Experiences of coping with the first wave of COVID-19 epidemic in Philadelphia, PA: Mixed methods analysis of a cross-sectional survey of worries and symptoms of mood disorders
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Abstract
Our objective was to describe how residents of Philadelphia, Pennsylvania, coped psychologically with the first wave of COVID-19 pandemic. In a cross-sectional design, we aimed to estimate the rates and correlates of anxiety and depression, examine how specific worries correlated with general anxiety and depression, and synthesize themes of “the most difficult experiences” shared by the respondents. We collected data through an on-line survey in a convenience sample of 1,293 adult residents of Philadelphia, PA between April 17 and July 3, 2020, inquiring about symptoms of anxiety and depression (via the Hospital Anxiety and Depression Scale), specific worries, open-ended narratives of “the most difficult experiences” (coded into themes), demographics, perceived sources of support, and general health. Anxiety was evident among 30 to 40% of participants and depression—about 10%. Factor analysis revealed two distinct, yet inter-related clusters of specific worries related to mood disorders: concern about “hardships” and “fear of infection”. Regression analyses revealed that anxiety, depression, and fear of infection, but not concern about hardships, worsened over the course of the epidemic. “The most difficult experiences” characterized by loss of income, poor health of self or others, uncertainty, death of a relative or a friend, and struggle accessing food were each associated with some of the measures of worries and mood disorders. Respondents who believed they could rely on support of close personal network fared better psychologically than those who reported relying primarily on government and social services organizations. Thematic analysis revealed complex perceptions of the pandemic by the participants, giving clues to both positive and negative experiences that may have affected how they coped. Despite concerns about external validity, our observations are concordant with emerging evidence of psychological toll of the COVID-19 pandemic and measures employed to mitigate risk of infection.
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SciScore for 10.1101/2021.03.31.21254725: (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 Sentences Resources All statistical calculations were performed in SAS v 9.4 (SAS Institute, Cary, NC). SAS Institutesuggested: (Statistical Analysis System, RRID:SCR_008567)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:Our work suffers from numerous limitations. The principal among these is the selection mechanism by which participants enrolled in the study. They had to be healthy enough …
SciScore for 10.1101/2021.03.31.21254725: (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 Sentences Resources All statistical calculations were performed in SAS v 9.4 (SAS Institute, Cary, NC). SAS Institutesuggested: (Statistical Analysis System, RRID:SCR_008567)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:Our work suffers from numerous limitations. The principal among these is the selection mechanism by which participants enrolled in the study. They had to be healthy enough to participate and willing enough to disclose sensitive information in an online survey. Persons who were particularly afflicted with worries may have been more likely to try to respond to a long questionnaire, skewing our associations to be stronger than they are in the source population (selection bias). Thus, there is no chance that our sample is representative of the city of Philadelphia and there are not statistical techniques to compensate for this: sampling weights for key factors, such as mental health, are unknown. Our samples heavily skewed toward non-Hispanic whites and likely did not adequately capture the experiences of racial and ethnic minorities. This is important to note because there is evidence of difference in rates of symptoms of mental ill health by race and ethnicity. For example, Fitzpatrick et al.,[6] reported that non-Whites and those of Hispanic origin experienced higher rates of depressive symptoms compared to non-Hispanic Whites during the pandemic. Furthermore, since the pandemic, there was an increase of 150% in anti-Asian hate crime in the US and increase in hate incidents due to faulted stereotypes of Asian Americans and blame for the pandemic [23]. Documenting experiences of racial and ethnic minorities would require resources of community engaged research that was beyond o...
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.
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- No protocol registration statement was detected.
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