Psychiatric manifestations and associated risk factors among hospitalised patients with COVID-19 in Edo State, Nigeria: a cross-sectional study

  1. Esther Osemudiamen Okogbenin
  2. Omonefe Joy Seb-Akahomen
  3. Osahogie Edeawe
  4. Mary Ehimigbai
  5. Helen Eboreime
  6. Angela Odike
  7. Michael Olukunle Obagaye
  8. Benjamin Efi Aweh
  9. Paul Erohubie
  10. Williams Eriyo
  11. Chinwe Inogbo
  12. Peter Akhideno
  13. Gloria Eifediyi
  14. Reuben Eifediyi
  15. Danny A Asogun
  16. Sylvanus Okogbenin

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Abstract

To estimate the prevalence of depression and anxiety and identify associated risk factors in hospitalised persons with confirmed COVID-19 in Edo, Nigeria.

Design

A multicentre cross-sectional survey.

Setting

Patients with COVID-19 hospitalised at the three government-designated treatment and isolation centres in Edo State, Nigeria.

Participants

The study was conducted from 15 April to 11 November 2020 among 489 patients with confirmed COVID-19 and in treatment and isolation centres in Edo State, Nigeria. The mean age of participants was 43.39 (SD=16.94) years. Male participants were 252 (51.5%) and female were 237 (48.5%).

Main outcome measures

The nine-item Patient Health Questionnaire for depression, (total score: 0–27, depression ≥10), Generalized Anxiety Disorder-7 for anxiety (total score: 0–21, anxiety ≥10), and social demographic and clinical characteristics for associated risk factors.

Results

Of the 489 participants, 49.1% and 38.0% had depressive and anxiety symptoms, respectively. The prevalence rates of depression, anxiety and combination of both were 16.2%, 12.9% and 9.0%, respectively. Moderate-severe symptoms of COVID-19, ≥14 days in isolation, worrying about the outcome of infection and stigma increased the risk of having depression and anxiety. Additionally, being separated/divorced increased the risk of having depression and having comorbidity increased the risk of having anxiety.

Conclusion

A substantial proportion of our participants experienced depression, anxiety and a combination of both especially in those who had the risk factors we identified. The findings underscore the need to address modifiable risk factors for psychiatric manifestations early in the course of the disease and integrate mental health interventions and psychosocial support into COVID-19 management guidelines.

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  1. Version published to 10.1136/bmjopen-2021-058561
  2. ScreenIT

    SciScore for 10.1101/2021.10.12.21264913: (What is this?)

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

    Table 1: Rigor

    EthicsConsent: Exclusion criteria comprised of hospitalized persons who tested positive for COVID-19 but declined or were unable to give consent to participate in the study and persons below 11 years due to the inappropriateness of the assessment tools for anxiety and depression in this age group.
    IACUC: Ethics: Ethical clearance was obtained from our institutional ethical committee.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line AuthenticationAuthentication: Its use has been validated in adolescents.[18] A cut-off score of ≥ 10 was used to represent cases of anxiety.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: The collected data were analysed using the Statistical Package for Social Sciences (SPSS) version 21.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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:
    Strengths and limitations of this study: As far as we know, this is the second study exploring psychiatric manifestations in hospitalized patients with COVID-19 in Nigeria, the most populous country in Africa. The study identified important risk factors. Also, we conducted a multi-centre study that collected samples over 30 weeks in the ongoing pandemic, this increased our sample size compared to the previous study, giving more room for generalization of findings. Our study had some limitations. Firstly, it had a cross-sectional design and so could not permit causal inferences. Secondly, we did not have a control group, this minimised our ability to estimate the true impact of COVID-19 on the mental health of our participants and thirdly, a structured diagnostic interview was not used to confirm our cases of depression and anxiety. In conclusion, we report that a considerable proportion of hospitalized patients with COVID-19 had depression, anxiety, and a combination of both. Risk factors identified should be monitored and addressed promptly when managing patients with COVID-19. Mental health interventions and psychosocial support need to be integrated into COVID-19 management guidelines to ensure holistic care and ameliorate the mental health effects of the disease. Prospective studies are recommended to determine the true mental health impact of COVID-19 on persons with the disease.

    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.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.10.12.21264913 on medRxiv