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      Prevalence and predictors of post-traumatic stress symptoms and depressive symptoms among Bangladeshi students during COVID-19 mandatory home confinement: A nationwide cross-sectional survey

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          Abstract

          The COVID-19 pandemic has brought not only the risk of infection but also unbearable mental health difficulties with the concern of educational loss among students. This study explored the adverse impact of the COVID-19 outbreak on Bangladeshi students’ mental health and detected potential influencing factors related to post-traumatic stress symptoms (PTSS) and depressive symptoms. Convenience sampling was applied to collect data via online survey from 3997 college and university students between 29th May and 22nd July 2020. PHQ-9 and IES scales were used to assess depressive symptoms and PTSS, respectively. Of all participants, 52.87% had depressive symptoms and 40.91% had PTSS. Severe educational disruption was a risk factor for depressive symptoms (AOR = 1.68; 95% CI: 1.37–2.06) and PTSS (AOR = 1.86; 95% CI: 1.51–2.29). COVID-19 like symptoms including fever, cough, breathing difficulty and fatigue showed a stronger association with higher IES and PHQ-9 scores than other symptoms (e.g., diarrhea, sore throat) (p ≤ 0.01). Fear of infection and death by COVID-19 were risk factors for PTSS and depressive symptoms (p ≤ 0.01). Recreational activity and regular physical exercise emerged as the most protective factors for depressive symptoms and PTSS. The mental health of students is significantly affected in this pandemic suggesting the need for adequate psychological support.

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          The PHQ-9: validity of a brief depression severity measure.

          K Kroenke, R L Spitzer, J. Williams (2001)
          While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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            The psychological impact of quarantine and how to reduce it: rapid review of the evidence

            Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)
            Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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              The PHQ-9

              Kurt Kroenke, Robert L Spitzer, Janet B W Williams (2001)
              Article 0 comments Cited 2650 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Child Youth Serv Rev
                Journal ID (iso-abbrev): Child Youth Serv Rev
                Title: Children and Youth Services Review
                Publisher: Elsevier Ltd.
                ISSN (Print): 0190-7409
                ISSN (Electronic): 0190-7409
                Publication date PMC-release: 25 December 2020
                Publication date (Print): March 2021
                Publication date (Electronic): 25 December 2020
                Volume: 122
                Page: 105880
                Affiliations
                [a ]Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
                [b ]Public Health Foundation, Bangladesh
                [c ]School of Nursing and Midwifery, La Trobe University, Australia
                [d ]Department of Primary Care and Mental Health, University of Liverpool, United Kingdom
                Author notes
                [* ]Corresponding author at: Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh.
                [1]

                These two authors have similar contribution.

                Article
                Publisher Item ID: S0190-7409(20)32302-1 Publisher ID: 105880
                DOI: 10.1016/j.childyouth.2020.105880
                PMC ID: 9756039
                PubMed ID: 36540198
                SO-VID: 1d5ade97-0990-4794-91e9-3191760118ef
                Copyright © © 2020 Elsevier Ltd. All rights reserved.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 17 October 2020
                Date revision received : 18 December 2020
                Date accepted : 18 December 2020
                Categories
                Subject: Article

                Keywords: covid-19,post-traumatic stress symptoms,depressive symptoms,students,mental health,bangladesh
                Data availability:
                Keywords: covid-19, post-traumatic stress symptoms, depressive symptoms, students, mental health, bangladesh

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