Factors associated with psychological distress during the coronavirus disease 2019 (COVID-19) pandemic on the predominantly general population: A systematic review and meta-analysis

• Published in: PloS one Vol. 15; no. 12; p. e0244630
• Main Authors: Wang, Yeli, Kala, Monica Palanichamy, Jafar, Tazeen H.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 28.12.2020; Public Library of Science (PLoS)
• Subjects: Adults; Age; Animals; Anxiety; Anxiety disorders; Bias; Biology and Life Sciences; Complications and side effects; Confidence intervals; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - psychology; Cross-Sectional Studies; Demographic aspects; Disease transmission; Epidemics; Estimates; Gender; Health aspects; Health risks; Health services; Humans; Insomnia; Medical personnel; Medicine and Health Sciences; Men; Mental depression; Meta-analysis; Pandemics; People and Places; Physical Sciences; Population; Psychological aspects; Psychological stress; Public health; Quantitative psychology; Research and Analysis Methods; Residential areas; Risk factors; Rural areas; Rural populations; SARS-CoV-2 - pathogenicity; Severe acute respiratory syndrome coronavirus 2; Signs and symptoms; Singapore; Social Sciences; Socioeconomics; Statistical analysis; Stress (Psychology); Stress, Psychological - etiology; Stress, Psychological - psychology; Systematic review; Urban areas; Urban populations; Viral diseases; Singapore
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244630

The Coronavirus Disease 2019 (COVID-19) outbreak has escalated the burden of psychological distress. We aimed to evaluate factors associated with psychological distress among the predominantly general population during the COVID-19 pandemic. We searched PubMed, EMBASE, Scopus, Cochrane Library, PsycINFO, and World Health Organization COVID-19 databases (Dec 2019-15 July 2020). We included cross-sectional studies that reported factors associated with psychological distress during the COVID-19 pandemic. Primary outcomes were self-reported symptoms of anxiety and depression. Random-effects models were used to pool odds ratios (OR) and 95% confidence intervals (CI). The protocol was registered in PROSPERO (#CRD42020186735). We included 68 studies comprising 288,830 participants from 19 countries. The prevalence of anxiety and depression was 33% (95% CI: 28%-39%) and 30% (26%-36%). Women versus men (OR: 1.48 [95% CI: 1.29-1.71; I2 = 90.8%]), younger versus older (< versus ≥35 years) adults (1.20 [1.13-1.26]; I2 = 91.7%), living in rural versus urban areas (1.13 [1.00-1.29]; I2 = 82.9%), lower versus higher socioeconomic status (e.g. lower versus higher income: 1.45 [1.24-1.69; I2 = 82.3%]) were associated with higher anxiety odds. These factors (except for residential area) were also associated with higher depression odds. Furthermore, higher COVID-19 infection risk (suspected/confirmed cases, living in hard-hit areas, having pre-existing physical or mental conditions) and longer media exposure were associated with higher odds of anxiety and depression. One in three adults in the predominantly general population have COVID-19 related psychological distress. Concerted efforts are urgently needed for interventions in high-risk populations to reduce urban-rural, socioeconomic and gender disparities in COVID-19 related psychological distress.