Frequency and correlates of anxiety symptoms during the COVID-19 pandemic in low- and middle-income countries: A multinational study. (January 2021)

• Record Type: Journal Article
• Authors: Cénat, Jude Mary; Dalexis, Rose Darly; Guerrier, Mireille; Noorishad, Pari-Gole; Derivois, Daniel; Bukaka, Jacqueline; Birangui, Jean-Pierre; Adansikou, Kouami; Clorméus, Lewis Ampidu; Kokou-Kpolou, Cyrille Kossigan; Ndengeyingoma, Assumpta; Sezibera, Vincent; Auguste, Ralph Emmanuel; Rousseau, Cécile
• Is Part Of: Journal of psychiatric research. Volume 132(2021)
• Page Start: 13
• Page End: 17
• Publication Date: 2021-01
• Subjects: COVID-19 -- Exposure -- Stigmatization -- Resilience -- Anxiety -- Low- and middle-income countries; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2020.09.031
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: Objective: Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic. Methods: A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety. Results: Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x 2 = 32.6, p < .0001). For the pooled data, exposure to COVID-19 ( β = 0.06, p = .005), stigmatization related to COVID-19 ( β = 0.03, p < .001), and resilience ( β = −0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries ( β = 0.02, p < .00; β = 0.05, p = .013; β = 0.03, p = .021; β = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo). Conclusions: The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems. Highlights: Little is known on the mental health impact of the COVID-19 in low- and middle-income countries. One out of four individuals in individuals in low- and middle-income countries reported high level of anxiety. Exposure to COVID-19, stigmatization related to COVID-19 and resilience contributed in the prediction of anxiety. Cultural strength-based mental health programs need to be developed to reinforce individual and community resilience.