A chain mediation model on COVID-19 symptoms and mental health outcomes in Americans, Asians and Europeans

Wang, Cuiyan; Chudzicka‐Czupała, Agata; Tee, Michael L.; Núñez, María Inmaculada López; Tripp, Connor; Fardin, Mohammad Ali; Habib, Hina Ayaz; Tran, Bach Xuan; Adamus, Katarzyna; Anlacan, Joseph P.; García, Marta Evelia Aparicio; Grabowski, Damian; Hussain, Shahzad; Hoang, Men Thi; Hetnał, Mateusz; Le, Xuan Thi Thanh; Ma, Wenfang; Pham, Hai Quang; Reyes, Patrick Wincy C.; Shirazi, Mahmoud; Tan, Yilin; Tee, Cherica A.; Xu, Linkang; Xu, Ziqi; Vu, Giang Thu; Zhou, Danqing; Chan, Noreen; Kuruchittham, Vipat; McIntyre, Roger S.; Ho, Cyrus S.H.; Ho, Roger; Sears, Samuel F.

doi:10.1038/s41598-021-85943-7

Cited by 191 publications

(191 citation statements)

References 58 publications

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“…Although these measures have importance to suppress the outbreak, subsequent mental health impacts are not escaped, which evaluates mental health instabilities by accumulating psychological stressors like experiencing fear and panic, feeling frustrated and bored, facing a paucity of basic supplies, lacking authentic and reliable information, overwhelming with stigma, losing from jobs, and facing financial recession, etc., 8–11 and these devastating issues are alleged for subsequent suicide occurrences in globally including Bangladesh. 12–17 For instance, a systematic review 18 reported high rates of mental health outcomes (ie, up to 50.9% anxiety, 48.3% depression, 53.8% post-traumatic stress disorder, 38% psychological distress, and 81.9% stress were found) among the general population globally, as consistent with other literatures concerned with either multi-centered cross-sectional studies, 19 , 20 or systematic reviews. 6 , 21 …”

Section: Introductionsupporting

confidence: 74%

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

Al‐Mamun¹,

Hosen²,

Misti³

et al. 2021

PRBM

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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.

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Section: Introductionsupporting

confidence: 74%

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

Al‐Mamun¹,

Hosen²,

Misti³

et al. 2021

PRBM

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“…Linear regression showed that headache, myalgia, and dizziness were associated with higher DASS- 21…”

Section: Physical and Mental Health Parametersmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Physical and Mental Health in China and Spain: Cross-sectional Study (Preprint)

Wang¹,

López-Núñez²,

Pan³

et al. 2021

Preprint

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BACKGROUND The differences between physical and mental health across continents during the Coronavirus Disease 2019 (COVID-19) pandemic was unknown. OBJECTIVE This study compared the levels of impact of COVID-19 and mental health between people from Spain and China, and to correlate mental health parameters with variables relating to symptoms similar to COVID-19, COVID-19 knowledge and precautionary measures. METHODS We collected information on demographic data, physical symptoms, contact history, COVID-19 knowledge and precautionary measures. Participants filled the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21). To analyze the differences in the mental health parameters, the mean score between the Chinese and Spanish respondents was compared by the independent sample t-test. The differences in categorical variables between the two samples was analyzed by the chi-squared test. Linear regressions was used to calculate the univariate associations between independent variables and mental health parameters for the Chinese and Spanish respondents separately RESULTS A total of 1539 participants (678 from Spain; 861 from China) were recruited. Spanish participants reported significantly more symptoms similar to COVID-19 infection, contact history with COVID-19, higher perceived risk of contracting COVID-19, frequent use of medical services and less confidence in medical services as compared with Chinese (p<0.001). Spanish participants reported significantly higher stress and depression scores while the Chinese participants reported significantly higher IES-R scores (p<0.001). Chinese participants encountered more discrimination from other countries (p<0.001). Significantly fewer Spanish participants preferred to use face masks as well as obtained health information related to COVID-19 (p<0.001). Significantly more Chinese participants reported the use of face masks was associated with less depression but more health information was associated with adverse mental health in Spanish (p<0.05). CONCLUSIONS Our study found that Spanish respondents reported higher levels of stress and depression as well as more symptoms and medical services. Before the next pandemic, Spain needs to establish a prompt policy to implement rapid response and enhanced medical services to safeguard physical and mental health.

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“…As a result, we proposed a study to conduct an in-depth analysis of physical and mental health in China and Spain during the pandemic. The theoretical framework of this study was based on the chain mediation model, which shows the need for health information, and the perceived impacts of the pandemic were sequential mediators between physical symptoms resembling COVID-19 infection and consequent mental health status [21].…”

Section: This Studymentioning

confidence: 99%

“…Spanish and Chinese respondents showed different results in the linear regression analysis (Table S3, Multimedia Appendix 2). In terms of the level of confidence in doctors to diagnose COVID-19, Chinese individuals who were somewhat confident and very confident were associated with lower scores on the DASS- 21…”

Section: Knowledge and Views Of Covid-19 And Mental Health Parametersmentioning

confidence: 99%

“…The linear regression analysis found that the avoidance of sharing utensils, covering one's mouth when coughing and sneezing, practicing hand hygiene, and using a face mask were significantly associated with lower DASS- 21 S4, Multimedia Appendix 2). Among Spanish respondents, covering one's mouth when coughing and sneezing and hand hygiene measures were associated with lower DASS-21 anxiety and stress subscale scores, respectively (covering mouth when coughing and sneezing: anxiety, P=.02; stress, P=.02; hand hygiene-wash hand with soap: anxiety, P=.04; stress, P=.01).…”

Section: Precautionary Measures and Mental Health Parametersmentioning

confidence: 99%

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The Impact of the COVID-19 Pandemic on Physical and Mental Health in China and Spain: Cross-sectional Study

Wang¹,

López-Núñez²,

Pan³

et al. 2021

JMIR Form Res

Self Cite

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Background Differences in physical and mental health impact across continents during the COVID-19 pandemic are unknown. Objective This study compared the levels of impact of COVID-19 on mental health among people from Spain and China and correlated mental health parameters with variables relating to symptoms similar to COVID-19, COVID-19 knowledge, and precautionary measures. Methods We collected information on demographic data, physical symptoms, contact history with persons with a confirmed COVID-19 diagnosis, COVID-19 knowledge, and precautionary measures. Participants completed the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale–21 Items (DASS-21). To analyze the differences in the mental health parameters, the mean scores between Chinese and Spanish respondents were compared using the independent samples t test. The differences in categorical variables between the two samples were analyzed by the chi-square test. Linear regression was used to calculate the univariate associations between the independent variables and mental health parameters for both groups separately, with adjustments made for age, gender, and education. Results A total of 1528 participants (Spain: n=687; China: n=841) were recruited. The mean age of the Chinese respondents was 24.73 years (SD 7.60; range 18-65 years), and the mean age of the Spanish respondents was 43.06 years (SD 11.95; range 18-76 years). Spanish participants reported significantly more symptoms similar to COVID-19 infection (eg, fever, sore throat, and breathing difficulties), contact history with COVID-19, higher perceived risk of contracting COVID-19, frequent use of medical services, and less confidence in medical services compared with their Chinese counterparts (P<.001). Spanish participants reported significantly higher DASS-21 stress and depression scores, while Chinese participants reported significantly higher IES-R scores (P<.001). Chinese participants encountered more discrimination from other countries (P<.001). Significantly more Chinese participants reported using face masks than Spanish ones (P<.001). More exposure to health information was associated with adverse mental health in Spain (depression: P=.02; anxiety: P=.02; stress: P=.001). Conclusions Our study found that Spanish respondents reported higher levels of stress and depression as well as more symptoms and use of medical services. In preparation for the next pandemic, Spain needs to establish a prompt policy to implement rapid response and enhance medical services to safeguard physical and mental health.

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A chain mediation model on COVID-19 symptoms and mental health outcomes in Americans, Asians and Europeans

Cited by 191 publications

References 58 publications

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

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

The Impact of the COVID-19 Pandemic on Physical and Mental Health in China and Spain: Cross-sectional Study (Preprint)

The Impact of the COVID-19 Pandemic on Physical and Mental Health in China and Spain: Cross-sectional Study

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