Background The COVID-19 pandemic has caused unprecedented stress and fear throughout the world. Aims To evaluate the psychological effects of the COVID-19 pandemic on the Saudi public, and to examine the performance of the Arabic version of the Four-Dimensional Symptom Questionnaire (4DSQ) scale. Method We conducted an online questionnaire-based cross-sectional survey of a sample of the Saudi public. Results The study included 347 participants, who reported significantly higher levels of distress, depressive symptoms, anxiety symptoms and somatisation compared with a normative sample. Females scored higher in terms of somatisation, depression and anxiety symptoms, and distress. Obtaining COVID-19 information from friends and relatives was associated with higher levels of somatisation, depression and anxiety symptoms, and distress. Cronbach's alpha was 0.93 for the distress scale, 0.88 for the depression scale, 0.88 for the anxiety scale and 0.86 for the somatisation scale. Conclusions Levels of psychological distress were high among the Saudi public during the COVID-19 pandemic. We found high reliability for the Arabic version of the 4DSQ scale. However, three items did not conform to the four-factor structure, namely, item 1: ‘During the past week, did you suffer from dizziness or feeling light-headed?’, item 20: ‘During the past week, did you suffer from disturbed sleep?’ and item 46: ‘During the past week did you ever think I wish I was dead?’.

Background The sense of coherence is as focused on one’s awareness of the level of pervasive, enduring, and dynamic feelings. Stronger sense of coherence leads to better physical and mental health and promotes recovery from life stressors. Sense of coherence-13 (SOC-13) is a 13-item valid and reliable measure for individual’s healthy living. However, the factor structure of SOC-13 was criticized in several cultures and languages. The current study was set to explore the factor structure of an Arabic adaptation for SOC-13. Methods This cross-sectional study of the SOC-13 included (n = 1235) Arabic speaking individuals. We used confirmatory factor analysis to contrast unidimensional, bidimensional, three-dimensional, and four-dimensional factor structure for the SOC-13. We carried out measurement invariance analysis across age and gender groups to examine the stability of fit indices among participants’ subgroups. Results We found the reliability coefficient to be 0.82, indicative of good internal consistency. The three-factor structure, after modification of items 1, 2, and 3 was the best-fitting factor model. However, measurement invariance was indicative of discrepancy for the three-factor model between genders and age classes. The mean overall SOC-13 total score in our sample was 52.1 (SD = 16.1). Conclusions The SOC-13 showed acceptable psychometric properties in terms of internal consistency and a modified three-factor structure in its Arabic version. However, the reliability of the three underlying dimensions was sub-optimum. Moreover, the three-factor structure requires modification by either removing the first three problematic items or allowing the residuals to correlate.

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