TABLE I. Studies of Psychiatric Symptoms During the COVID-19 Pandemic Among General Population and Healthcare Workers.
| Assessment | Participants(n) | Country | Stress | Depression | Anxiety | Insomnia | Key results | Ref. |
|---|---|---|---|---|---|---|---|---|
| A. General population | ||||||||
| GAD-7 | undergraduates (7143) | China | N/A | N/A | 3.6 % | N/A | - Social support were negatively associated with anxiety symptom | [36] |
| DASS-21, PSQI > 5 | young adults (1310) | Italy | 50.1 % | 24.4 % | 32.6 % | 52.4 % | –Sleep difficulty was associated with stress, anxiety and depression. | [37] |
| CES-D > 28, GAD-7, PSQI > 7 | general public (7236) | China | N/A | 20.1 % | 35.1 % | 18.2 % | –Young people had a higher risk of anxiety–HCWs were at high risk for poor sleep#x2013;Spending ≥ 3 hr./day thinking about COVID-19 were associated with anxiety. | [38] |
| PHQ-8 ≥ 10, GAD-7 | young adults (898) | US | N/A | 43.3 % | 45.4 % | N/A | –Family support was associated with lower levels of depression and anxiety. | [39] |
| PHQ-9 | people who visited the clinic (3974) | Vietnam | N/A | 7.4 % | N/A | N/A | –People with suspected COVID-19 symptoms had a higher depression likelihood–Health literacy shows a protective effect on depression during the epidemic. | [40] |
| DASS-21 | university member (2530) | Spain | 40.3 % | 48.1 % | 35.2 % | N/A | –University staff had less DASS-21 scores compared to students. | [41] |
| DASS-21, ISI ≥ 15 | workforce (673) | China | 1.5 % | 3.7 % | 3.9 % | 2.4 % | –returning to work had not caused a high level of psychiatric symptoms in the workforce. | [42] |
| PHQ-9 | undergraduates (2485) | China | N/A | 9 % | N/A | N/A | –Feeling extreme fear and short sleep duration were associated with depression. | [43] |
| PSQI > 5 | general public (1630) | China | N/A | N/A | N/A | 36.4 % | –Higher perceived stress was related to lower sleep quality. | [44] |
| GAD-7, PHQ-9 | student (8079) | China | N/A | 17.4 % | 10.3 % | N/A | –Female gender and senior high school had higher risk for depressive and anxiety symptoms. | [45] |
| DASS-21 | general public (1879) | Philippines | 13.4 % | 16.9 % | 28.8 % | N/A | –Home quarantine is related to stress, depression, and anxiety. | [46] |
| DASS-21 | general public (1210) | China | 8.0 % | 16.5 % | 28.8 % | N/A | –Women, students and specific physical symptoms had higher risk for stress, depression, and anxiety. | [47] |
| B. Healthcare workers (HCWs) | ||||||||
| DASS-21 | HCWs (906) | India & Singapore | 5.2 % | 10.6 % | 15.7 % | N/A | –HCWs with physical symptoms had higher rates of depression, anxiety, stress. | [48] |
| DASS-21 | physician (442) | Turkey | 31.0 % | 47.1 % | 35.2 % | N/A | –Woman, young and less experienced people were in the high-risk group of stress, depression and anxiety. | [49] |
| GAD-7, ISI ≥ 15, PHQ-9 | physician (493) & nurse (764) (total = 1257) | China | N/A | 14.8 % (13.8 vs 15.4) | 12.3% (11.6 vs 12.7) | 7.7 % (5.7 vs 9) | –HCWs exposed to COVID-19, women, nurses, those in Wuhan, and front-line had a high risk of adverse mental health outcomes. | [50] |
| HAMA ≥ 7, HAMD ≥ 7 | HCWs (2299) | China | N/A | 11.7 % | 24.7 % | N/A | –Medical staff had greater psychological distress than the administrative staff.–Front line medical staff were twice more likely to suffer anxiety and depression. | [51] |
| GAD-7, ISI ≥ 8, PHQ-9, | HCWs (1563) | China | N/A | 17.2 % | 12.9 % | 36.1 % | –Insomnia were associated with currently working in an isolation unit, worried about being infected, and perceived lack of mental support. | [52] |
| SAD, SDS | physician(79) & nurse (86) (total = 165) | China | N/A | 44.2 % (45.6 vs 43.0) | 20.0 % (11.4 vs 27.9) | N/A | –History of depression or anxiety was a risk factor for anxiety and depressive symptoms, while male was a protective factor for depression | [53] |
| C. General population and health care workers | ||||||||
| GAD-2 ≥ 3, ISI > 8, PHQ −2 ≥ 3 | HCW (927) & non-HCW (1255) (total = 2182) | China | N/A | 10.6% | 10.4% | 33.9% | –HCWs, Living in rural areas, female, and at risk of contact with COVID-19 patients had higher risk for insomnia, anxiety, and depression | [54] |
| D. Patient with COVID-19 | ||||||||
| GAD-7, PHQ-9, PSS-10 | patient (103) & normal (103) (total = 206) | China | N/A | 17.5 % (patient) | 7.0 % (patient) | N/A | –CRP levels correlated with the scores of PHQ-9 in patients with depressive symptom. | [55] |
| E. Patient with chronic disease | ||||||||
| DASS-21, ISI ≥ 15 | psychiatric patient (76) | China | 17.1 % | 22.4 % | 23.7 % | 26.3 % | –Stress, depression, anxiety, and insomnia were higher in psychiatric patients. | [56] |
| DASS-21 | RA and SLE patient (512) | Philippines | 12.3 % | 27.7 % | 38.7 % | N/A % | –Satisfaction with available health information was associated with low levels of stress and depression. | [57] |
Abbreviations: CES-D; Center for Epidemiological Studies Depression Scale, CRP; C-Reactive Protein DASS-21; Depression Anxiety Stress Scale, GAD-7; General Anxiety Disorder 7-items scale, HAM-A; Hamilton Anxiety Rating Scale, HAM-D; Hamilton Depression Rating Scale, ISI; Insomnia Severity Index, PHQ-8; Patient Health Questionnaire-8, PHQ-9; Patient Health Questionnaire-9, PSQI; Pittsburg Sleep Quality Index, RA; Rheumatoid Arthritis, SAS; The Zung Self-Rating Anxiety Scale, SDS; The Zung Self-Rating Depression Scale, SLE; Systemic Lupus Erythematosus