Stress symptoms and reactions to COVID-19: A multinational survey from six Asian regions

  1. Ricci P.H. Yue
  2. Edmund W. Cheng
  3. Nick H.K. Or
  4. Samson W.H. Yuen

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

People may experience a heightened level of stress reactions during a pandemic event and in an isolated social environment. A multi-national survey about such mental health information about COVID-19 was conducted in May 2020 across six Asian regions: Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand. Data were collected from a population representative sample of 11,895 adults on their stress symptoms and reactions to COVID-19 and the related public health measures. 59.1% of the respondents showed at least one substantial stress symptom. The situation was particularly worrying in South Korea, where 75% of the respondents reported substantial stress symptoms. Respondents who were young, educated, lived in an urban area, had a high socioeconomic status, had a history of chronic illness or mental illness, or who lived with a pregnant woman, elderly or children were most vulnerable to stress during the pandemic. Stress reactions showed a positive relationship with the amount of time spent following news about the COVID-19 outbreak. Asian adults coped with their stress by preparing safety equipment and extra daily commodities (62.4%) and by following government-issued public health measures (60.1%). Most Asian (71%) also frequently checked on the safety of family members and friends to keep each other safe. The COVID-19 pandemic and the associated stringent public health measures have largely increased the prevalence of substantial stress symptoms across multiple Asian regions. Governments should prepare this mental health pandemic and the associated social repercussions.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.08.24.20179762: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: Data were analysed with Stata software and with linear regression to outline the association between the dependent variables and the predictor variables.
    Stata
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has limitations. The study design did not incorporate a full assessment of post-traumatic stress disorder and thus may have underestimated the respondents’ level of stress or trauma. However, the strength of this study is the stress symptom data obtained from a vast population across six Asian regions differentially affected by the COVID-19 outbreak and with different responses to the pandemic. The data from our study contribute to a growing evidence base regarding the mental health crisis that is spreading along with the pandemic. Previous studies of disaster suggest that most stress symptoms fade over time, especially in those who experience the trauma indirectly. However, the current COVID-19 pandemic presented a chronic hazard with waves of overlapping outbreaks rather than a single acute one. Many people are unable to cope with uncertainty and stress for weeks and months. This can ultimately lead to exhaustion and depression, which could amplify the impact of COVID-19 and jeopardise decision-making when combating the pandemic. Although this is unlikely to anticipate the endpoint of the current COVID-19 pandemic, we call for additional early detection, intervention, public health resources and policy focus for those who are most vulnerable to stress and post-traumatic stress disorder. The global society must prepare for this storm. Contributors: RPHY, EWC, NHKO, and SWHY contributed to study concept and design. RPHY, EWC, NHKO, and SWHY contributed to acquisiti...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.08.24.20179762v1 on medRxiv