Abstract
Background:Feelings of isolation, insecurity, and instability triggered by COVID-19 could have a long-term impact on the mental health status of individuals.Objectives:The aim of this study was to examine the prevalence of mental health symptoms (anxiety, depression, and stress) in Bangladesh and the factors associated with these symptoms during the COVID-19 pandemic.Methods:From 1 to 30 April 2020, we used a validated self-administered questionnaire to conduct a cross-sectional study on 10,609 participants through an online survey platform. We assessed mental health status using the Depression, Anxiety, and Stress Scale (DASS-21). The total depression, anxiety, and stress subscale scores were divided into normal, mild, moderate, severe, and multinomial logistic regression was used to examine associated factors.Findings:The prevalence of depressive symptoms was 15%, 34%, and 15% for mild, moderate, and severe depressive symptoms, respectively. The prevalence of anxiety symptoms was 59% for severe anxiety symptoms, 14% for moderate anxiety symptoms, and 14% for mild anxiety symptoms, while the prevalence for stress levels were 16% for severe stress level, 22% for moderate stress level, and 13% for mild stress level. Multivariate analyses revealed that the most consistent factors associated with mild, moderate, and severe of the three mental health subscales (depression, anxiety, and stress) were respondents who lived in Dhaka and Rangpur division, females, those who self-quarantined in the previous seven days before the survey, and those respondents who experienced chills, breathing difficulty, dizziness, and sore throat.Conclusion:Our results showed that about 64%, 87%, and 61% of the respondents in Bangladesh reported high levels of depression, anxiety, and stress, respectively. There is a need for mental health support targeting women and those who self-quarantined or lived in Dhaka and Rangpur during the pandemic.
Highlights
As the global population tries to make sense of the transformations, including personal adjustments to lifestyle, brought about by the COVID-19 pandemic, residents of low- to middle-income countries (LMIC) including Bangladesh face greater challenges due to the fragile health systems [1, 2], the dense population of Bangladesh, and the fact that the country houses a million stateless Rohingya refugees in sprawling refugee camps that are conducive to the spread of epidemics
Of the 10,900 participants who completed the questionnaire, data for 10,660 adult respondents from the 8 divisions in Bangladesh who provided responses for the outcome measures of interest were included in the analysis
Respondents who were tested for COVID-19, those who traveled via public transport, and people who practiced self-quarantine self-reported a higher prevalence of depression, anxiety, and stress in this study
Summary
As the global population tries to make sense of the transformations, including personal adjustments to lifestyle, brought about by the COVID-19 pandemic, residents of low- to middle-income countries (LMIC) including Bangladesh face greater challenges due to the fragile health systems [1, 2], the dense population of Bangladesh, and the fact that the country houses a million stateless Rohingya refugees in sprawling refugee camps that are conducive to the spread of epidemics. Whilst the mortality rates in Bangladesh have remained low, due to the timing of the infection, the early transmission of the virus, and the response to the pandemic by authorities, the low socio-economic status of the country and the existing health inequalities usually lead to worse effects [3]. Science has played a significant role in improving people’s understanding of the virus, finding effective ways of containment through timely sequencing of the virus and rapid sharing of the data [4], and most recently the development of different vaccines. The COVID-19 pandemic spread faster, and the mortality rate is higher, than those attributed to the Middle Eastern respiratory syndrome (MERS) and Severe acute respiratory syndrome (SARS). No one has been able to report comprehensively the mental health impact of the pandemic in most LMIC. Insecurity, and instability triggered by COVID-19 could have a long-term impact on the mental health status of individuals
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