The impact of COVID-19 on mental health outcomes among hospital fever clinic attendants across Nepal: A cross-sectional study

Abstract

Background The COVID-19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID-19 outbreak and explore the potential influencing factors among the population attending the hospital fever clinics with COVID–19 symptoms. Methods A cross-sectional survey was conducted between May—June, 2020 with a sample of 645 participants aged 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety and Stress (DASS-21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables. Results The prevalence of anxiety, depression and stress were 14%, 7% and 5% respectively. In reference to Karnali, participants from Bagmati province reported higher level of anxiety (OR 3.44, 95% CI 1.31–9.06), while stress (OR 4.27, 95% CI 1.09–18.32) and depressive symptoms (OR 3.11, 95% CI 1.05–9.23) observed higher among the participants in Province 1. Women were more at risk of anxiety (OR 3.41, 95% CI 1.83–6.36) than men. Similarly, people currently living in rented houses reported more stress (OR 2.97, 95% CI 1.05–8.43) and those living far from family reported higher rates of depressive symptoms (OR 3.44, 95% CI 1.03–11.46). Conclusion The study identified increased prevalence of stress, anxiety and depressive symptoms during the initial stage of COVID-19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID-19 symptoms and who are prone to develop adverse mental health outcomes.

COVID-19 depression and its risk factors in Asia Pacific – A systematic review and meta-analysis

“… Sun et al, 2021 ), ( Tsang et al, 2021 ), (H. Wang et al, 2021 ), (Y. Wang et al, 2021 ), ( Wickens et al, 2021 ), ( Wu et al, 2021a ), (R. Yadav et al, 2021 ), ( Yan et al, 2021 ), ( Yasmin et al, 2021 ), ( Young et al, 2021 ) Gender 30 11.86 (Xu Chen et al, 2021 ), ( Chi et al, 2021 ), ( Devkota et al, 2021 ), ( Fang et al, 2021 ), ( Glenister et al, 2021 ), (Huang et al, 2021), ( Rashid et al, 2021 ), ( Kibbey et al, 2020 ), (S. Liu et al, 2021 ), ( Liu et al, 2020 ), ( Matsumoto et al, 2021 ), ( Moore et al, 2021 ), ( Nomura et al, 2021 ), ( Matsumoto et al, 2021 ), ( Moore et al, 2021 ), ( Nomura et al, 2021 ), ( Pandey et al, 2021 ), ( Parthasarathy et al, 2021 ), ( Peng et al, 2021 ), ( Robillard et al, 2021 ), ( Rossell et al, 2021 ), ( Safa et al, 2021 ), ( Sakib et al, 2021 ), ( Song et al, 2020 ), ( Suzuki et al, 2021 ), ( Turna et al, 2021 ), ( Veldhuis et al, 2021 ), (Y. Wang et al, 2021 ), ( Wong et al, 2021 ), ( Wu et al, 2021a ), (R. Yadav et al, 2021 ), ( Yan et al, 2021 ) Deterioration of medical problems/ medical condition/ diagnosed disease/ underlying disease 21 8.30 (J.…”

“… Chen et al, 2021 ), ( Fang et al, 2021 ), ( Fukase et al, 2021 ), ( Gotlib et al, 2021 ), ( Hammond et al, 2021 ), ( Hao et al, 2021 ), ( Hazarika et al, 2021 ), ( Kibbey et al, 2020 ), ( Liu et al, 2020 ), ( Mistry et al, 2021 ), ( Nishimura et al, 2021 ), ( Robillard et al, 2021 ), ( Sakib et al, 2021 ), ( Suzuki et al, 2021 ), ( Tsang et al, 2021 ), (Y. Wang et al, 2021 ), ( Wong et al, 2021 ), ( Yang et al, 2021 ), ( Young et al, 2021 ) Age 20 7.91 ( An et al, 2021 ), ( Cheema et al, 2021 ), ( Fukase et al, 2021 ), ( Glenister et al, 2021 ), ( Kar et al, 2021 ), ( Kar et al, 2021 ), ( Rashid et al, 2021 ), ( Kim et al, 2021 ), ( Matsumoto et al, 2021 ), ( Nkire et al, 2021 ), ( Robillard et al, 2021 ), ( Rossell et al, 2021 ), (Song et al, 2021), ( Tang et al, 2021 ), ( Turna et al, 2021 ), ( Veldhuis et al, 2021 ), ( Wong et al, 2021 ), ( Yan et al, 2021 ), ( Yang et al, 2021 ), ( Yunus et al, 2020 ) Income disruption/ financial restraints 19 7.51 (Xi an Chen et al, 2021 ), ( Cheng et al, 2021 ), ( Devkota et al, 2021 ), ( Fukase et al, 2021 ), ( ...…”

“… Liu et al, 2021 ), ( Wang Liu et al, 2021 ) Lack of education/awareness towards COVID 5 1.98 ( Cheema et al, 2021 ), ( Cheng et al, 2021 ), ( Faisal et al, 2021 ), ( Hazarika et al, 2021 ), ( Yang et al, 2021 ) Being HCW 4 1.58 (Huang et al, 2021), ( Kar et al, 2021 ), ( Liu et al, 2021 ), ( Matsumoto et al, 2021 ) Job burnout 4 1.58 (J. Chen et al, 2021 ), ( He et al, 2021 ), ( Rashid et al, 2021 ), ( Young et al, 2021 ) Others 21 8.32 ( An et al, 2021 ) (Yu an Liu et al, 2021 ), ( Robillard et al, 2021 ), ( Suzuki et al, 2021 ), ( Cheema et al, 2021 ), ( Glenister et al, 2021 ), ( Nishimura et al, 2021 ), ( Devkota et al, 2021 ), (Y. Liu et al, 2021 ), ( Matsumoto et al, 2021 ), ( Gotlib et al, 2021 ), ( Wolfson et al, 2021 ), Lietal 2021a, ( Nomura et al, 2021 ), ( Perera et al, 2021 ), (S. Sun et al, 2021 ), ( Moore et al, 2021 ) …”

The second wave of COVID‐19 hits Nepal: Burden for Nepal's healthcare system

“…4 , 12 In addition, the prevalence of mental health issues such as anxiety, depression, and stress has escalated significantly. 5 , 13 Closure of health services coupled with the lack of awareness, misinformation, and stigma associated with COVID‐19 have instigated limited affordability and fears of COVID‐19 transmission that further contribute to healthcare deficits. 6 , 14 …”

The Psychological Impacts of COVID-19 Pandemic among Emerging Adults: An Observational Cross-Sectional Study

“…This study determined the psychological impacts of the COVID-19 pandemic amongst emerging adults (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), including students in Saudi Arabia, using the DSM-5 and ASQ screening tools [18]. A high proportion (91.45%) of respondents reported mental symptoms that would warrant further inquiry, and 3.26% of respondents self-reported a diagnosis of mental illness.…”