Saudi Arabia Mental Health Surveillance System (MHSS): mental health trends amid COVID-19 and comparison with pre-COVID-19 trends

Abstract

Background:The impact of the COVID-19 pandemic on populations' mental health has started to emerge. Objectives: To describe the mental health trends of the risk of major depressive disorder (MDD) and generalized anxiety disorder (GAD) between May and August 2020. It also compares the results with pre-COVID-19 results and identifies risk factors associated with increased likelihood of being at risk of MDD and GAD. Method: This study utilizes repeated cross-sectional design, at national-level coverage of mental health screenings via computer-assisted phone interviews conducted in four waves monthly (between May and August 2020). Arabic-speaking adults from Saudi Arabia were recruited via a random phone list. The questionnaire includes the Arabic version of the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). Pre-COVID-19 comparison was done using the PHQ-2 score to allow for comparison with a previous and similar national study conducted in 2018. Results: Across the four waves, 16,513 participants completed the interviews, with an overall response rate of 81.3%. The weighted national prevalence of people at risk of MDD was 14.9% overall, and 13.8%, 13.6%, 16.8%, and 15.3% in Waves 1, 2, 3, and 4, respectively. The weighted national prevalence of people at risk of GAD was 11.4%, overall, and 10.9%, 10.7%, 12.4%, and 11.7% in Waves 1, 2, 3, and 4, respectively. The weighted national proportion of individuals who were at risk of MDD and GAD at the same time was 7.4% overall. The risk of MDD on PHQ-2 increased by 71.2%, from 12.5% in 2018 to 21.4% in 2020. Conclusions: The risks of MDD and GAD in this study are relatively high. These results can help decision makers to understand the impact of the COVID-19 pandemic on the population's mental health and the most-impacted subgroups. Sistema de Vigilancia de Salud Mental de Arabia Saudita (MHSS): Tendencias de salud mental durante la pandemia COVID-19 y comparación con las tendencias pre COVID-19Antecedentes: El impacto de la pandemia COVID-19 en la salud mental de la población ha comenzado a emerger. Objetivos: Describir las tendencias en salud mental del riesgo de tener un trastorno depresivo mayor (MDD por sus siglas en inglés) y un trastorno de ansiedad generalizado (GAD por sus siglas en inglés) entre Mayo y Agosto de 2020. También compara los resultados con los resultados pre COVID-19 e identifica factores de riesgo asociados con el aumento de la probabilidad de estar en riesgo de sufrir MDD y GAD Método: Este estudio utiliza un diseño transversal repetido, a un nivel de cobertura nacional de tamizaje sobre salud mental vía entrevistas telefónicas asistidas por computador, conducidas en 4 olas mensualmente (entre Mayo y agosto de 2020). Adultos que hablasen árabe de Arabia Saudita fueron reclutados mediante una lista aleatoria de teléfonos. El cuestionario incluía la versión árabe del Cuestionario de Salud del Paciente (PHQ-9) y de La Escala del Trastorno de Ansiedad Generalizada (GAD-7). Se hicieron comparaciones pre-COVID 19 usando ...

Exploring the Impact of COVID-19 Response on Population Health in Saudi Arabia: Results from the “Sharik” Health Indicators Surveillance System during 2020

“…The reduction in physical activity was due to complete or partial lockdown, the closure of sports and fitness centers, and the increase in working from home, which all directly affect the attainment of the recommended physical activity levels. Fear of contracting COVID-19 may also have affected people’s willingness to go to fitness centers or attend group fitness activities, even after the end of the lockdown [ 4 ]. A recent systematic review exploring changes in physical activity and sedentary behaviors from before to during the pandemic stated that the majority of studies reported decreases in physical activity and increases in sedentary behaviors across several populations during their respective lockdowns, including in children and patients with a variety of medical conditions [ 16 ].…”

“…The indirect health effects of the COVID-19 pandemic and the responses to it can also be regarded as substantial [ 1 , 2 ]. The indirect effects may include denied or delayed disease prevention and medical procedures for acute and chronic conditions; reductions in awareness and educational public health campaigns for noncommunicable diseases; reduced physical activity [ 4 , 5 ]; losses of jobs and income and reductions in overall living status; disruption of social networks; increases in self-harm and anxieties over contracting the disease [ 4 ]; changes in the quantity and quality of food and overall diet; use of tobacco, alcohol and other drugs; changes in other infectious disease rates [ 1 , 2 ]. Such changes in the behavioral and intermediate risk factors related to noncommunicable diseases could significantly increase or decrease their prevalence in the population.…”

“…In Saudi Arabia, on 2 March 2020, the government reported the first case of COVID-19 [ 4 ]. As COVID-19 continued to spread, the Saudi government enforced many drastic measures to curb the spread of the disease, including partial (usually between 3 p.m. and 6 a.m.) and 24 h lockdowns, suspensions of religious activities such as prayer in mosques and Umrah mass gatherings, and a complete lockdown during the Eid holidays [ 4 ]. Consequently, as in many countries, the economic impact of the lockdown affected many businesses in Saudi Arabia, leading to job losses or reductions in income [ 4 ].…”

“…As COVID-19 continued to spread, the Saudi government enforced many drastic measures to curb the spread of the disease, including partial (usually between 3 p.m. and 6 a.m.) and 24 h lockdowns, suspensions of religious activities such as prayer in mosques and Umrah mass gatherings, and a complete lockdown during the Eid holidays [ 4 ]. Consequently, as in many countries, the economic impact of the lockdown affected many businesses in Saudi Arabia, leading to job losses or reductions in income [ 4 ]. The whole period of complete and partial lockdown lasted around three months, between mid-March 2020 and the end of May 2020, and for some cities and businesses the lockdown continued until the end of June 2020 [ 4 ].…”

“…Consequently, as in many countries, the economic impact of the lockdown affected many businesses in Saudi Arabia, leading to job losses or reductions in income [ 4 ]. The whole period of complete and partial lockdown lasted around three months, between mid-March 2020 and the end of May 2020, and for some cities and businesses the lockdown continued until the end of June 2020 [ 4 ]. Working from home was encouraged for government sector employees until August 2020, and at the time of writing is still being encouraged for some subgroups or organizations with small workspaces, in order to facilitate social distancing.…”