doi: 10.56294/shp2024102

 

ORIGINAL

 

Depression, anxiety and stress due to the COVID-19 pandemic in residents attending a community health facility in North Lima

 

Depresión, ansiedad y estrés por la pandemia del COVID-19 en pobladores que acuden a un establecimiento de salud comunitario en Lima Norte

 

Olmar Reymer Tumbillo Machacca1 , Juan Alberto Almirón Cuentas1 , Yaneth Fernández-Collado2, César Carbache Mora3  *, Juan Richar Villacorta Guzmán4  *

 

1Universidad Peruana Unión. Perú.  

2Universidad Nacional de San Agustín de Arequipa. Perú.  

3Universidad Laica Eloy Alfaro de Manabí. Ecuador.  

4Escuela Militar de Ingeniería. Bolivia.  

 

Cite as: Tumbillo Machacca OR, Almirón Cuentas JA, Fernández-Collado Y, Carbache Mora C, Villacorta Guzmán JR. Depression, anxiety and stress due to the COVID-19 pandemic in residents attending a community health facility in North Lima. South Health and Policy. 2024; 3:102. https://doi.org/10.56294/shp2024102

 

Submitted: 20-06-2023                 Revised: 12-11-2023              Accepted: 14-04-2024                Published: 15-04-2024

 

Editor: Dr. Telmo Raúl Aveiro-Róbalo  

 

Corresponding author: César Carbache Mora *

 

ABSTRACT

 

Mental disorders are one of the problems caused by the coronavirus pandemic in the general population. Therefore, the objective of this study is to determine the levels of depression, anxiety, and stress caused by the COVID-19 pandemic in people who attend a community health centre in northern Lima. This is a quantitative, descriptive, cross-sectional study with a total population of 140 people who attend a community health centre and who responded to a questionnaire on sociodemographic aspects and the depression, anxiety and stress scale. The results show that 51,4 % (n=72) of participants have moderate depression, 45 % (n=63) have moderate anxiety, and 42,1 % (n=59) have moderate stress. In conclusion, comprehensive actions aimed at the mental health of the general population must be reinforced, improved, or implemented due to the COVID-19 pandemic.

 

Keywords: Depression; Anxiety; Stress; Mental Health, Primary Health Care.

 

RESUMEN

 

Los trastornos mentales son una de las problemáticas que ha ocasionado la pandemia del coronavirus en la población en general, por ello el objetivo del estudio es determinar la depresión, ansiedad y estrés por la pandemia del COVID-19 en pobladores que acuden a un establecimiento de salud comunitario en Lima Norte. Es un estudio cuantitativo, descriptivo-transversal, con una población total de 140 personas que acuden a un establecimiento de salud comunitario, que respondieron un cuestionario de aspectos sociodemográficos y la escala de depresión, ansiedad y estrés. En sus resultados, podemos observar que, el 51,4 %(n=72) de los participantes tienen depresión moderada, 45 %(n=63) ansiedad moderada y 42,1 %(n=59) estrés moderado. En conclusión, se debe reforzar, mejorar o implementar acciones de manera integral orientadas a la salud mental de la población en general por la pandemia del COVID-19.

 

Palabras clave: Depresión; Ansiedad; Estrés; Salud Mental; Atención Primaria.

 

 

 

INTRODUCTION

In the past, during pandemics or epidemics, mental and social disorders have arisen that can disrupt the activities of the population.(1) The fear of becoming ill worsens the condition of the population. During pandemics, the community experiences stress and anxiety to a certain extent, and psychological disorders become common.(2,3)

There is no doubt that the coronavirus (COVID-19) pandemic is one of the factors that has caused mental disorders affecting mental health worldwide, given that the experiences it has generated in each person have been psychologically damaging, both physically, socially, and spiritually.(4,5,6)

Although mental health and mental health conditions were a concern before the pandemic, they have worsened considerably during it. In 2019, according to the National Institute of Health (NIH), mental health was considered one of the health priorities affecting the general population.(7) However, during the COVID-19 pandemic, lockdowns and strict social restrictions have hurt people’s mental health, requiring the health system to respond to counteract the fear and uncertainty present in the population.(8)

The health emergency caused by the COVID-19 pandemic meant that all health efforts were redirected to caring for people with coronavirus, in many cases neglecting mental health care.(9,10) These two situations favor the emergence of more cases of people whose emotional health is affected.(11,12)

According to the Ministry of Health (MINSA) in our country, between January and August 2021, 813,426 mental health cases were treated throughout the country, with most patients attending Community Mental Health Centers (CSMC).(13)

In a study conducted in India with 147 participants, the results showed that 33,33 % of the participants had high levels of depression, 37,4 % had high levels of anxiety, and 19,72 % had high levels of stress. The study concluded that the symptoms of these conditions are too high, given that they significantly affect the individual and their family.(14)

In a study conducted in Iran with 149 participants, the results showed that 36,6 % of the participants had normal levels of stress, 57,9 % had anxiety, and 47,9 % had depression. They concluded that there was a significant impact on mental health in the Iranian population, given that educational level, having a family member at high risk of contracting any disease, and contracting COVID-19 all contributed to compromising mental health.(15)

In a study conducted in Vietnam with 1,385 participants, the results showed that 35,9 % of the population experienced psychological distress, 22,3 % depression, 14,1 % anxiety, and 22,3 % stress. The study concluded that concerns, distress, and fear about COVID-19 hurt people’s mental health.(16)

Therefore, the research objective is to determine depression, anxiety, and stress due to the COVID-19 pandemic in residents who visit a community health center in northern Lima.

 

METHOD

Research type and design

The study is quantitative in nature and descriptive-transversal in methodology, and is non-experimental.(17)

 

Population

The total population consists of 140 patients who visit the general medicine clinic.

 

Inclusion Criteria

·      People over 18 years of age

·      People who are within the jurisdiction of the health facility

·      People who participate voluntarily in the study

 

Technique and Instrument

The data collection technique was a survey, consisting of a questionnaire on sociodemographic aspects and the Depression Anxiety and Stress Scale (DASS-21).

The DASS-21 is an instrument that presents three scales containing 14 items, divided into subscales of 2 to 5 items with similar content. The depression scale assesses dysphoria, hopelessness, devaluation of life, self-contempt, lack of interest or participation, anhedonia, and inertia. The anxiety scale assesses autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect. The stress scale is sensitive to levels of nonspecific chronic arousal. It assesses difficulty relaxing, nervous excitement, annoyance, agitation, or irritation, overreactivity, and impatience.(18) It consists of four response options: 0 “not at all,” 1 “sometimes,” 2 “much of the time,” and 3 “most of the time,” which are used to rate

The degree to which each state has been experienced during the past week.

The sample adequacy measure to validate the instrument using the Kaiser-Mayer-Olkin test obtained a coefficient of 0,958 (KMO > 0,8), and Bartlett’s sphericity test obtained significant results (Approx. X2= 7417,128; gl = 215; Sig.= 0,000).

Finally, Cronbach’s alpha internal consistency coefficient was 0,975 (α > 0,8; N of elements = 21), thus determining that the instrument has a high degree of reliability.

 

Place and Application of the Instrument

First, preliminary arrangements were made to obtain authorization from the health facility where the study was conducted, in addition to providing information about the research so that they would have the necessary knowledge of what was going to be done.

 

RESULTS

Figure 1. Depression due to the COVID-19 pandemic in residents who attend a community health facility in northern Lima

 

In figure 1, with regard to the results of the depression scale, we can see that 10,7 % of participants have normal levels of depression, 24,3 % have mild depression, 51,4 % have moderate depression, 12,1 % have severe depression, and 1,4 % have extremely severe depression.

 

Figure 2. Anxiety due to the COVID-19 pandemic among residents who attend a community health center in northern Lima

 

In figure 2, with regard to the results of the anxiety scale, we can see that 15 % of participants have normal anxiety, 25,7 % have mild anxiety, 45 % have moderate anxiety, 12,1 % have severe anxiety, and 2,1 % have extremely severe anxiety.

 

Figure 3. Stress due to the COVID-19 pandemic in residents who attend a community health center in northern Lima

 

In figure 3, with regard to the results of the stress scale, we can see that 9,3 % of participants have normal stress, 36,4 % have mild stress, 42,1 % have moderate stress, 11. have severe stress, and 0,7 % have extremely severe stress.

 

DISCUSSION

Due to the COVID-19 pandemic, many of the measures taken to counter its spread have had an impact on people’s daily lives, which has led to mental health problems given the situation that this disease has left behind.

Regarding the results of the depression scale, we observe that the participants have moderate depression. Depression, being a state of sadness and low mood, affects the body and thinking in response to situations that put their health at risk, and this can be aggravated if it persists in the person, since being confined to the home, seeing their relatives become infected, the death of one of them, and restrictions to prevent the disease can cause short- and long-term depressive disorders.

As for anxiety, the results were moderate among participants. This is because anxiety is described as an adaptive response to avoid a health risk, but at the same time, when it occurs repeatedly, it can cause a mental disorder that can compromise health. Due to the COVID-19 pandemic, many people have found themselves anxious, as they were unable to carry out their everyday activities and, being confined to their homes, anxiety symptoms increased considerably, including restlessness, fear, sleeping problems, difficulty breathing, and dry mouth. All of this can manifest itself in the long term in people who, as a result of the pandemic, have found themselves isolated from all the activities they used to do before.

As for stress, the results were moderate among participants. This is because the uncertainty and personal and family despair caused by changes in life and daily activities due to COVID-19 have generated stressful symptoms in people, such as headaches, muscle tension, fatigue, discomfort, and sleep problems, which affect individuals. After all, they cannot do what they could do before the pandemic.

 

CONCLUSIONS

It is concluded that comprehensive actions aimed at the mental health of the general population should be reinforced, improved, or implemented due to the COVID-19 pandemic.

It is concluded that the population should be educated on strategies to maintain their mental health, enabling them to develop skills or abilities to adapt to any situation that may compromise their health.

 

REFERENCES

1. Liu Y, Gayle A, Wilder A, Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020;27(2):1-4. doi:10.1093/jtm/taaa021.

 

2. Necho M, Tsehay M, Birkie M, Biset G, Tadesse E. Prevalence of anxiety, depression, and psychological distress among the general population during the COVID-19 pandemic: A systematic review and meta-analysis. Int J Soc Psychiatry. 2021;67(7):892-906. doi: https://10.1177/00207640211003121.

 

3. Guo K, et al. Assesing social support impact on depression, anxiety, and stress among undergraduate students in Shaanxi province during the COVID-19 pandemic of China. PLoS One. 2021;16(7):1-10. doi: https://10.1371/journal.pone.0253891.

 

4. Chatterjee K, Chauhan V. Epidemics, quarantine and mental health. Med J Armed Forces India. 2020;76(2):125-127. doi: https://10.1016/j.mjafi.2020.03.017.

 

5. Mautong H, et al. Assessment of depression, anxiety and stress levels in the Ecuadorian general population during social isolation due to the COVID-19 outbreak: a cross-sectional study. BMC Psychiatry. 2021;21(1):1-15. doi: https://10.1186/s12888-021-03214-1.

 

6. Woon L, Leong M, Sidi H, Mansor N, Nik N. Depression, anxiety, and the COVID-19 pandemic: Severity of symptoms and associated factors among university students after the end of the movement lockdown. PLoS One. 2021;16(5):e0252481. doi: https://10.1371/journal.pone.0252481.

 

7. Instituto Nacional de Salud. Prioridades de Investigación en Salud en el Perú 2019-2023. 2019;7. https://cdn.www.gob.pe/uploads/document/file/343478/Resolución_Ministerial_N__658-2019-MINSA.PDF.

 

8. Ministerio de Salud. Minsa: Más de 300 mil casos de depresión fueron atendidos durante el 2021. MINSA. 2022. https://www.gob.pe/institucion/minsa/noticias/575899-minsa-mas-de-300-mil-casos-de-depresion-fueron-atendidos-durante-el-2021/.

 

9. Brailovskaia J, Truskauskaite I, Margraf J, Kazlauskas E. Coronavirus (COVID-19) outbreak: Addictive social media use, depression, anxiety and stress in quarantine - an exploratory study in Germany and Lithuania. J Affect Disord Reports. 2021;5(1):100182. doi: https://10.1016/j.jadr.2021.100182.

 

10. Amu H, et al. Prevalence and predictors of depression, anxiety, and stress among adults in Ghana: A community-based cross-sectional study. PLoS One. 2021;16(10):1-17. doi: https://10.1371/journal.pone.0258105.

 

11. Serafim A, et al. Exploratory study on the psychological impact of COVID-19 on the general Brazilian population. PLoS One. 2021;16(2):e0245868. doi: https://10.1371/journal.pone.0245868.

 

12. Mosolova E, Sosin D, Mosolov S. Stress, anxiety, depression and burnout in frontline healthcare workers during two peaks of COVID-19 pandemic in Russia. Psychiatry Res. 2021;306(9):114226. doi: https://10.1016/j.psychres.2021.114226.

 

13. Ministerio de Salud. Ministerio de Salud atendió 813 426 casos de salud mental entre enero y agosto de 2021. MINSA. 2021. https://www.gob.pe/institucion/minsa/noticias/542324-ministerio-de-salud%02atendio-813-426-casos-de-salud-mental-entre-enero-y-agosto-de-2021.

 

14. Prakash J, Dangi A, Chaterjee K, Yadav P, Srivastava K, Chauhan V. Assessment of depression, anxiety and stress in COVID-19 infected individuals and their families. Med J Armed Forces India. 2021;77(1):S424-S429. doi: https://10.1016/j.mjafi.2021.06.013.

 

15. Khademian F, Delavari S, Koohjani Z, Khademian Z. An investigation of depression, anxiety, and stress and its relating factors during COVID-19 pandemic in Iran. BMC Public Health. 2021;21(1):1-7. doi: https://10.1186/s12889-021-10329-3.

 

16. Duong K, et al. Psychological impacts of COVID-19 during the first nationwide lockdown in Vietnam: Web-based, cross-sectional survey study. JMIR Form Res. 2020;4(12):1-10. doi: https://10.2196/24776.

 

17. Fernández C, Baptista P. Metodología de la Investigación. 2015;634. http://observatorio.epacartagena.gov.co/wp-content/uploads/2017/08/metodologia-de-la-investigacion-sexta-edicion.compressed.pdf.

 

18. Lovibond A. Depression Anxiety Stress Scale (DASS-21). 1995. http://www2.psy.unsw.edu.au/dass/Download files/Dass21.pdf.

 

FUNDING

None.

 

CONFLICT OF INTEREST

None.

 

AUTHOR CONTRIBUTION

Conceptualization: Olmar Reymer Tumbillo Machacca, Juan Alberto Almirón Cuentas, Yaneth Fernández-Collado, César Carbache Mora, Juan Richar Villacorta Guzmán.

Research: Olmar Reymer Tumbillo Machacca, Juan Alberto Almirón Cuentas, Yaneth Fernández-Collado, César Carbache Mora, Juan Richar Villacorta Guzmán.

Methodology: Olmar Reymer Tumbillo Machacca, Juan Alberto Almirón Cuentas, Yaneth Fernández-Collado, César Carbache Mora, Juan Richar Villacorta Guzmán.

Writing – original draft: Olmar Reymer Tumbillo Machacca, Juan Alberto Almirón Cuentas, Yaneth Fernández-Collado, César Carbache Mora, Juan Richar Villacorta Guzmán.

Writing – review and editing: Olmar Reymer Tumbillo Machacca, Juan Alberto Almirón Cuentas, Yaneth Fernández-Collado, César Carbache Mora, Juan Richar Villacorta Guzmán.