The Iranian Corona Stress Study: Psychological Impacts of COVID‑19 Pandemic in an Iranian Population

Sadegh Sabouhi, Atefeh Vaezi, Mohammad Reza Sharbafchi, Amanda Aerni, Dorothee Bentz, David Coynel, Dominique de Quervain, Bernhard Fehlmann, Virginie Freytag, Christiane Gerhards, Andreas Papassotiropoulos, Nathalie Schicktanz, Thomas Schlitt, Anja Zimmer, Priska Zuber, Ehssan Amini

Abstract


Background: To assess the psychological consequences of changes during the coronavirus 2019 (COVID‑19) pandemic in the Iranian population.

Methods: We performed an anonymous online survey in the first 3 weeks of March 2020. Individuals older than 14 who could read Persian, and lived in Iran, were eligible for the study. The participants had to rate their stress levels and depressive symptoms (using a nine‑item Patient Health Questionnaire PHQ-9) during the last 2 weeks and before the pandemic retrospectively. The changes in the psychological measurements and their association with the sociodemographic factors and burdens due to confinement were assessed.

Results: Overall, among the 3,210 subjects who participated in our study, both the stress levels and average depression scores increased. However, about 23% of the subjects reported a decrease in their stress levels. The burden of childcare, restrictions in private life, and thoughts about the future were positively correlated with the changes in the stress levels and depression scores (|r| > 0.15). However, feeling relieved in the pandemic condition, and enjoying more family time were associated with less change in the stress and depression scores. Being religious (odds ratio [OR] [CI]: 1.5 [1.3‑1‑8]) and older age (OR [CI]: 2.9 [1.8–4.6] for >55 years old) were identified as the resilience factors, whereas being a student (OR [CI]: 2.1 [1.6;2.7]), seeking a job (OR [CI]: 2.6 [1.8;3.9]), and history of a psychiatric disorder (OR [CI]: 3.2 [2.6;4]) were identified as the risk factors for depression.

Conclusions: The stress levels and depressive symptoms have increased during the COVID‑19 pandemic and this increase is related to different social and personal burdens due to the confinement conditions.


Keywords


COVID‑19; depression; epidemiology; psychological; stress

Full Text:

PDF

References


WHO announces COVID‑19 outbreak a pandemic.

Available from: https://www.who.int/dg/speeches/detail/

who‑director‑general‑s‑opening‑remarks‑at‑the‑media‑briefing

‑on‑covid‑19 [Last accessed on 2020 Mar 11].

Holmes EA, O’Connor RC, Perry VH, Tracey I, Wessely S,

Arseneault L, et al. Multidisciplinary research priorities for the

COVID‑19 pandemic: A call for action for mental health science.

Lancet Psychiatry 2020;7:547‑60.

Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological

and mental impact of coronavirus disease 2019 (COVID‑19)

on medical staff and general public‑A systematic review and

meta‑analysis. Psychiatry Res 2020;291:113190.

COVID‑19 situation report, Islamic Republic of Iran. Available

from: https://covid19.who.int/region/emro/country/ir.

Xiong J, Lipsitz O, Nasri F, Lui LM, Gill H, Phan L, et al.

Impact of COVID-19 pandemic on mental health in the general

population: A systematic review. Journal of affective disorders.

;277:55-64.

Lau JT, Yang X, Tsui HY, Pang E, Wing YK. Positive mental

health‑related impacts of the SARS epidemic on the general

public in Hong Kong and their associations with other negative

impacts. J Infect 2006;53:114‑24.

de Quervain D, Aerni A, Amini E, Bentz D, Coynel D,

Gerhards C, et al. The Swiss Corona Stress Study 2020.

doi:10.31219/osf.io/jqw6a.

Kroenke K, Spitzer RL. The PHQ‑9: A new depression diagnostic

and severity measure. Psychiatr Ann 2002;32:509‑15.

Dadfar M, Kalibatseva Z, Lester D. Reliability and validity of the

Farsi version of the Patient Health Questionnaire‑9 (PHQ‑9) with

Iranian psychiatric outpatients. Trends Psychiatry Psychother

;40:144‑51.

Statistical Center of Iran. Findings of the 2016 National

Population and Housing Census. (2016). Available from: https://www.amar.org.ir/english/Population‑and‑Housing‑Censuses.

Vindegaard N, Benros ME. COVID‑19 pandemic and mental

health consequences: Systematic review of the current evidence.

Brain Behav Immun 2020;89:531‑42.

Maarefvand M, Hosseinzadeh S, Farmani O, Safarabadi Farahani A,

Khubchandani J. Coronavirus outbreak and stress in Iranians. Int J

Environ Res Public Health 2020;17:4441.

Salari N, Hosseinian‑Far A, Jalali R, Vaisi‑Raygani A,

Rasoulpoor S, Mohammadi M, et al. Prevalence of stress,

anxiety, depression among the general population during the

COVID‑19 pandemic: A systematic review and meta‑analysis.

Glob Health 2020;16:57.

Nicola Cantore FH, Lavopa A, Haverkamp K, Laplane A,

Rodousakis N. 2020. Coronavirus: The economic

impact – 10 July 2020. Available from: https://www.unido.org/

stories/coronavirus‑economic‑impact‑10‑july‑2020.

Greco V, Roger D. Uncertainty, stress, and health. Pers Individ

Differ 2003;34:1057‑68.

Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The

psychological impact of the COVID‑19 epidemic on college

students in China. Psychiatry Res 2020;287:112934.

Burcusa SL, Iacono WG. Risk for recurrence in depression. Clin

Psychol Rev 2007;27:959‑85.

Pfefferbaum B, North CS. Mental health and the Covid‑19

pandemic. N Engl J Med 2020;383:510‑2.

Ozdin S, Bayrak Ozdin S. Levels and predictors of anxiety,

depression and health anxiety during COVID‑19 pandemic in

Turkish society: The importance of gender. Int J Soc Psychiatry

;66:504‑11.

Braam AW, Koenig HG. Religion, spirituality and depression

in prospective studies: A systematic review. J Affect Disord

;257:428‑38.

Forouhari S, Hosseini Teshnizi S, Ehrampoush MH,

Mazloomy Mahmoodabad SS, Fallahzadeh H, Tabei SZ,

et al. Relationship between religious orientation, anxiety, and

depression among college students: A systematic review and

meta‑analysis. Iran J Public Health 2019;48:43‑52.

Rodriguez‑Llanes JM, Vos F, Guha‑Sapir D. Measuring

psychological resilience to disasters: Are evidence‑based

indicators an achievable goal? Environ Health 2013;12:115.

Coughlin SS. Recall bias in epidemiologic studies. J Clin

Epidemiol 1990;43:87‑91.




ijpm_12_448