Abstract
This study assessed symptoms of anxiety, depression and fear of COVID-19 in members of the general community and healthcare workers (HCWs) attending for COVID testing. This cross-sectional study was conducted in a public hospital COVID-19 testing clinic (June-September 2020) using self-administered questionnaires (i.e. the Hospital Anxiety and Depression Scale (HADS) and the Fear of COVID-19 Scale). In all, 430 participants who met the criteria for COVID-19 testing with nasopharyngeal and throat swabs completed the questionnaires. The mean (±s.d.) age of participants was 37.6 ± 12.6 years. HCWs made up 35.1% of the sample. Overall, the mean (±s.d.) score for anxiety was 6.09 ± 4.41 and 'case' prevalence (any severity) was 151/430 (35.1%), higher than normative population scores. Higher anxiety was found in women (P = 0.001) and in clients who had previously been tested for coronavirus (P = 0.03). HCWs had lower anxiety scores than members of the general community (P = 0.001). For depression, the mean (±s.d.) score was 4.18 ± 3.60, with a 'case' prevalence (any severity) of 82/430 (19.1%), similar to normative population scores. Women reported a higher level of COVID-19 fear (P = 0.001), as did people with a lower education level (P = 0.001). A greater psychological impact of COVID-19 was observed in women, people undergoing repeat testing and participants reporting lower levels of educational attainment. HCWs had fewer symptoms of anxiety and depression than non-HCWs attending the same clinic for COVID-19 testing. This information can be used to plan mental health interventions in primary care and testing settings during this and future pandemics.
Highlights
The psychological effects of the COVID-19 pandemic and the associated lockdown have been severe, with an increase in people reporting mental illness or not receiving ongoing treatment for previously existing mental illness (Pfefferbaum and North 2020; Rajkumar 2020)
Male gender (relative risk (RR) 0.57; 95% confidence interval (CI) 0.43–0.75; P, 0.001) and being an healthcare workers (HCWs) rather than a layperson (RR 0.53; 95% CI 0.39–0.72; P, 0.001) were associated with lower risk of anxiety, whereas having undergone a previous COVID-19 test was associated with a higher risk of anxiety (RR 1.30; 95% CI 1.02–1.66; P 1⁄4 0.03)
This study has demonstrated high levels of anxiety and fear of COVID-19 in laypersons attending ambulatory COVID-19 testing, despite a very low likelihood of a subsequent positive result
Summary
The psychological effects of the COVID-19 pandemic and the associated lockdown have been severe, with an increase in people reporting mental illness or not receiving ongoing treatment for previously existing mental illness (Pfefferbaum and North 2020; Rajkumar 2020). Generalised anxiety is more prevalent in areas with large COVID-19 caseloads and strict quarantine measures. A Spanish study reporting experiences early in the COVID-19 pandemic showed that 20% of the general community experienced significant symptoms of anxiety (Gonzalez-Sanguino et al 2020), with higher levels (.30%) reported in similar Chinese studies (Wang et al 2020a, 2020b). In Australia, in a sample of 1491 adults recruited through social media in April 2020, the prevalence of ‘any level’ anxiety, depression and stress was 21.2%, 38.3% and 27.8% respectively (Stanton et al 2020). A similar online study of 5071 participants found rates that were nearly twice as high: anxiety, 49.8%; depression, 61.8%; and stress, 54.5% (Newby et al 2020). Asked about the level of concern and worry about the possibility of contracting COVID-19, 66.4% were ‘a little’ or ‘moderately’ concerned and 25.7% were ‘very’ or ‘extremely’ concerned (Newby et al 2020)
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