Objectives Coronavirus disease 2019 (COVID-19) pandemic has been associated with a great level of psychological distresses in people around the world. This study aims to assess the prevalence of depression, anxiety and stress among COVID-19 patients and identify the associated factors, in Herat Province of Afghanistan.
Methods This cross-sectional study was conducted on 459 hospitalized patients between May and September 2021. Data was collected with a structured questionnaire on depression, anxiety and stress scale, which was the validated Dari-version. Chi-square test was adopted to analyze the associations of the prevalence of the mental disorders and the factors.
Results The mean age of participants was 38.05; 51.9% (238/459) were male and 84.1% (386/459) were married. Median scores for depression, anxiety and stress were 5.0, 8.0, and 10.0, respectively. Gender, general health condition, nutritional status, COVID-19 clinical manifestation and concurrent comorbidities (except diabetes and hypertension) were significantly associated with mental disorders; while association between marital status and these psychological disorders was not significant. Moreover, a significant difference was observed in the level of anxiety between healthcare workers and other respondents.
Conclusion This is the first study to report the high prevalence of depression, anxiety and stress among COVID-19 patients in Herat, which indicates the negative effect of mental health for COVID-19 patients globally and highlights the need for urgent and appropriate interventions to improve mental health of people during the pandemic.
The coronavirus disease 2019 (COVID-19) was first reported in Wuhan City of China at the end of 2019.1 On 11 March 2020, the disease which is caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) was characterized as “pandemic” by the World Health Organization (WHO).2 In Afghanistan, the first case of COVID-19 was diagnosed on 24 February 2020, in Herat Province (hereafter referred as Herat).3,4
The pandemic rapidly spreads in the world, affecting more people day by day. As of 1 February 2022, over 360 million COVID-19 cases and 5.6 million deaths have been confirmed in the world, of which over 160 000 cases and 7 400 deaths come from Afghanistan.5
Due to the rapid spread and negative impacts on economy, health and well-being of people, many studies assessed the impact of COVID19 pandemic on psychological status of the patients, mainly including impulsivity, insomnia, cognitive impairment, persistent fatigue and mood disorders.6–10 Accumulating evidence suggests that COVID-19 can cause many mental illnesses such as depression, anxiety, stress and suicidal behavior.9–14 This highlighted the need for a thorough understanding of the magnitude of these mental illnesses during the pandemic.
Depression, anxiety and stress are very prevalent in general COVID19 patients in Herat. Females, those with poor health condition and poor nutritional status, those with apparent COVID-19 symptoms, and concurrent comorbidities were at higher risk of developing these mental disorders. Considering global research evidence, including this study, it seems that COVID-19 negatively affects the mental health of people around the world. Public health sectors and policy makers should pay particular attention to mental health of COVID-19 patients as well as health workers, and minimize the pandemic’s impact on mental health of all populations.