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      The impact of COVID-19 pandemic on physical and mental health of Asians: A study of seven middle-income countries in Asia

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          Abstract

          The coronavirus disease (COVID-19) pandemic has impacted the economy, livelihood, and physical and mental well-being of people worldwide. This study aimed to compare the mental health status during the pandemic in the general population of seven middle income countries (MICs) in Asia (China, Iran, Malaysia, Pakistan, Philippines, Thailand, and Vietnam). All the countries used the Impact of Event Scale–Revised (IES-R) and Depression, Anxiety and Stress Scale (DASS-21) to measure mental health. There were 4479 Asians completed the questionnaire with demographic characteristics, physical symptoms and health service utilization, contact history, knowledge and concern, precautionary measure, and rated their mental health with the IES-R and DASS-21. Descriptive statistics, One-Way analysis of variance (ANOVA), and linear regression were used to identify protective and risk factors associated with mental health parameters. There were significant differences in IES-R and DASS-21 scores between 7 MICs (p<0.05). Thailand had all the highest scores of IES-R, DASS-21 stress, anxiety, and depression scores whereas Vietnam had all the lowest scores. The risk factors for adverse mental health during the COVID-19 pandemic include age <30 years, high education background, single and separated status, discrimination by other countries and contact with people with COVID-19 (p<0.05). The protective factors for mental health include male gender, staying with children or more than 6 people in the same household, employment, confidence in doctors, high perceived likelihood of survival, and spending less time on health information (p<0.05). This comparative study among 7 MICs enhanced the understanding of metal health in the general population during the COVID-19 pandemic.

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          Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

          Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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            Impact of COVID-19 Pandemic on Mental Health in the General Population: A Systematic Review

            Highlights • The Coronavirus disease 2019 (COVID-19) pandemic has resulted in unprecedented hazards to mental health globally. • Relatively high rates of anxiety, depression, post-traumatic stress disorder, psychological distress, and stress were reported in the general population during the COVID-19 pandemic in eight countries. • Common risk factors associated with mental distress during the COVID-19 pandemic include female gender, younger age group (≤40 years), presence of chronic/psychiatric illnesses, unemployment, student status, and frequent exposure to social media/news concerning COVID-19. • Mitigation of COVID-19 induced psychological distress requires government intervention and individual efforts.
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              A Longitudinal Study on the Mental Health of General Population during the COVID-19 Epidemic in China

              Highlights • A significant reduction in psychological impact 4 weeks after COVID outbreak. • The mean scores of respondents in both surveys were above PTSD cut-offs. • Female gender, physical symptoms associated with a higher psychological impact. • Hand hygiene, mask-wearing & confidence in doctors reduced psychological impact. • Online trauma-focused psychotherapy may be helpful to public during COVID-19.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: Visualization
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: SupervisionRole: Visualization
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Supervision
                Role: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Validation
                Role: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Validation
                Role: Data curationRole: Project administrationRole: Validation
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                11 February 2021
                2021
                11 February 2021
                : 16
                : 2
                : e0246824
                Affiliations
                [1 ] Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
                [2 ] College of Medicine, University of the Philippines, Manila, Philippines
                [3 ] University Malaysia Sarawak (UNIMAS), Sarawak, Malaysia
                [4 ] Department of Psychology, Zahedan Branch, Islamic Azad University, Zahedan, Iran
                [5 ] College of Public Health Sciences, Chulalongkorn University, a member of Thailand One Health University Network (THOHUN), Bangkok, Thailand
                [6 ] Institute of Clinical Psychology, University of Karachi, Karachi, Pakistan
                [7 ] Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
                [8 ] Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
                [9 ] DHQ Hospital Jhelum, Jhelum, Pakistan
                [10 ] Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
                [11 ] Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
                [12 ] Department of Psychology, University of Sistan and Baluchestan, Zahedan, Iran
                [13 ] Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
                [14 ] Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
                [15 ] Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
                [16 ] Department of Psychological Medicine, National University Health System, Singapore, Singapore
                [17 ] Institute for Health Innovation and Technology (iHealthtech), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
                [18 ] Southeast Asia One Health University Network (SEAOHUN), Chiang Mai, Thailand
                Jouf University, Kingdom of Saudi Arabia, SAUDI ARABIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-4080-3196
                https://orcid.org/0000-0001-9629-4493
                https://orcid.org/0000-0001-7236-7547
                Article
                PONE-D-20-32623
                10.1371/journal.pone.0246824
                7877638
                33571297
                67083837-a3d9-48d7-b5dc-b073104d0001
                © 2021 Wang et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 17 October 2020
                : 27 January 2021
                Page count
                Figures: 1, Tables: 5, Pages: 20
                Funding
                Funded by: Huaibei Normal University, China.
                Award Recipient :
                Funded by: National University of Singapore iHealthtech Other Operating Expenses
                Award ID: R-722-000-004-731
                Award Recipient :
                Funded by: Vingroup Innovation Foundation (VINIF) COVID in Vietnam
                Award ID: VINIF.2020.Covid19.DA07
                Award Recipient :
                This study has the following funding sources: 1. Author C.W, 1 grant, Huaibei Normal University, China. 2. Author R.H, 1 grant, National University of Singapore iHealthtech Other Operating Expenses (R-722-000-004-731) 3. Author B.X.T, 1 grant, Vingroup Innovation Foundation (VINIF) COVID research grant (VINIF.2020.Covid19.DA07) in Vietnam
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Medicine and Health Sciences
                Epidemiology
                Pandemics
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                People and Places
                Geographical Locations
                Asia
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.
                COVID-19

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