treatment. Transvaginal ultrasound examination showed a normal endometrial cavity with triple lining endometrium and absence of hydrometra; and clinical pregnancy was the main outcome measure. Surgical correction of cesarean section scar defect was successfully performed in the cases presented. The patients had their fertility restored. Clinical studies revealed that cesarean section scar defect may lead to abnormal uterine bleeding, dysmenorrhea, pre-/post-menstrual spotting, heavy or prolonged menses, pelvic pain and secondary infertility. Theoretically, an inflammatory response, such as a wound healing process in the uterus due to hydrometra associated with scar defect may impair embryo implantation. The clinical case studies presented here are based on the correct diagnosis of the cesarean section scar defect with hydrometra and its successful surgical repair. The patients in our study had their symptoms resolved and attained clinical pregnancy.