Associations of Depression and Anxiety with Stigma in a Sample of Patients in Saudi Arabia Who Recovered from COVID-19

Abstract

Purpose The coronavirus disease (COVID-19) outbreak combined with social distancing, isolation, and movement restrictions has had a profound impact on individuals’ physical and psychological well-being. The aim of this study was to examine the associations of depression and anxiety with feelings of stigma among patients in Saudi Arabia who have recovered from COVID-19. Materials and Methods A cross-sectional survey was conducted between July and December 2020. Trained healthcare providers contacted and interviewed participants by phone. Depression, anxiety, and stigma were assessed using the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7) questionnaire, and the Explanatory Model Interview Catalogue stigma scale (EMIC). Data on sociodemographic characteristics, comorbidities, and family history of mental illness were also collected. Multiple linear regression models were performed to explore factors associated with depression and anxiety. Results A total of 174 adult participants (≥18 years old) who had recently recovered from COVID-19 were interviewed. The mean PHQ-9 and GAD-7 scores were 7.53 (±5.04) and 3.77 (±4.47), respectively. About 68% of the participants had at least mild depression (PHQ-9 score of 5–9), whereas only 29.89% had at least mild anxiety (GAD-7 score of 5–9) during their infections with COVID-19. Multiple linear regression showed that females were more vulnerable to depression and anxiety disorders than their male counterparts were ( β =3.071 and β =1.86, respectively). Notably, participants’ stigma scores were significantly associated with higher scores on depression and anxiety. Conclusion These findings highlight the negative consequences of COVID-19 infection on the mental health of recovered patients. Therefore, considerable attention from local and international health authorities is needed to improve the mental well-being of recovered COVID-19 patients.

Relationship between cognition and emotions caused by the COVID-19 infection, and depression and anxiety

“…Our results supported previous studies indicating relationships between COVID-19-related self-stigma and psychiatric symptoms such as depression, anxiety, insomnia, and overall mental health (30,31,59). Selfstigma is suggested to activate low self-esteem resulting in depression, as with patients with other several illnesses (60-62).…”

Perceived Stigma among Discharged Patients of COVID-19 in Wuhan, China: a Latent Profile Analysis

“…Similar to previously published studies, anxiety was a major risk factor for stigma. In a study that evaluated the depression and anxiety symptoms among 174 patients who recovered from symptomatic COVID-19 infection in Saudi Arabia, the stigma scores were signi cantly associated with higher scores on anxiety (53). Some other studies on people living with epilepsy, dementia, and cancer patients also demonstrated that anxiety is one of the psychosocial determinants of perceived stigma (54)(55)(56).…”

Age Differences in Psychological Antecedents and Behavioral Consequences of Stigmatization Associated with COVID-19 among Koreans

“…The stigmatization leads to social rejection and the avoidance of ICC [ 8 ]. At the individual level, the ICC may feel depressed and anxious due to the stigmatization [ 9 , 10 ]. Such negative emotions may last and reduce their social interactions for a long time after their recovery from COVID-19 [ 11 , 12 ].…”