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ISSN: 2690-5760

Journal of Clinical & Community Medicine

Review Article(ISSN: 2690-5760)

Lessons from the Early Phase of the COVID-19 Pandemic: Prevalence, Risk and Protective Factors for Psychological Morbidity– Systematic Review Volume 2 - Issue 4

Suleman Bakhshi1, Harry Kyriazis2 and Meagan E Brennan1,3*

  • 1University of Notre Dame, School of Medicine, Sydney, Australia
  • 2University of New South Wales, Department of Exercise Physiology, Faculty of Medicine, Sydney, Australia
  • 3University of Sydney, Westmead Clinical School, Faculty of Medicine and Health, Sydney, Australia

Received: January 22, 2020   Published: February 23, 2021

Corresponding author: Meagan Brennan, PhD, School of Medicine, The University of Notre Dame Australia, Sydney, Australia

DOI: 10.32474/JCCM.2021.02.000150


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The COVID-19 pandemic has had a devastating impact on psychological well-being globally. Study aims were to examine the extent of psychological morbidity and to identify risk and protective factors that could be targeted with interventions. A systematic review was performed using PRISMA guidelines. Studies reporting depression, anxiety and COVID-related fear were included. 30 studies (43,634 participants) were included. Anxiety prevalence was 6.3–34% and depression 14.6%–43.7%. Higher levels of anxiety, depression and/or COVID-related fear were found in women, younger people, rural residents, areas with high rates of COVID-19 and people with poor general health. Quarantine and feeling overwhelmed with negative information were risk factors for COVID-related fear. Protective factors were: comfortable amount of information, good social support’ and confidence in doctor. Health professionals had high rates of psychological morbidity.

Risk and protective factors were identified in this study. These could be targeted with COVID-specific public health support and interventions.

What we already know

a. The COVID-19 pandemic has had a devastating impact on psychological well-being globally.

b. Rates of anxiety and/or depression over 35% have been reported during the pandemic.

c. Responding to mental health issues is a priority area of public health policy.

What this article adds

a. Risk groups for psychological morbidity have been identified, including health professionals, young people, women, people affected by quarantine and those living in hot-spot and rural areas.

b. Protective factors have also been identified, including good family and social supports, positive coronavirus news feeds and confidence in doctors.

c. This information can be used to target strategies to support the mental health of communities affected by COVID-19.

Keywords: Anxiety; COVID-19; Depression; Fear; Mental health; Psychological distress

Abstract| Introduction| Methods| Discussion| Conclusion| References|