The Impact of COVID-19 on the People with Mental Illnesses: Health Anxiety, Coping Strategies, and Psychological Well-Being

Yıl 2022, , 607 - 628, 28.10.2022

Selin Karaköse

https://doi.org/10.31682/ayna.1080127

Öz

Although depression, anxiety, and stress were highly prevalent in the general population during the pandemic, some marginalized groups, including patients with mental disorders might have been overlooked in studies. This study examined the relationship between health anxiety, coping strategies, and mental health outcomes, particularly depressive symptoms, anxiety, and stress. The aim of the current study is to examine the mediator role of coping strategies between health anxiety and mental health outcomes in using data from 80 individuals with mental diagnosis. Also, using 168 healthy controls (N = 248 participants), we sought to investigate whether an individuals’ mental diagnoses was associated with their scores on health anxiety, coping strategies, and mental health outcomes. Sociodemographic Information and Health Data Form, Health Anxiety Inventory – Short Form [SHAI], Ways of Coping Strategies [WCQ], and Depression, Anxiety, Stress Scale [DASS-42] were given to the participants. Results demonstrated that people with mental illnesses had moderate levels of depression, anxiety, and stress, in contrast to healthy controls. Furthermore, mediator analysis revealed that accepting responsibility significantly mediated the relationship between health anxiety, depression, anxiety, and stress in people with mental illnesses. The findings have suggested that individuals with psychological problems are at risk for adverse mental health outcomes. Furthermore, these findings highlight that therapists should prioritize intervention studies focusing on health anxiety, coping strategies, and mental health outcomes during COVID-19.

Anahtar Kelimeler

COVID-19, health anxiety, coping strategies, mental health, people with illnesses

Destekleyen Kurum

The Scientific and Technological Research Council of Turkey (TÜBİTAK)

Proje Numarası

Contract Approval: 06/24/2020, Project No.: 120K421).

COVID-19 Pandemisinin Psikiyatrik Tanı Almış Bireyler Üzerindeki Etkisi: Sağlık Kaygısı, Baş Etme Stratejileri ve Psikolojik İyi Oluş

Öz

COVID-19 pandemisinde depresyon, anksiyete ve stresdüzeyinde yüksek oranlar bilinmesine rağmen yürütülen pek çok çalışmada ruh sağlığı açısından önceliklendirilmesi gereken psikiyatrik tanı almış bireylerin göz ardı edildiği dikkat çekmektedir. Bu çalışma, sağlık kaygısı, baş etme stratejileri ve psikolojik oluş değişkenlerini (depresyon, anksiyete ve stress) psikiyatrik tanı almış bireylerde incelemeyi amaçlamıştır. COVID-19 pandemisi öncesinde psikiyatrik tanı almış 80 birey ile sağlık kaygısı ve psikolojik iyi oluş arasında baş etme yollarının aracı etkisi araştırılmış, sağlıklı kontrol grubunu da içeren toplam 248 birey arasında da araştırma değişkenlerinin ortalama puanları karşılaştırılmıştır. Sosyodemografik Bilgi ve Sağlık Veri Formuna ek olarak, Sağlık Kaygısı Ölçeği-Kısa Form [SHAI-SF], Baş Etme Yolları Ölçeği [WCQ] ve Depresyon, Kaygı, Stres Skalası [DASS-42] katılımcılara sunulmuştur. Sonuçlar, sağlıklı kontrol grubunun depresyon, anksiyete ve stress puanlarının normal düzeyde olduğunu, ancak psikiyatrik tanı almış bireylerin orta düzeyde depresyon, anksiyete ve stres düzeyine sahip olduğunu göstermektedir. Ayrıca, sorumluluğu kabul etme baş etme stratejinin sağlık kaygısı ve depresyon, anksiyete, stres arasında aracılık gösterdiği bulunmuştur. Çalışmanın bulguları, COVID-19 pandemisinde, psikiyatrik tanısı olan bireylerin ruh sağlığı açısından risk altında olduğunu ve sağlık kaygısı, baş etme yolları ile psikolojik iyi oluş düzeylerine yönelik müdahalelerin önceliklendirilmesi gerektiğine işaret etmektedir.

Anahtar Kelimeler

COVID-19, sağlık kaygısı, baş etme yolları, ruh sağlığı, psikiyatrik tanı almış bireyler

Proje Numarası

Contract Approval: 06/24/2020, Project No.: 120K421).

Kaynakça

• Abramowitz, J. S., & Braddock, A. E. (2008). Psychological treatment of health anxiety and hypochondriasis: A biopsychosocial approach. Hogrefe & Huber Publishers.
• Ahorsu, D. K., Lin, C. Y., Imani, V., Saffari, M., Griffiths, M. D., & Pakpour, A. H. (2020). The Fear of COVID-19 Scale: Development and Initial Validation. International Journal of Mental Health Addict, 27, 1-9. https://doi.org/10.1007/s11469-020-00270-8
• Alper, S., Bayrak, F., & Yilmaz, O. (2021). Psychological correlates of COVID-19 conspiracy beliefs and preventive measures: Evidence from Turkey. Current Psychology, 40(11), 5708-5717. https://doi.org/10.1007/s12144-020-00903-0
• Arora, T., Grey, I., Östlundh, L., Lam, K. B. H., Omar, O. M., & Arnone, D. (2020). The prevalence of psychological consequences of COVID-19: A systematic review and meta-analysis of observational studies. Journal of Health Psychology, Advance online publication. https://doi.org/10.1177/1359105320966639
• Asmundson, G. J. G., & Taylor, S. (2020). Coronaphobia: Fear and the 2019-nCoV outbreak. Journal of Anxiety Disorders .70,102196. https://doi.org/10.1016/j.janxdis.2020.102196
• Atak, Z. B., & Yalçınkaya Alkar, Ö. (2022). Turkish adaptation of COVID-19 stressors scale: A validity and reliability study . AYNA Clinical Psychology Journal, 9(1), 135-159. https://doi.org/10.31682/ayna.973914
• Ay, T., Oruç, D., & Özdoğru, A. A. (2022). Adaptation and evaluation of COVID-19 related Psychological Distress Scale Turkish form. Death Studies, 46(3), 560-568. https://doi.org/10.1080/07481187.2021.1873459
• Aydemir, Ö., Kırpınar, İ., Satı, T., Uykur, B., & Cengisiz, C. (2013). Reliability and validity of the Turkish version of the Health Anxiety Inventory. Archives of Neuropsychiatry, 50(4), 325-331. https://doi.org/10.4274/npa.y6383
• Baloran, E. T. (2020). Knowledge, attitudes, anxiety, and coping strategies of students during COVID-19 pandemic. Journal of Loss and Trauma, 25(1), 1-8. https://doi.org/10.1080/15325024.2020.1769300
• Bekaroğlu, E., & Yılmaz, T. (2020). COVID-19 and psychological effects: A Review in clinical psychology perspective. Nesne, 8(18), 573-584. https://doi.org/10.7816/nesne-08-18-14
• Bilge, Y., & Bilge, Y. (2020). Investigation of the effects of corona virus pandemic and social isolation on psychological symptoms in terms of psychological resilience and coping styles. Journal of Clinical Psychology, 23(1), 38-51. https://doi.org/ 10.5505/kpd.2020.66934
• Bilgel, N., & Bayram, N. (2010). Turkish version of the Depression Anxiety Stress Scale (DASS-42): Psychometric properties. Archives of Neuropsychiatry, 47(2), 118-126. https://doi.org/10.4274/npa.5344
• Bizri, A. R., Khachfe, H. H., Fares, M. Y., & Musharrafieh, U. (2020). COVID-19 Pandemic: An Insult Over Injury for Lebanon. Journal of Community Health, 46(3), 1–7. https://doi.org/10.1007/s10900-020-00884-y
• Blakey, S. M., & Abramowitz, J. S. (2017). Psychological predictors of health anxiety in response to the Zika Virus. Journal of Clinical Psychology in Medical Settings, 24(3-4), 270–278. https://doi.org/10.1007/s10880-017-9514-y
• Blakey, S. M., Reuman, L., Jacoby, R. J., & Abramowitz, J. S. (2015). Tracing “Fearbola”: psychological predictors of anxious responding to the threat of Ebola. Cognitive Therapy and Research, 39, 816–825. https://doi.org/10.1007/s10608-015-9701-9
• Byrne, B. M. (2016). Structural equation modelling with AMOS: Basic concepts, applications, and programming (3rd ed.). Routledge.
• Carone, D. A., & Barone, D. F. (2001). A social cognitive perspective on religious beliefs: Their functions and impact on coping and psychotherapy. Clinical Psychology Review, 21(7), 989–1003. https://doi.org/ 10.1016/s0272-7358(00)00078-7
• Case, T. I., Fitness, J., Cairns, D. R., & Stevenson, R. J. (2004). Coping with uncertainty: Superstitious strategies and secondary control. Journal of Applied Social Psychology, 34, 848–871. https://doi.org/10.1111/j.1559-1816.2004.tb02574.x
• Chew, Q. H. & Wei, K. V., S. & Chua, H., & Sim, K. (2020). Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic. Singapore Medical Journal, 61(7), 350-356. https://doi.org/ 10.11622/smedj.2020046
• Folkman, S., & Lazarus, R.S. (1985). If it changes it must be a process: Study of emotion and coping during 3 stages of a college-examination. Journal of Personality and Social Psychology, 48(1), 150–170. https://doi.org/10.1037/0022-3514.48.1.150
• Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., Delongis, A., & Gruen, R.J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50(5), 992–1003. https://doi.org/10.1037/0022-3514.50.5.992
• Galica, J., Liu, Z., Kain, D., Merchant, S., Booth, C., Koven, R., & Haase, K. R. (2021). Coping during COVID-19: a mixed methods study of older cancer survivors. Supportive Care in Cancer, 29(6), 1-10. https://doi.org/ 10.1007/s00520-020-05929-5
• Garbóczy, S., Szemán-Nagy, A., Ahmad, M. S., Harsányi, S., Ocsenás, D., Rekenyi, V., Al‑Tammemi, A. B., & Kolozsvári, L. R. (2021). Health anxiety, perceived stress, and coping styles in the shadow of the COVID-19. BMC Psychology, 9(53). https://doi.org/10.1186/s40359-021-00560-3
• Gerhold, L. (2020). Risk perception and coping strategies. PREPRINT. https://doi.org/10.31234/osf.io/xmpk4
• Göral, F. S., Kesimci, A., & Gençöz, T. (2006). Roles of the controllability of the event and coping strategies on stress-related growth in a Turkish sample. Stress and Health, 22, 297–303. https://doi/10.1002/smi.1107
• Görgen, S. M., Hiller, W. & Witthöft, M. (2014). Health anxiety, cognitive coping, and emotion regulation: a latent variable approach. International Journal of Behavioral Medicine, 21(2),364-374. https://doi.org/%2010.1007/s12529-013-9297-y
• Guo, Y. R., Cao, Q. D., Hong, Z. S., Tan, Y. Y., Chen, S. D., Jin, H. J., Tan, K. S., Wang, D. Y., & Yan, Y. (2020). The origin, transmission, and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Military Medical Research, 7(1), 11-24. https://doi.org/10.1186/s40779-020-00240-0
• Gurvich, C., Thomas, N., Thomas, E. H., Hudaib, A. R., Sood, L., Fabiatos, K., Sutton, K., Isaacs, A., Arunogiri, S., Sharp, G., & Kulkarni, J. (2021). Coping styles and mental health in response to societal changes during the COVID-19 pandemic. The International Journal of Social Psychiatry, 67(5), 540–549. https://doi.org/10.1177/0020764020961790
• Hadjistavropoulos, H. D., Hadjistavropoulos, T., & Quine, A. (2000). Health anxiety moderates the effects of distraction versus attention to pain. Behaviour Research and Therapy, 38, 425–438. https://doi.org/10.1016/S0005-7967(99)00044-3
• Harris, M. B., Baloğlu, M., & Stacks, J. R. (2002). Mental health of trauma-exposed firefighters and critical incident stress debriefing. Journal of Loss and Trauma, 7(3), 223–238. https://doi.org/10.1080/10811440290057639
• Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process: A regression-based approach (2nd ed.). The Guilford Press.
• Helmy, Y. A, Fawzy, M., Elaswad, A., Sobieh, A., Kenney, S. P & Shehata, A. A. (2020). The COVID-19 Pandemic: A Comprehensive review of taxonomy, genetics, epidemiology, diagnosis, Treatment, and Control. Journal of Clinical Medicine, 9(4),1225-1254. https://doi.org/10.3390/jcm9041225
• Jeong, H., Yim, H. W., Song, Y. J., Ki, M., Min, J. A., Cho, J., & Chae, J. H. (2016). Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiology and Health, 38-45. https://doi.org/10.4178/epih.e2016048
• Karaköse, S., & Akçinar, B.(2021a). Health cognition questionnaire COVID-19 Form: Adaptation study. Ayna Clinical Psychology Journal, 8(3), 557-579. https://doi.org/10.31682/ayna.911020
• Karaköse, S., & Akçinar, B. (2021b). Factors associated with COVID-19 preventive health behaviors. Nesne, 9(21), 619-636. https://doi.org/10.7816/nesne-09-21-09
• Keinan, G. (2002). The effects of stress and desire for control on superstitious behavior. Personality and Social Psychology Bulletin, 28(1), 102–108. https://doi.org/10.1177/0146167202281009
• Khan, S., Siddique, R., Xiaoyan, W., Zhang, R., Nabi, G., Sohail, Afzal, M., Liu, J., & Xue, M. (2021). Mental health consequences of infections by coronaviruses including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Brain Behavior, 11(2), https://doi.org/10.1002/brb3.1901
• Kocakaya, H., & Harmacı, H. (2022). Evaluation of the effect of psychological resilience and temperament on epidemic anxiety. The Journal of Kırıkkale University Faculty of Medicine, 24(1), 144-152. http://doi.org/10.24938/kutfd.1039035
• Landi, G., Pakenham, K. I., Boccolini, G., Grandi, S., & Tossani, E. (2020). Health anxiety and mental health outcome during COVID-19 lockdown in Italy: The Mediating and moderating roles of psychological flexibility. Frontiers in Psychology, 11, 2195-2209. https://doi.org/ 10.3389/fpsyg.2020.02195.
• Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
• Lazarus, R. S. & Launier, R. (1978) Stress-related transactions between person and environment. In L. A. Pervin, and M. Lewis (Eds.), Perspectives in Interactional Psychology, Plenum (ss. 287-327). http://doi.org/10.1007/978-1-4613-3997-7_12
• Lipowski, Z. J. (1970). Physical illness, the individual and the coping processes. Psychiatry in Medicine, 1(2), 91–102. https://doi.org/10.2190/19Q3-9QL8-XYV1-8XC2
• Liu, Y., Ning, Z., Chen, Y., Guo, M, Liu, Y., Gali, N. K., Sun, L., Duan, Y., & Cai, J. (2020) Westerdahl D, Liu X, Xu K, Ho KF, Kan H, Fu Q, Lan K. (2020). Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals. Nature, 582,557-560. https://doi.org/ 10.1038/s41586-020-2271-3
• López-Morales, H., Del Valle, M. V., Canet-Juric, L., Andrés, M. L., Galli, J. I., Poó, F., & Urquijo, S. (2021). Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study. Psychiatry Research, 295, 113567. https://doi.org/10.1016/j.psychres.2020.113567
• Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335-343. https://doi.org/10.1016/0005-7967(94)00075-U
• MacSwain, K. L. H., Sherry, S. B., Stewart, S. H., Watt, M. C., Hadjistavropoulos, H. D., & Graham, A. R. (2009). Gender differences in health anxiety: An investigation of the interpersonal model of health anxiety. Personality and Individual Differences, 47(8), 938-943. https://doi.org/10.1016/j.paid.2009.07.020
• Mahmoud, J. S, Staten, R., Hall, L. A, & Lennie, T.A (2012). The relationship among young adult college students' depression, anxiety, stress, demographics, life satisfaction, and coping styles. Issues in Mental Health Nursing, 33(3),149-56. https://doi.org/10.3109/01612840.2011.632708
• Main, A., Zhou, Q., M, Y., Luecken, L. J., & Liu, X. (2011). Relations of SARS-related stressors and coping to Chinese college students' psychological adjustment during the 2003 Beijing SARS epidemic. Journal of Counseling Psychology, 58(3),410-23. https://doi.org/10.1037/a0023632
• Matud, M. P. (2004). Gender differences in stress and coping styles. Personality and individual differences, 37(7), 1401-1415. https://doi.org/10.1016/j.paid.2004.01.010
• Melamed O. C., Hahn M. K., Agarwal S. M., Taylor V. H., Mulsant B. H., & Selby P. (2020). Physical health among people with serious mental illness in the face of COVID-19: Concerns and mitigation strategies. General Hospital Psychiatry, 66, 30–33. 10.1016/j.genhosppsych.2020.06.013
• Nakamura Z. M., Nash R. P., Laughon S. L., & Rosenstein D. L. (2021). Neuropsychiatric complications of COVID-19. Current Psychiatry Reports, 23(5)25-34. 10.1007/s11920-021-01237-9
• Ogueji, I. A., Okoloba, M. M., & Demoko-Ceccaldi, B. M. (2021). Coping strategies of individuals in the United Kingdom during the COVID-19 pandemic. Current Psychology (New Brunswick, N.J.), 1–7. Advance online publication. https://doi.org/10.1007/s12144-020-01318-7
• Pieh, C., O Rourke, T., Budimir, S., & Probst, T. (2020). Relationship quality and mental health during COVID-19 lockdown. PLOS One, 15(9), e0238906. https://doi.org/10.1371/journal.pone.0238906
• Radfar, A., Ferreira, M. M., Sosa, J. P., & Filip, I. (2021). Emergent crisis of COVID-19 pandemic: Mental health challenges and opportunities. Frontiers in Psychiatry, 12, 631008. https://doi.org/10.3389/fpsyt.2021.631008
• Republic of Turkey Ministry of Health. (2020). https://covid19. saglik.gov.tr/
• Riecher-Rössler, A. (2017). Sex and gender differences in mental disorders. The Lancet Psychiatry, 4(1), 8-9. https://doi.org/10.1016/S2215-0366(16)30348-0
• Rossi, R., Socci, V., Talevi, D., Mensi, S., Niolu, C., Pacitti, F., Di Marco, A., Rossi, A., Siracusano, A., & Di Lorenzo, G. (2020). COVID-19 Pandemic and Lockdown Measures Impact on Mental Health Among the General Population in Italy. Frontiers in Psychiatry, 11, 790-796. https://doi.org/10.3389/fpsyt.2020.00790
• Rubin, G., & Amlôt, R., Page, L., & Wessely, S. (2009). Public perceptions, anxiety, and behaviour change in relation to the Swine Flu Outbreak: Cross-sectional telephone survey. British Medical Journal (Clinical research ed.), 339(3), 1-8. https://doi.org/10.1136/bmj.b2651
• Salkovskis, P. M., Rimes, K., Warwick, H. M. C., & Clark, D. (2002). The Health Anxiety Inventory: Development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(5), 843-53. https://doi.org/%2010.1017/s0033291702005822
• Senol-Durak, E., Durak, M., & Elagöz, F. (2011). Testing the psychometric properties of the ways of coping questionnaire (WCQ) in Turkish university students and community samples. Clinical psychology & Psychotherapy, 18(2),172-185. https://doi.org/%2010.1002/cpp.677
• Sharma, A., & Kar, N. (2019). Posttraumatic stress, depression, and coping following the 2015 Nepal earthquake: a study on adolescents. Disaster Medicine Public Health Preparedness, 13(2), 236-247. https://doi.org/10.1017/dmp.2018.37
• Siva, A.N. (1991). Coping with distress, learned powerfulness and depression among infertile people [Unpublished Doctoral Dissertation]. Hacettepe University.
• Stanisławski, K. (2019). The coping circumplex model: an integrative model of the structure of coping with stress. Frontiers in Psychology, 16(10), 694-720. https://doi.org/10.3389/fpsyg.2019.00694
• Tuncay, T., Musabak, I., Gok, D. E., & Kutlu, M. (2008). The relationship between anxiety, coping strategies and characteristics of patients with diabetes. Health and Quality Life Outcomes, 6,79-88. https://doi.org/10.1186/1477-7525-6-79
• Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2021). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. General Psychiatry, 33(2), e100213. https://doi.org/10.1136/gpsych-2020-100213
• Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health, 17(5), 1729-1754. https://doi.org/10.3390/ijerph17051729
• Wasserman, D., Iosue, M., Wuestefeld, A., & Carli, V. (2020). Adaptation of evidence-based suicide prevention strategies during and after the COVID-19 pandemic. World Psychiatry, 19, 294–306. https://doi.org/10.1002/wps.20801
• Wheaton, M., Abramowitz, J., Berman, N., Fabricant, L., Bunmi, B., & Olatunji, O. (2012). Psychological Predictors of Anxiety in Response to the H1N1 (Swine Flu) Pandemic. Cognitive Therapy and Research, 36(3), 210-218. https://doi.org/10.1007/s10608-011-9353-3
• Wheaton, M., Berman, N., Franklin, J., & Abramowitz, J. (2010). Health anxiety: Latent structure and associations with anxiety-related psychological processes in a student sample. Journal of Psychopathology and Behavioral Assessment, 32(4), 565-574. https://doi.org/10.1007/s10862-010-9179-4
• World Health Organization (WHO). (2020). WHO director-general's opening remarks at the media briefing on COVID-19 - 26 April 2020. Retrieved from https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-−11-march-2020
• World Health Organization (WHO). (2022). WHO Coronavirus (COVID-19) Dashboard – Turkey. Retrieved from https://covid19.who.int/region/euro/country/tr
• Wright A., Salazar A., Mirica M., Volk L. A., & Schiff G. D. (2020). The invisible epidemic: neglected chronic disease management during COVID-19. Journal of General International Medicine, 35, 2816–2817. https://doi.org/10.1007/s11606-020-06025-4
• Xiang, Y. T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., & Ng, CH. (2020). Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry, 7(3),228-229. https://doi.org/10.1016/S2215-0366(20)30046-8
• Vahia, I. V., Jeste, D. V., & Reynolds, C.F. (2020). Older adults and the mental health effects of COVID-19. JAMA, 324(22),2253–2254. https://doi.org/10.1001/jama.2020.21753
• Yıldırım, M., & Güler, A. (2022). COVID-19 severity, self-efficacy, knowledge, preventive behaviors, and mental health in Turkey. Death studies, 46(4), 979-986. https://doi.org/10.1080/07481187.2020.1793434
• Zambelli, Z., Fidalgo, A. R., Halstead, E. J., & Dimitriou, D. (2021). Acute impact of a national lockdown during the COVID-19 pandemic on wellbeing outcomes among individuals with chronic pain. Journal of Health Psychology, 1359105321995962. Advance online publication. https://doi.org/10.1177/1359105321995962