Suicidal Ideation and Predictors of Psychological Distress during the COVID-19 Pandemic in Eswatini: A Population-Based Household Telephone Survey

Abstract

The unpredictability of the COVID-19 pandemic can induce psychological distress in individuals. We investigated perceived stressors, prevalence of psychological distress and suicidal ideation, and predictors of psychological distress among adults during the COVID-19 pandemic in Eswatini. This study was a cross-sectional, population-based household telephone survey of 993 conveniently sampled adults (18+ years) from all the four administrative regions of Eswatini. Data were collected between 9 June and 18 July 2020 during the first wave of the COVID-19 pandemic, when the country was under a partial lockdown. COVID-19-related psychological distress was assessed using the Kessler 6-item Psychological Distress Scale (K6). We performed weighted modified Poisson regression analyses to identify significant predictors of moderate/severe psychological distress (K6 scores: ≥5). The weighted prevalences of moderate (K6 scores: 5–12) and severe psychological distress (K6 scores: ≥13) were 41.7% and 5.4%, respectively. Participants reported several perceived COVID-19-related stressors, including worries and fears of the contagion-specific death, serious need for food and money, and concerns about loss of income or business. The weighted prevalence of suicidal ideation was 1.5%. Statistically significant predictors of increased risk for moderate/severe psychological distress included living in the Hhohho and Manzini regions; feeling not well informed about COVID-19; feeling lonely; having received COVID-19 food or financial relief from the government; feeling burdened by the lockdown; being married; and being youth (18–24 years). The results call for the government to urgently augment the provision of mental health services during the pandemic. Mental health practitioners and programs may use several stressors and risk factors identified in this study to inform interventions and government policies aimed at reducing psychological distress induced by the pandemic.

Risk factors of psychological distress during the COVID-19 pandemic: The roles of coping style and emotional regulation

“…Considering many previous reports about psychologic status during the COVID-19 pandemic were scored by K6 or K10, it is necessary to compare the PD prevalence results with these studies. The PD prevalence in this study was much lower than a sample of 993 adults from Eswatini using K6 ( Shongwe and Huang, 2021 ) and a sample of 553 medical students from Jordan using K10 ( Seetan et al., 2021 ), who had a PD rate of 47.1% and 50.3%, respectively. In Shongwe and Huang's study, desperate need for food and concerns about the loss of business were associated with the increased of PD prevalence, which was different with our sample, who were protected by their families and did not need to deal with these problems.…”

“…Then, the extent of the lockdown ( Bell et al., 2021 ), pre-existing depressive disorders ( Yamamoto et al., 2020 ), and food insecurity ( Serafini et al., 2021 ) have been proved to significantly impact the PD prevalence. Furthermore, the stage of the pandemic ( Goodwin et al., 2021 ), the data collection periods ( Yu et al., 2020 ), and the country's response to the pandemic ( Shongwe and Huang, 2021 ) also could be important reasons for the different PD prevalence.…”

Psychological Distress, Anxiety, Family Violence, Suicidality, and Wellbeing in Pakistan During the COVID-19 Lockdown: A Cross-Sectional Study

“…Our study shows 21.4% people reporting suicide ideation which is higher than the 6% reported in New Zealand, 1.5% in Eswatini and 4.5% reported in Spain during the first lockdown ( Every-Palmer et al, 2020 ; Mortier et al, 2021 ; Shongwe and Huang, 2021 ). Suicide cases are expected to rise further during lockdown as was seen in previous viral outbreaks ( The Dawn, 2021 ).…”

Psychosocial stress, adult suicidal ideation, and the mediating effect of poor sleep quality during the COVID‐19 pandemic in South Africa

“…While studies of suicidal behavior during the COVID‐19 pandemic in sub‐Saharan Africa are limited, a small handful of studies have documented prevalence rates of suicidal ideation in adult samples. Aloba and Opakunle (2021) reported that 11% of Nigerian adults in their sample of 498 adults with mild COVID‐19 symptoms experienced suicidal ideation, while a study of adults in Eswatini reported a 1.5% prevalence rate of thoughts of suicide (Shongwe & Huang, 2021). Another study of young adult college students in Uganda found a 13.9% prevalence rate of suicidal ideation (Kaggwa et al, 2022).…”