Abstract
The novel Coronavirus-2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020, impacting the lifestyles, economy, physical and mental health of individuals globally. This study aimed to test the model triggered by physical symptoms resembling COVID-19 infection, in which the need for health information and perceived impact of the pandemic mediated the path sequentially, leading to adverse mental health outcomes. A cross-sectional research design with chain mediation model involving 4612 participants from participating 8 countries selected via a respondent-driven sampling strategy was used. Participants completed online questionnaires on physical symptoms, the need for health information, the Impact of Event Scale-Revised (IES-R) questionnaire and Depression, Anxiety and Stress Scale (DASS-21). The results showed that Poland and the Philippines were the two countries with the highest levels of anxiety, depression and stress; conversely, Vietnam had the lowest mean scores in these areas. Chain mediation model showed the need for health information, and the perceived impact of the pandemic were sequential mediators between physical symptoms resembling COVID-19 infection (predictor) and consequent mental health status (outcome). Excessive and contradictory health information might increase the perceived impact of the pandemic. Rapid COVID-19 testing should be implemented to minimize the psychological burden associated with physical symptoms, whilst public mental health interventions could target adverse mental outcomes associated with the pandemic.
Highlights
The novel Coronavirus-2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020, impacting the lifestyles, economy, physical and mental health of individuals globally
The objective of this study was to compare the levels of DASS-21 scores and to rest the association between physical symptoms resembling COVID-19 infection and adverse mental health outcomes, as well as the mechanisms accountable for this association in multi-national populations across Asia, Europe and North America
The need for health information did not act as a mediator when considered alone, there was a sequential mediating effect in which physical symptoms was associated with the need for health information, which in turn associated with higher perceived impact of the pandemic, which in turn associated with adverse mental health outcomes
Summary
The novel Coronavirus-2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020, impacting the lifestyles, economy, physical and mental health of individuals globally. This study aimed to test the model triggered by physical symptoms resembling COVID-19 infection, in which the need for health information and perceived impact of the pandemic mediated the path sequentially, leading to adverse mental health outcomes. Chain mediation model showed the need for health information, and the perceived impact of the pandemic were sequential mediators between physical symptoms resembling COVID-19 infection (predictor) and consequent mental health status (outcome). Amanzio et al (2020) proposed a theoretical framework to explain the association between health information, the psychological impact of a pandemic, physical symptoms and mental health outcomes based on the nocebo phenomenon for the infectious disease[21]. The physical symptoms resembling COVID-19 infection would trigger the need to search for health information, affecting the perceived impact of the pandemic and adverse mental health outcomes (i.e., anxiety, depression and stress)
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