Fear and Depression during the COVID-19 Outbreak in Cameroon: A Nation-wide Observational Study

Abstract

Background: The COVID-19 pandemic has been associated with significant psychological and social distress worldwide. We investigated fear and depression among adults in Cameroon during different phases of the COVID-19 outbreak.Methods: An online survey was conducted in Cameroon from June–December 2020 using a structured questionnaire. Socio-demographic data and information regarding COVID-19 history were obtained. Fear and depressive symptoms were assessed using the Fear of COVID-19 score (FCV-19S) and the Patient Health Questionnaire (PHQ-9), respectively. Responses were clustered in weeks to better appreciate their evolution over time.Results: Overall, 7381 responses from all ten regions of Cameroon were analysed (median age: 30 years, 73.3% male). The prevalence of depression (PHQ-9 score ≥10) was 8.4%, and that of high fear of COVID-19 (FCV-19S scores ≥19) was 57.4%. These rates were similar across genders, age-groups, and region of residence. While mean weekly PHQ-9 scores remained fairly stable throughout the study period (range: 2.53 – 3.21; p=0.101), mean FCV-19S scores were highest during the early weeks but decreased significantly thereafter (from 20.31 to 18.34; p <0.001). Multivariate analyses revealed that having a postgraduate degree, a history of quarantine, flu-like symptoms during the past 14 days, and higher FCV-19S scores were associated with more severe depressive symptoms, while obtaining COVID-19 information from various sources reduced the odds for depression. Conclusion: Depression amidst the COVID-19 crisis is less prevalent in Cameroon than in other countries. Prompt and widespread dissemination of adequate COVID-19 information may reduce the risks for depression by dispelling fear and anxiety among Cameroonians.

Prevalence of Anxiety and Depression Among the General Population in Africa During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

“…Marital status (i.e., being single, widowed, divorced, or separated) ( 59 , 67 , 79 ), living alone without family or having a lack of emotional support from family and society ( 71 , 97 ) ( 45 , 46 ), family size ≥ 3 ( 48 , 49 ) and living in an urban area ( 31 , 32 , 69 ) were found to significantly increase depression, with the exception of two studies ( 47 , 60 ) which indicated that married people were more than three times as likely to experience depression ( p < 0.05). Higher educational level and professional qualification were found to significantly increase depression ( 29 , 31 , 49 , 59 , 60 , 69 ) with the exception of one study, which indicated higher depressive symptoms among non-educated people with disability (AOR = 2.12, 95% CI: 1.12–5.90) ( 67 ). Unemployment (AOR = 2.1, 95% CI: 1.32–5.11) ( 67 ) and low socioeconomic status significantly influenced the prevalence of depressive symptoms ( 35 , 48 , 49 , 57 , 69 ).…”

“…Anxiety prevalence was significantly associated with depression or depressive symptoms ( 35 , 40 , 50 ). Other anxiety-related symptoms reported were insomnia ( 14 , 27 , 40 , 54 , 60 , 65 , 67 , 70 , 72 , 77 , 81 ), fear of covid ( 29 , 53 , 92 ), psychological distress ( 30 ), worry ( 38 ), and fear of getting sick ( 93 ) ( Table 1 ).…”

“…Similarly, nurses who received negative feedback from their families (AOR = 2.19, 95% CI: 1.27–3.79) and a lack of COVID-19 management guidelines (AOR = 2.26, 95% CI: 1.21–4.21) were more likely to experience depression ( 51 ). Depression was associated with a history of other medical conditions or chronic disease ( 32 , 44 – 46 , 49 , 63 , 94 ), flu-like symptoms ( 29 ), fear of death ( 76 ), the recent death of a loved one ( 84 ), quarantine or home stay ( 29 , 43 , 44 ) and poor social support among students ( 35 , 44 , 46 ) and chronic medical patients ( 79 ). Reading or watching COVID-19 related news via media or internet sources was associated with increased depression ( 43 , 45 , 97 ).…”

“…Policies on the adoption of vaccine passports, while meant to incentivize vaccination among the general public, are replete with ethical and legal concerns ( 114 ). Within Africa, the public perception of these impending circumstances may potentially exacerbate symptoms of COVID-19 related anxiety and depression ( 29 , 53 , 92 ), in addition to the possibility of novel viral strains that are likely to emerge in subsequent waves ( 5 ). The anticipatory distress of potentially contracting the virus ( 30 , 38 , 93 ) among the overall population (encompassing frontline health care workers) ( 87 ) is contributing to what we see as an emerging mental health crisis throughout the African continent ( 36 ).…”

Depression, Stress, and Suicide in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutritional Examination Survey

“…On the other hand, some regional reports described a nonsignificant increase in depression during the COVID-19 pandemic [ 21 ]. In an online survey in Cameroon, fear and depressive symptoms were high in participants with a history of quarantine, flu-like symptoms, and fear of COVID-19, while adequate COVID-19 information reduced the odds for depression [ 21 ]. In line with these results, another online survey predicted that the participants with viral symptoms and pre-existing mental health problems had a greater risk of depression [ 22 ].…”