Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2022; 10(25): 8880-8892
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.8880
Mental health of the Slovak population during COVID-19 pandemic: A cross-sectional survey
Maria Kralova, Alexandra Brazinova, Veronika Sivcova, Lubomira Izakova
Maria Kralova, Lubomira Izakova, Department of Psychiatry, Faculty of Medicine Comenius University and University Hospital Bratislava, Bratislava 81369, Slovakia
Alexandra Brazinova, Veronika Sivcova, Institute of Epidemiology, Faculty of Medicine Comenius University Bratislava, Bratislava 81372, Slovakia
Author contributions: Kralova M, Brazinova A, and Izakova L designed the research, interpreted the research findings, and wrote the manuscript; Brazinova A analyzed the data; Sivcova V constructed and edited the tables and figures, and edited the references of the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the internal ethical committee of the non-governmental organization League for Mental Health.
Informed consent statement: This is an observational study not requiring the signed informed consent form–the study works with anonymous data.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lubomira Izakova, PhD, Associate Professor, Department of Psychiatry, Faculty of Medicine Comenius University and University Hospital Bratislava, Mickiewiczova 13, Bratislava 81369, Slovakia. lubomira.izakova@gmail.com
Received: March 31, 2022
Peer-review started: March 31, 2022
First decision: May 11, 2022
Revised: June 6, 2022
Accepted: August 1, 2022
Article in press: August 1, 2022
Published online: September 6, 2022
Processing time: 147 Days and 16.3 Hours
Abstract
BACKGROUND

Population’s mental health surveillance is essential for knowing the distribution of mental well-being and mental disorders in the society. This allows for the establishment, evaluation, and revision of preventive measures and curative services. The results of such monitoring should serve as a database for evidence-based mental health policy. Mental disorders are among the top ten causes of burden globally and crisis situations such as the pandemic increase the risk of mental health problems, as they cause constant fear of contagion and the implementation of restrictive measures. The impact of the coronavirus disease 2019 (COVID-19) pandemic on the general population of the Slovak Republic has not yet been studied. The hypothesis was that more than one fifth of the population (women to a greater extent) will have symptoms of anxiety and depression.

AIM

To assess the mental health of the general Slovak population aged 15 years and older in the summer of 2021 by determining the prevalence of depressive and anxiety symptoms.

METHODS

An anonymous cross-sectional survey was implemented in a sample of 1501 respondents in the summer of 2021 during the COVID-19 pandemic. The inclusion criteria were age of 15 years and older and ability to complete the survey questionnaire online or in a face-to-face interview. The survey assessed anxiety symptoms by the seven-item general anxiety disorder and depressive symptoms by the nine-item patient health questionnaire instruments. Recognized cut-off scores of 10 or greater were used for both.

RESULTS

Anxiety symptoms were present in 19.32% and depression in 24.65% of the sample. Symptoms of both disorders were more common in females: 15.00% of males and 24.00% of females experienced anxiety symptoms, and 19.00% of males and 30.00% of females experienced symptoms of depression. Symptoms of both disorders were the most common in the youngest age group (15-25 years old): One fifth of males (20.29%) and one third of females (35.32%) had symptoms of anxiety, and 26.09% males and 43.79% females had symptoms of depression. Mean score for anxiety was 5.44 [standard deviations (SD) = 4.96] for the overall sample, 6.15 (SD = 5.14) for females, and 4.67 (SD = 4.63) for males. The youngest females of the 15-25 years age group had the highest score (7.55, SD = 5.27) among all age groups, for both sexes. Mean score for depression was 6.74 for the overall sample (SD = 5.75), 7.43 for females (SD = 5.87), and 5.99 (SD = 5.52) for males. The highest depression score was observed in the youngest females of the 15-25 years age group (9.34, SD = 6.07). We found a significant association between anxiety or depressive symptoms and younger age [odds ratio (OR): 1.69, 95% confidence interval (CI): 1.16-2.45 and OR: 1.65, 95%CI: 1.17-2.34, respectively], being female (OR: 1.86, 95%CI: 1.42-2.42 and OR: 1.76, 95%CI: 0.20-0.29, respectively), and having primary education (OR: 1.66, 95%CI: 1.08-2.54 and OR: 1.65, 95%CI: 1.16-2.63, respectively).

CONCLUSION

Results of our study indicate that anxiety and depression are frequent in the Slovak Republic during the COVID-19 pandemic. This important observation should serve as an information basis for the development of effective mental health policies, consisting of preventive programs, and early detection and effective treatment services. The study results provide strong argument for the necessity of mental health reform that is currently being shaped in the Slovak Republic.

Keywords: Mental health; COVID-19 pandemic; Anxiety; Depression; Slovak Republic

Core Tip: We have implemented a survey to assess anxiety and depressive symptoms by the general anxiety disorder and the patient health questionnaire instruments in the Slovak Republic during the coronavirus disease 2019 pandemic. Anxiety was present in 19.32% and depression in 24.65% of the population. Both disorders were more common in females. Our results indicate that anxiety and depressive symptoms were significantly associated with younger age, female sex, and lower than high school education. This is the first such survey of the population’s mental health in the Slovak Republic and the findings are important for the planning and improvement of mental health services in the country.