Assessment of Depression Severity During Coronavirus Disease 2019 Pandemic Among the Palestinian Population: A Growing Concern and an Immediate Consideration

Abstract

Background: Aggressive quarantine and lockdown measures were implemented as protective public health actions during the coronavirus disease 2019 (COVID-19) pandemic. Assessing the psychological effects associated with these measures is an important attempt to inform local policymakers in an early stage. Yet little is known about these effects, specifically depression, among the Palestinians. This study aimed to assess the prevalence and predictors of depression among the Palestinian community during this pandemic.Materials and methods: A cross-sectional web-based survey throughout social media (Facebook and Instagram) was carried out using an anonymous online questionnaire. The validated and standardized depression, anxiety, and stress scale (DASS) was used to measure depression severity. A snowball technique recruiting the general public living in Palestine was conducted. Data were collected between 6 and 16 April 2020, which corresponded to the middle interval of strict massive lockdown in Palestine on 22 March to 5 May 2020. Multinomial logistic regression model was developed to predict depression severity.Results: About 2,819 respondents filled out the questionnaire. Depression prevalence was (57.5%; n = 1,621). Out of them, 66% had mild/moderate severity, and 34% had severe/extremely severe degree. Depression severity was negatively associated with age {mild/moderate degree [OR (95% CI) = 0.98 (0.97–0.99)] and severe/extremely severe [OR (95% CI) = 0.96 (0.94–0.97)]} degrees compared with normal degree. Males were significantly less likely to have higher depression than females {mild/moderate degree [OR (95% CI) = 0.69 (0.57–0.85)] and severe/extremely severe [OR (95% CI) = 0.52 (0.40–0.86)]} degree. However, those who reported having inadequate food supply and lesser monthly incomes were more likely to have a higher degree of depression as compared with normal degree. Single persons were significantly more likely to have mild/moderate depression than those in a relationship [OR (95% CI) = 1.31 (1.05–1.64)].Conclusions: High depression prevalence (57.5%) among the Palestinian community during the COVID-19 pandemic is a growing public health concern. It is essential to provide psychological counseling and treatment during and after the pandemic for the targeted people at high risk (young age/female gender) who were affected psychologically. Strategic long-term policy to address pandemic ramifications, including depression, by implementing comprehensive interventions taking into account socioeconomic disparities, vulnerability, and inequities, is crucial to emerge from this crisis in Palestine.

COVID-19 lockdown and lifestyles: A narrative review

“…A high prevalence of stress and post-traumatic stress disorders was documented among Nepalese 150 , Lebanese 151 , Saudi Arabian 152 , Vietnamese 153 , and Philippine nationals 154 at the height of lockdown. High levels of anxiety and depression were also documented in studies from India [155][156][157] , Ecuador 158 , Albania 159 , Ireland 160 , Hungary 88,161 , Spain 162 , Palestine 163 , the UK 164 , Kuwait 165 , Brazil, and Portugal 166 . The prevalence of people reporting clinical depression and anxiety in a sample of 1215 respondents in Italy was recorded to be 32.3% and 35.7%, respectively (compared to 15.39% and 21.40%, respectively, during pre-COVID-19 times) 142 .…”

Prevalence of depression in China during the early stage of the COVID-19 pandemic: a cross-sectional study in an online survey sample

“…In China, the estimated overall prevalence of depression was 26.9% 13. In all studies on depression during the initial COVID-19 pandemic, only four studies included the general population,14–18 and none investigated the prevalence of depression by province. Moreover, several cross-sectional studies in different countries suggest an association between depression and sociodemographic characteristics such as female,16 nurses,15 low income,15 19 young age,14 16 lower education level,20 having higher COVID-19 contraction risk, living in urban areas and social isolation 21.…”

“…In all studies on depression during the initial COVID-19 pandemic, only four studies included the general population,14–18 and none investigated the prevalence of depression by province. Moreover, several cross-sectional studies in different countries suggest an association between depression and sociodemographic characteristics such as female,16 nurses,15 low income,15 19 young age,14 16 lower education level,20 having higher COVID-19 contraction risk, living in urban areas and social isolation 21. However, some recent studies have contradicted these findings regarding the association between depression and these sociodemographic characteristics 22.…”

What can internet users' behaviours reveal about the mental health impacts of the COVID-19 pandemic? A systematic review

“… 61 Several cross-sectional studies, based on online surveys administered to convenience samples, have been published throughout 2020, without any information on the real generalisability and representativeness of results. 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 In contrast, these novel data streams might reduce several biases typical of surveys, such as social desirability and recall bias, as well as improving the above-mentioned representativeness of the sample, since thousands or millions of users’ data can be analysed together. Moreover, Big Data and novel data streams reduce the time lag between traditional epidemiological data collection and data analysis, as well as the data entry burden and potential errors that can occur with traditional epidemiological systems.…”