Psychological distress in Nepalese residents during COVID-19 pandemic: a community level survey

Abstract

Background COVID-19 pandemic has created unprecedented health and economic impact. Psychological stress, anxiety and depression are affecting not only COVID-19 patients but also health professionals, and general population. Fear of contracting COVID-19, forced restrictive social measures, and economic hardship are causing mental trauma. Nepal is a developing country from South Asia where the COVID-19 pandemic is still evolving. This online survey has been carried out to understand impact of COVID- 19 on mental health of Nepalese community dwellers. Methods The COVID-19 Peritraumatic Distress Index (CPDI) questionnaire adapted from the Shanghai Mental Health Centre was used for online data collection from 11 April-17 May 2020. Collected data were extracted to Microsoft excel-13 and imported and analyzed using SPSS (Statistical Package for Social Sciences) version-22. An initial univariate analysis was conducted for all variables to assess the distribution. Logistic regression analyses were done to estimate the odds ratios of relevant predicting variables. Results A total of 410 participants completed the self-rated questionnaires. Mean age of study participants was 34.8 ± 11.7 years with male preponderance. 88.5% of the respondents were not in distress (score less than 28) while, 11% had mild to moderate distress and 0.5% had severe distress. The prevalence of distress is higher among age group > 45 years, female gender, and post-secondary education group. Health professional were more likely to get distressed. Respondents with post-secondary education had higher odds (OR = 3.32; p = 0.020) of developing distress as compared to respondents with secondary education or lower. Conclusion There is lower rate of psychological distress in city dwellers and people with low education. Adequate intervention and evaluation into mental health awareness, and psychosocial support focused primarily on health care workers, female and elderly individuals is necessary.

Increased Psychological Distress, Loneliness, and Unemployment in the Spread of COVID-19 over 6 Months in Germany

“…We chose the CPDI scale because it has been a pioneering instrument for measuring psychological distress among general populations. It has been culturally and linguistically validated in a large range of studies across countries, including in Germany [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. The longitudinal outcome can be better assessed if standardized scales are applied over time to better understand the impact of the pandemic.…”

“…Among those studies, Shanghai Mental Health Center designed a COVID-19 Peritraumatic Distress Index (CPDI) questionnaire to assess psychological distress among the general population in China [ 10 ]. As the worldwide COVID-19 cases dramatically increased, several countries initiated their own nationwide mental health surveys between the end of March and the middle of May 2020 [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. They used the same CPDI design, employed previously in China [ 10 ], to assess mental status of the general population during this period of peak transmission of COVID-19 [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ].…”

“…As the worldwide COVID-19 cases dramatically increased, several countries initiated their own nationwide mental health surveys between the end of March and the middle of May 2020 [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. They used the same CPDI design, employed previously in China [ 10 ], to assess mental status of the general population during this period of peak transmission of COVID-19 [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. The results show that the general population across countries experienced psychological distress and that the prevalence of psychological distress varied from low (11.5% (N = 410) in Nepal [ 11 ]) to mild and moderate (24.1% (N = 1007) in Germany [ 12 ] and 28.6% (N = 1035) in Italy [ 13 ]) and to high (61.1% (N = 1058) in Iran [ 14 ] and 70.8% (N = 638) in Brazil [ 15 ]) compared to 34.4% (N = 52730) in China [ 10 ].…”

“…They used the same CPDI design, employed previously in China [ 10 ], to assess mental status of the general population during this period of peak transmission of COVID-19 [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. The results show that the general population across countries experienced psychological distress and that the prevalence of psychological distress varied from low (11.5% (N = 410) in Nepal [ 11 ]) to mild and moderate (24.1% (N = 1007) in Germany [ 12 ] and 28.6% (N = 1035) in Italy [ 13 ]) and to high (61.1% (N = 1058) in Iran [ 14 ] and 70.8% (N = 638) in Brazil [ 15 ]) compared to 34.4% (N = 52730) in China [ 10 ]. These studies yielded consistent findings that psychological distress and challenges to well-being during the outbreak arose in cross-cultural settings [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ].…”

Psychological distress among Italians during the 2019 coronavirus disease (COVID-19) quarantine

“…The survey script was available for all devices. The questionnaire used (Additional Table 1) was similar to those used in China during the tumultuous time of the COVID-19 epidemic [11], and to small surveys in Saudi Arabia [14], India [15], Iran [16], Brazil [17], Nepal [18], and Germany [19]. The socio-demographic section was modified to be more compliant with the Italian situation.…”