Abstract
ObjectiveFear of COVID-19 was associated with more severe depressive and anxiety symptoms. This study aimed to explore COVID-19-related fear, depressive and anxiety symptoms, social responsibility, and behavioral responses during the COVID-19 pandemic in Greece.MethodA cross-sectional study was conducted from April 10 to April 13, 2020. Members of the Greek general population completed anonymously an online survey, distributed through the social media. Among the 3,700 adult respondents, 3,029 fulfilled inclusion criteria. The survey included sociodemographic questions, questions exploring potential risk factors for increased fear of COVID-19, questions about the employment of safety and checking behaviors, and questions about compliance with public health guidelines. In addition, four psychometric scales were used, the Fear of COVID-19 Scale (FCV-19S), the Brief Patient Health Questionnaire (PHQ-9) depression scale, the Generalized Anxiety Disorder scale (GAD-7), and Steele’s Social Responsibility Motivation scale. Multivariate General Linear Models (GLM) were used to depict significant differences among dependent variables (FCV-19S, PHQ-9, GAD-7) and independent variables (potential risk factors, safety and checking behaviors, compliance with guidelines). The relationship between the FCV-19S total score and influencing factors was quantified by linear regression analysis.ResultsSeveral participants reported high levels of COVID-19-related fear (35.7%) and moderate to severe depressive symptoms (22.8%), while a significant proportion reported moderate to severe anxiety symptoms (77.4%). Women scored altogether significantly higher than men. Respondents under the age of 30 reported less fear and depressive symptoms and showed the least social responsibility. Based on GLM, a significant other’s COVID-19 illness, being on psychiatric medication, employment of safety and checking behaviors, and compliance with guidelines were associated with higher COVID-19-related fear. Linear regression analysis revealed that gender, age, depressive, and anxiety symptoms modified levels of COVID-19-related fear.ConclusionsGreater behavioral responses to the pandemic, that is, excessive employment of safety/checking behaviors and greater compliance with guidelines, were shown to amplify fear, potentially due to increased contamination awareness. In addition, female gender, older age, and more severe anxiety symptoms were related with higher COVID-19-related fear. Describing and weighing carefully the psychosocial and behavioral impact of the pandemic will enable the implementation of both supportive and preventive interventions.
Highlights
On December 31, 2019, the World Health Organization (WHO) China Country Office received information about the outbreak of a series of pneumonia cases in Wuhan, Hubei, China
AR2 = .258 (Adjusted R2 = .250); bR2 = .128 (Adjusted R2 = .119); cR2 = .187 (Adjusted R2 = .179); PRF1: Have you contracted the virus; PRF2: Has someone close to you contracted the virus; PRF3: Have you been on psychiatric medication during the past 6 months; SB1: I clean/disinfect the objects that I use; SB2: I take care of my personal hygiene; SB3: I use personal protective equipment; ChB1: I check myself for COVID-19 symptoms; ChB2: I have restricted physical contact with other people; ChB3: I communicate with my family doctor because I think I have COVID-19; Comp1: I follow the instructions of the World Health Organization; Comp2: I abide by the measures that the government has enacted to avoid spread of COVID-19
Since people with mental health disorders are likely to be more affected by COVID-19 due to higher vulnerability to stress compared with the general population [23, 34], this study considered a third potential risk factor for increased levels of fear, that is, receiving psychiatric medication during the past 6 months, indicative of the presence of a mental disease
Summary
On December 31, 2019, the World Health Organization (WHO) China Country Office received information about the outbreak of a series of pneumonia cases in Wuhan, Hubei, China. WHO announced the emersion of pneumonia in 41 confirmed cases, without specific recommendations for health measures by travelers [1]. The virus started spreading to neighbor Asian countries, to Europe, reaching United States on January 21, when the first confirmed COVID-19 case, a patient who had recently returned from Wuhan, was reported in Washington [3]. By the end of February, the virus had spread to countries worldwide [5], so that on March 11, WHO declared COVID-19 a pandemic, placing Europe at its center with over 20,000 confirmed cases and as many as 1,000 reported deaths. WHO/Europe advised European countries to prepare for different public health scenarios and encouraged the public to become accustomed, among others, to hand hygiene and social distancing [6]
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