Mental illness stigma in Bangladesh: Findings from a cross-sectional survey.

Background: Mental illness stigma is universally prevalent and a significant barrier to achieving global mental health goals. Mental illness stigma in Bangladesh has gained little attention despite its widespread impact on seeking mental health care in rural and urban areas. This study aimed to investigate mental illness stigma and the associated factors in rural and urban areas of Bangladesh. Methods: The study areas were divided into several clusters from which 325 participants (≥18 years) were recruited with systematic random sampling. The Bangla version of the Days' Mental Illness Stigma Scale was used to collect data. Independent-samples t-test, ANOVA, and multiple regression were performed. Results: Results suggest that gender, age, geographical location, socioeconomic status, and occupation significantly differed across subscales of stigma. Age, gender, seeking treatment of mental illness, having knowledge on mental health, and socioeconomic status were predictive factors of mental illness stigma. The results also showed a high treatment gap in both rural and urban areas. Conclusion: This study supports that mental illness stigma is prevalent in Bangladesh, requiring coordinated efforts. Results can inform the development of contextually tailored mental health strategies to reduce stigma and contribute to the promotion of mental health of individuals and communities across Bangladesh.

Anxiety, depressive symptoms, sleep patterns & associated factors among Bangladeshi wage earners during the COVID-19 pandemic: a cross-sectional study.

The economic vulnerability imposed by the COVID-19 pandemic induces stress on mental health of wage earners in Bangladesh which is largely unexplored. This evidence gap was addressed in this study aiming to evaluate the mental health difficulties among Bangladeshi wage earners by assessing the associated factors influencing anxiety, depressive symptoms and sleep patterns. This cross-sectional study was conducted among 707 individual Bangladeshi wage earners in May 2020. The questionnaire included information about sleep duration, the Patient health questionnaire (PHQ-9), and the Generalized anxiety disorder (GAD-7) scales. The study revealed that anxiety and depressive symptoms were associated with male sex, higher educational status, service holder occupation and lower monthly income (p ≤ 0.01). Fear of COVID-19 when working outside during the pandemic situation was inextricably linked with anxiety (AOR = 2.08; 95% CI: 1.42-3.04) and depressive symptoms (AOR = 1.51; 95% CI = 1.04-2.20). Respondents who were responsible to financially support their family experienced significantly decreased duration of sleep (ß = -0.68; 95% CI: -1.18 to -0.20). The results of this study provided novel evidence on psychological difficulties among Bangladeshi wage earners which calls for an in-depth and longitudinal evaluation and immediate low-intensity psychosocial interventions.

COVID-19 associated fear & anxiety among students: Findings from a large-scale online survey in Bangladesh.

Objective: The study aimed to assess anxiety and fear of COVID-19 among home-staying Bangladeshi students. Participants: A total of 3997 university students across Bangladesh participated in the study. Methods: A cross-sectional study was conducted using the generalized anxiety disorder scale and the fear of COVID-19 scale to measure anxiety and fear, respectively. Results: 40.11% of participants had anxiety. Fear of death by COVID-19 (ß1'=4.45; 95% CI: 3.99-4.90) and perceiving COVID-19-like symptoms as having COVID-19 (ß1'=2.47; 95% CI: 1.76-3.18) were associated with higher fear. Exposure to COVID-19 news on social media was a predictor of fear and anxiety. Furthermore, the severe educational loss was associated with fear (ß1'=2.88; 95% CI: 2.25-3.50) and anxiety (ß2'=1.91; 95% CI: 1.41 to 2.41). Physical exercise and recreational activities were protective factors for fear and anxiety. Conclusion: The study reports a higher level of psychological difficulties among students during the COVID-19 pandemic which needs further longitudinal exploration to design appropriate interventions.

Factors associated with Facebook addiction among university students amid the COVID-19 pandemic: Findings from an online cross-sectional survey.

BACKGROUND: Facebook addiction (FA) has been suggested as a potential behavioral addiction. There is a severe lack of research evidence regarding the Facebook addiction behavior among university students during the ongoing COVID-19 pandemic. The aim of this study was to determine factors associated with Facebook addiction among Bangladeshi university students. METHODS: A cross-sectional online survey was conducted among 2,161 Bangladeshi university students during the COVID-19 pandemic from June 2021 to September 2021. A well fitted regression model in R programming language was used for this study. RESULTS: Female respondents and those whose family monthly income was <25,000 BDT were more addicted to Facebook than other respondents. Respondents who lost a family member or a relative to COVID-19, engaged in physical activities (exercise) during the pandemic, used Facebook for work purposes or used Facebook to relieve daily stress were more addicted to Facebook. CONCLUSION: Overuse of social media is problematic as it can trigger several mental health symptoms, especially among students. Adequate and effective interventions are required to educate students about the dangers of Facebook addiction and to provide an alternative, healthy options.

Factors associated with suicidal behavior among university students in Bangladesh after one year of COVID-19 pandemic.

BACKGROUND: The COVID-19 outbreak spillovers mental health burden where suicide is a common psychological public health issue that affects people all over the world. This study aimed to explore the factors associated with suicidal behavior among university students in Bangladesh after one year of the COVID-19 outbreak. METHODS: An online cross-sectional survey was conducted among 2100 Bangladeshi university students aged ≥18 years from April 29 to May 15, 2021. The survey questionnaire contained socio-demographic information, COVID-19 related physical and psychosocial factors (CRPPF), preventive response to psychological stress, and the Suicidal Behaviors Questionnaire-Revised (SBQ-R) scale. Descriptive statistics along with logistic regression were performed for statistical analysis. RESULTS: About 47.90% of the students were at risk of suicidal behavior, and female students were very likely to be at risk of suicidal behavior than their male counterparts (AOR = 2.28; 95% CI: 1.86 to 2.81). Keeping distance from friends or family (AOR = 1.66; 95% CI: 1.34 to 2.04), having relationship problems (AOR = 2.20; 95% CI: 1.79 to 2.70), feeling own selves as burden to families (AOR = 2.50; 95% CI: 2.02 to 3.11), and being stressed of lockdown (AOR = 1.56; 95% CI: 1.19 to 2.03) were highlighted as some of the significant factors associated with increased risk of suicidal behavior. CONCLUSION: University students were exposed to several factors that impose the risk of developing suicidal behavior. Concerned authorities should design & implement appropriate strategies for ensuring suicidal prevention besides their mental well-being.

Anxiety and depressive symptoms among physicians during the COVID-19 pandemic in Bangladesh: a cross-sectional study.

Objectives: In addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak. Methods and design: A cross-sectional study using an online survey following a convenience sampling technique was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS). Results: The survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded personal protective equipment (PPE), not received adequate training, lacking perceived self-efficacy to manage COVID-19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 h of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models. Conclusions: This study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers.

The Association Between Financial Hardship and Mental Health Difficulties Among Adult Wage Earners During the COVID-19 Pandemic in Bangladesh: Findings From a Cross-Sectional Analysis.

Background: The ongoing COVID-19 pandemic has created several challenges including financial burdens that may result in mental health conditions. This study was undertaken to gauge mental health difficulties during the COVID-19 pandemic and gain an insight into wage earners' mental health. Method: This cross-sectional study was conducted through an online survey. A t total of 707 individual Bangladeshi wage earners were enrolled between 20 and 30 May 2020. The questionnaire had sections on sociodemographic information, COVID-19 related questions, PHQ-9 and GAD-7 scales. STATA version 14.1 program was used to carry out all the analyses. Results: The study revealed that 58.6 and 55.9% of the respondents had moderate to severe anxiety and depressive symptoms, respectively. The total monthly income was <30,000 BDT (353.73USD) and displayed increased odds of suffering from depressive symptoms (OR = 4.12; 95% CI: 2.68-6.34) and anxiety (OR = 3.31; 95% CI: 2.17-5.03). Participants who did not receive salary income, had no income source during the pandemic, had financial problems, and inadequate food supply and were more likely to suffer from anxiety and depressive symptoms (p ≤ 0.01). Perceiving the upcoming financial crisis as a stressor was a potential risk factor for anxiety (OR = 1.91; 95% CI:1.32-2.77) and depressive symptoms (OR = 1.50; 95% CI:1.04-2.16). Limitations: The online survey method used in this study limits the generalizability of the findings and self-reported answers might include selection and social desirability bias as a community-based survey was not possible during the pandemic. Conclusion: Wage earners in a low resource setting like Bangladesh require mental health attention and financial consideration to deal with mental health difficulties.

Mental health difficulties in students with suspected COVID-19 symptoms and students without suspected COVID-19 symptoms: A cross-sectional comparative study during the COVID-19 pandemic.

INTRODUCTION: Mental health problems are taking a heavy toll on students during the COVID-19 pandemic. The purpose of this study was to compare the level of anxiety symptoms, depressive symptoms, post-traumatic stress symptoms (PTSS), and fear of COVID-19 between students with suspected COVID-19 symptoms and students without any suspected symptoms during the pandemic in Bangladesh. METHODS: This cross-sectional comparative study was conducted online among Bangladeshi students from May to July 2020. Anxiety symptoms, depressive symptoms, PTSS, and fear of COVID-19 were assessed by using the Generalized Anxiety Disorder scale, Patient Health Questionnaire, the Impact of Event Scale, and Fear of COVID-19 Scale, respectively. College and University students were the participants of the study. RESULTS: Among 3777 students, 1259 had suspected COVID-19 symptoms and 2518 had no suspected COVID-19 symptoms. Students who experienced suspected COVID-19 symptoms had higher prevalence (moderate to severe) of depressive symptoms (61.15% vs. 47.62%), anxiety symptoms (44.96% vs. 36.97%), and PTSS (48.3% vs. 39.75%) compared to those who had no such symptoms. The study identified having suspected COVID-19 symptoms as a significant associated factor for anxiety symptoms (ß1' = 1.39; 95% CI: 1.03-1.74), depressive symptoms (ß1' = 1.88; 95% CI: 1.43-2.32), PTSS (ß1' = 3.66; 95% CI: 2.66-4.65), and fear of COVID-19 (ß1' = 0.48; 95% CI: 0.02 to 0.94). Students with suspected COVID-19 symptoms thought more that they would be better off dead, or of hurting themselves (P < 0.01) and felt more afraid as if something awful might happen (P < 0.01) than their counterparts. CONCLUSION: Mental health difficulties are more prevalent among students with suspected COVID-19 symptoms than the students without having such symptoms. This finding suggests that public health practitioners should deploy a rapid diagnostic system and consider psychological intervention in addition to clinical management for those who have COVID-19 like symptoms during the pandemic.

Fear and depressive symptoms amid COVID-19: A cross-sectional pilot study among adult population in Bangladesh.

BACKGROUND: Fear is a primary emotional reaction to the deadly coronavirus disease which might be an associated factor for developing depressive symptoms. This study aimed to assess the level and associated factors of fear and depression amid the COVID-19 pandemic among the adult population of Bangladesh. METHODS: After providing informed consent, 1050 participants completed the cross-sectional online survey tool. Depressive symptoms and fear were assessed through the PHQ-9 and validated fear of COVID-19 scale (FCV-19S), respectively. Linear regression analysis was performed to predict potential factors of fear and depression. RESULTS: The study finds that females had higher scores for fear of COVID-19 scale (ß1' = 1.81; 95% CI: 1.15 to 2.47) and Patient Health Questionnaire (ß2' = 1.92; 95% CI: 0.95 to 2.88) than their male counterpart. Respondents considering the virus to be extremely dangerous had higher scores for FCV-19S (ß1' = 1.55; 95% CI: 0.66 to 2.44) and PHQ-9 (ß2 = 1.59; 95% CI: 0.25 to 2.92). Similarly, respondents considering themselves unsafe and very worried about the virus had increased scores for both FCV-19S and PHQ-9. On other hand, people those were reluctant to use masks (ß1' = -1.58; 95% CI: -3.12 to -0.04) or seek doctors' advice (ß1' = -0.93; 95% CI: -1.83 to -0.02) if COVID-19 symptoms appear, had comparatively lower scores for FCV-19S. CONCLUSIONS: Fear of COVID-19 and depression were found to be associated with some specific knowledge, attitude & preparedness towards COVID-19 which should be adequately addressed in public health strategies to prevent the virus.

Prevalence and predictors of post-traumatic stress symptoms and depressive symptoms among Bangladeshi students during COVID-19 mandatory home confinement: A nationwide cross-sectional survey.

The COVID-19 pandemic has brought not only the risk of infection but also unbearable mental health difficulties with the concern of educational loss among students. This study explored the adverse impact of the COVID-19 outbreak on Bangladeshi students' mental health and detected potential influencing factors related to post-traumatic stress symptoms (PTSS) and depressive symptoms. Convenience sampling was applied to collect data via online survey from 3997 college and university students between 29th May and 22nd July 2020. PHQ-9 and IES scales were used to assess depressive symptoms and PTSS, respectively. Of all participants, 52.87% had depressive symptoms and 40.91% had PTSS. Severe educational disruption was a risk factor for depressive symptoms (AOR = 1.68; 95% CI: 1.37-2.06) and PTSS (AOR = 1.86; 95% CI: 1.51-2.29). COVID-19 like symptoms including fever, cough, breathing difficulty and fatigue showed a stronger association with higher IES and PHQ-9 scores than other symptoms (e.g., diarrhea, sore throat) (p ≤ 0.01). Fear of infection and death by COVID-19 were risk factors for PTSS and depressive symptoms (p ≤ 0.01). Recreational activity and regular physical exercise emerged as the most protective factors for depressive symptoms and PTSS. The mental health of students is significantly affected in this pandemic suggesting the need for adequate psychological support.

Prevalence of anxiety and depressive symptoms among physicians during the COVID-19 pandemic in Bangladesh: a cross-sectional study.

OBJECTIVES: In addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the COVID-19 pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak. METHODS AND DESIGN: A cross-sectional study using an online survey was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded PPE, not received adequate training, lacking perceived self-efficacy to manage COVID -19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 hours of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models. CONCLUSIONS: This study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers. STHRENGHTS & LIMITATIONS OF THE STUDY: This study reports a novel and concerning findings on the prevalence of anxiety and depression symptoms with identification of several important associated factors among Bangladeshi physicians during the COVID-19 pandemic.The cross-sectional nature of the study design could not establish causal relationship between the dependent and independent variables.This study was carried out by conducting a web-based survey, which might generate sampling bias by excluding the physicians who do not have access to internet or inactive in social medias, and thus limit the generalizability of the findings.

The impact of COVID-19 pandemic on mental health & wellbeing among home-quarantined Bangladeshi students: A cross-sectional pilot study.

BACKGROUND: COVID-19 is imposing threat both on physical and mental health since its outbreak. Bangladesh adopted lockdown strategy with potential consequences on day to day life, mental and physical health and this study aims to explore the impact of COVID-19 on mental health and wellbeing among Bangladeshi students. METHODS: A cross-sectional study was conducted between 9th and 23rd April 2020 among 505 college and university students. Data was collected by using online questionnaire including DASS 21 and IES. Descriptive analysis and bivariate linear regression were performed to examine the association of variables. RESULTS: 28.5 % of the respondents had stress, 33.3% anxiety, 46.92% depression from mild to extremely severe, according to DASS 21 and 69.31% had event-specific distress from mild to severe in terms of severity according to IES. Perceiving physical symptoms as COVID-19 was significantly associated with DASS stress subscale (B = 3.71, 95% CI: 1.01 to 6.40), DASS anxiety subscale (B = 3.95, 95% CI: 1.95 to 5.96), DASS depression subscale (B = 3.82, 95% CI: 0.97 to 6.67) and IES scale (B = 7.52, 95% CI: 3.58 to 11.45). Additionally, fear of infection, financial uncertainty, inadequate food supply, absence of physical exercise and limited or no recreational activity had significant association with stress, anxiety, depression and post-traumatic symptoms. CONCLUSION: This COVID-19 outbreak imposes psychological consequences on people to a great extent which requires attention from the concerned authorities to cope with this situation mentally. The perception about the outbreak can also play a big role in psychological impact.