AccScience Publishing / GHES / Online First / DOI: 10.36922/ghes.2551
ORIGINAL RESEARCH ARTICLE

COVID-19: Sociodemographic determinants of selected mental health problems among adults in South-South Nigeria

Owoisinke Effiong Okon1,2 Margaret Inemesit Akpan1 Victor Bassey Archibong3*
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1 Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria
2 Department of Public Health, School of Applied and Health Sciences, Nexus International University, Kampala, Uganda
3 Department of Human Anatomy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
Submitted: 27 December 2023 | Accepted: 1 March 2024 | Published: 29 May 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

During the outbreak of highly infectious COVID-19, the Nigerian Ministry of Health primarily emphasized preventive strategies such as personal hygiene, social distancing, and self-isolation. However, there was a notable lack of information addressing mental well-being and coping mechanisms from both the Nigerian government and other relevant agencies. Notably, social distancing and self-isolation are well-documented triggers for mental health problems. Our study aimed to identify the socio-demographic correlates of mental health problems among adults in South-South Nigeria during the COVID-19 lockdown restrictions. This cross-sectional descriptive survey involved 1240 respondents from this region who completed online questionnaires designed using the Kobo Toolbox. The questionnaire covered sociodemographic information and included standardized assessments for generalized anxiety disorder (GAD), anger disorder, and depression disorder. Specifically, the GAD-7 assessed GAD, Spielberger’s State-Trait Anger Expression Inventory-2 assessed anger disorder, and the beck depression inventory assessed depression disorder. Our results revealed that 37% of respondents experienced mild depression, 29% reported mild anxiety, and 27% experienced minimal anger. Significant associations were found between depression and factors such as marital status, age, and education level (p < 0.001). Similarly, anger expression was significantly associated with family size, monthly income, age, and marital status (p < 0.001). Anxiety also exhibited significant associations with sociodemographic characteristics (p < 0.001) in the study. In conclusion, our study highlights that sex, educational level, income, and marital status are important sociodemographic determinants of mental health outcomes.

Keywords
COVID-19
Anxiety
Depression
Anger
Economic impact
Sociodemographic
South-South Nigeria
Funding
None.
References

Akinkuotu, E., Adelani, A., Ade, A., Oladimeji, R., Deji, L., Wale, O., et al. (2020). Black Tuesday: 49 Killed as Protest Turns Bloody. PUNCH. Available from: https://punchng. com/black-tuesday-49-killed-as-protest-turn-bloody [Last accessed on 2024 May 19].

 

Alia-Klein, N., Gan, G., Gilam, G., Bezek, J., Bruno, A., Denson, T.F., et al. (2020). The feeling of anger: From brain networks to linguistic expressions. Neuroscience and Biobehavioral Reviews, 108:480-497. https://doi.org/10.1016/j.neubiorev.2019.12.002

 

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Arlington, VA: American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596

 

Anwar-McHenry, J., Jalleh, G., Donovan, R.J., & Laws, A. (2013). Impact on community organizations that partnered with the act-belong-commit mental health promotion campaign. Health Promotion Journal of Australia, 24(1):44-48. https://doi.org/10.1071/HE12909

 

Archibong, V., Usman, I.M., Kasozi, K.I., Aigbogun, E.O. Jr., Josiah, I., Monima, A.L., et al. (2021). Anxiety, anger and depression amongst low-income earners in Southwestern Uganda during the COVID-19 total lockdown. Frontiers in Public Health, 9:590458. https://doi.org/10.3389/fpubh.2021.590458

 

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

 

Azevedo, F.B., Wang, Y.P., Goulart, A.C., Lotufo, P.A., & Benseñor, I.M. (2010). Application of the Spielberger’s state-trait anger expression inventory in clinical patients. Arquivos de Neuro-Psiquiatria, 68(2):231-234. https://doi.org/10.1590/s0004-282x2010000200015

 

Bangasser, D.A., & Valentino, R.J. (2014). Sex differences in stress-related psychiatric disorders: Neurobiological perspectives. Frontiers in Neuroendocrinology, 35(3):303-319. https://doi.org/10.1016/j.yfrne.2014.03.008

 

Bauldry, S. (2015). Variation in the protective effect of higher education against depression. Society and Mental Health, 5(2):145-161. https://doi.org/10.1177/2156869314564399

 

Beard, C., & Björgvinsson, T. (2014). Beyond generalized anxiety disorder: Psychometric properties of the GAD-7 in a heterogeneous psychiatric sample. Journal of Anxiety Disorders, 28(6):547-552. https://doi.org/10.1016/j.janxdis.2014.06.002

 

Beck, A.T. (1972). Depression: Causes and Treatment. Philadelphia, PA: University of Pennsylvania Press.

 

Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4:561-71. https://doi.org/10.1001/archpsyc.1961.01710120031004

 

Bjelland, I., Krokstad, S., Mykletun, A., Dahl, A.A., Tell, G.S., & Tambs, K. (2008). Does a higher educational level protect against anxiety and depression? The HUNT study. Social Science and Medicine, 66(6):1334-1345. https://doi.org/10.1016/j.socscimed.2007.12.019

 

Boylan, J.M., & Ryff, C.D. (2015). Psychological well-being and metabolic syndrome: Findings from the midlife in the United States national sample. Psychosomatic Medicine, 77(5):548-558. https://doi.org/10.1097/PSY.0000000000000192

 

Chukwuma, M., & Ijeoma, N. (2022). Why Over 50m Nigerians are Mentally ill, by Psychiatrists. The Guardian. Available from: https://guardian.ng/news/why-over-50m-nigerians-are-mentally-ill-by-psychiatrists/accessed on [Last accessed on 2024 May 19].

 

Cook, W.W., & Medley, D.M. (1954), Proposed hostility and Pharisaic-virtue scales for the MMPI. Journal of Applied Psychology, 38(6):414-418. https://doi.org/10.1037/h0060667

 

Dear, B.F., Titov, N., Sunderland, M., McMillan, D., Anderson, T., Lorian, C., & Robinson, E. (2011). Psychometric comparison of the generalized anxiety disorder scale-7 and the Penn State Worry Questionnaire for measuring response during treatment of generalised anxiety disorder. Cognitive Behaviour Therapy, 40(3):216-227. https://doi.org/10.1080/16506073.2011.582138

 

Deater-Deckard, K., & Wang, Z. (2012). Anger, and irritability. In: Zentner, M., & Shiner, R.L. (eds.). Handbook of Temperament. New York: The Guilford Press, p.124-144.

 

Deschênes, S.S., Dugas, M.J., Fracalanza, K., & Koerner, N. (2012). The role of anger in generalized anxiety disorder. Cognitive Behavioral Therapy, 41(3):261-271. https://doi.org/10.1080/16506073.2012.666564

 

De Zwart PL, Jeronimus BF, de Jonge P. Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review. Epidemiology and Psychiatric Sciences. 2019;28(5):544-562. https://doi.org/10.1017/S2045796018000227

 

DiGiuseppe, R., & Raymond, C.T. (2006). Understanding Anger Disorders. New York: Oxford Academic. [Last accessed on 2023 Dec 20]. https://doi.org/10.1093/9780195170795.001.0001

 

Dong, L., & Bouey, J. (2020). Public mental health crisis during COVID-19 pandemic, China. Emerging Infectious Diseases, 26(7):1616-1618. https://doi.org/10.3201/eid2607.200407

 

Fracalanza, K., Koerner, N., Deschênes, S.S., & Dugas, M.J. (2014), Intolerance of uncertainty mediates the relation between generalized anxiety disorder symptoms and anger. Cognitive Behavioral Therapy, 43(2):122-132. https://doi.org/10.1080/16506073.2014.888754

 

Fraguas, R. Jr., Iosifescu, D.V., Bankier, B., Perlis, R., Clementi- Craven, N., Alpert, J., & Fava, M. (2007). Major depressive disorder with anger attacks and cardiovascular risk factors. International Journal of Psychiatry Medicine, 37:99-111. https://doi.org/10.2190/Y361-2W83-268H-5W7V

 

Geiger, A.W., & Leslie, D.A. (2019). Growing Number of American Teenagers-Particularly Girls-are Facing Depression. Available from: https://www.pewresearch.org/ short-reads/2019/07/12/a-growing-number-of-american-teenagers-particularly-girls-are-facing-depression/accessed on [Last accessed on 2024 May 19].

 

Harvey, A.G., Watkins, E., & Mansell, W. (2004). Cognitive Behavioural Processes Across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment. USA: Oxford University Press.

 

Hawkins, K.A., & Cougle, J.R. (2011). Anger problems across the anxiety disorders: Findings from a population‐based study. Depression and Anxiety, 28(2):145-152. https://doi.org/10.1002/da.20764

 

Kasozi, K.I., Niedbała, G., Alqarni, M., Zirintunda, G., Ssempijja, F., Musinguzi, S.P., et al. (2020). Bee Venom-A potential complementary medicine candidate for SARS-CoV-2 infections. Frontiers in Public Health, 8:594458. https://doi.org/10.3389/fpubh.2020.594458

 

Kazeem, Y. (2020). How a Youth-led Digital Movement is Driving Nigeria’s Largest Protests in a Decade. Quartz Africa. Available from: https://qz.com/africa/1916319/how-nigerians-use-social-media-to organize-endsars-protests [Last accessed on 2024 May 19].

 

Kerr, M.A., & Schneider, B.H. (2008). Anger expression in children and adolescents: A review of the empirical literature. Clinical Psychology Review, 28(4):559-577. https://doi.org/10.1016/j.cpr.2007.08.001

 

Kingsley, C.M., & Ochi, I.B. (2021). Effect of the endsars protest on the Nigerian economy. Global Journal of Arts Humanity and Social Sciences, 9(3):1-15.

 

Lebron-Milad, K., & Milad, M.R. (2012). Sex differences, gonadal hormones and the fear extinction network: Implications for anxiety disorders. Biology of Mood and Anxiety Disorders, 2:3. https://doi.org/10.1186/2045-5380-2-3

 

Lee, K., Sahai, H., Baylis, P., & Greenstone, M. (2020). Job Loss, and Behavioral Change: The Unprecedented Effects of the India Lockdown in Delhi. University of Chicago, Becker Friedman Institute for Economics Working Paper No 2020-65. https://doi.org/10.2139/ssrn.3601979

 

Lemuel, A.M., Usman, I.M., Kasozi, K.I., Alghamdi, S., Aigbogun, E.O., Archibong, V., et al. (2021). COVID-19-related mental health burdens: Impact of educational level and relationship status among low-income earners of Western Uganda. Frontiers in Public Health, 9:739270. https://doi.org/10.3389/fpubh.2021.739270

 

Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., et al. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus-infected Pneumonia. The New England Journal of Medicine, 382(13):1199-1207. https://doi.org/10.1056/NEJMoa2001316

 

Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., et al. (2013). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859):2095-2128. https://doi.org/10.1016/S0140-6736(12)61728-0

 

Lucia F, Valeria TD. Bundled payment for mental health care: a realist review. International Journal of Integrated Care (IJIC); 2018;(S2):A155 pp 1-8. https://doi.org/10.5334/ijic.s2155

 

Lwanga, S.K., & Lemeshow, S. (1991). Sample size determination in Health Studies: A Practical Manual/S. K. Lwanga and S. Lemeshow. Geneva: World Health Organization. Available from: https://iris.who.int/handle/10665/40062. (Turkish) [Last accessed on 2024 May 28].

 

Mertens, G., Gerritsen, L., Duijndam, S., Salemink, E., & Engelhard, I.M. (2020). Fear of the coronavirus (COVID- 19): Predictors in an online study conducted in March 2020. Journal of Anxiety Disorders, 74:102258. https://doi.org/10.1016/j.janxdis.2020.102258

 

Painuly, N., Sharan, P., & Mattoo, S.K. (2005). Relationship of anger and anger attacks with depression: A brief review. European Archives of Psychiatry and Clinical Neuroscience, 255(4):215-222. https://doi.org/10.1007/s00406-004-0539-5

 

Posel, D., Oyenubi, A., & Kollamparambil, U. (2021). Job loss and mental health during the COVID-19 lockdown: Evidence from South Africa. PLoS One, 16(3):e0249352. https://doi.org/10.1371/journal.pone.0249352

 

Sareen, J., Afifi, T.O., McMillan, K.A., & Asmundson, G.J.G. (2011). Relationship between household income and mental disorders: Findings from a population-based longitudinal study. Archives of General Psychiatry, 68(4):419-427. https://doi.org/10.1001/archgenpsychiatry.2011.15

 

Segalàs, C., Alonso, P., Real, E., Garcia, A., Miñambres, A., Labad, J., et al. (2010). Memory and strategic processing in first-degree relatives of obsessive compulsive patients. Psychological Medicine, 40(12):2001-2011. https://doi.org/10.1017/S0033291710000310

 

Serpytis, P., Navickas, P., Lukaviciute, L., Navickas, A., Aranauskas, R., Serpytis, R., et al. (2018). Gender-based differences in anxiety and depression following acute myocardial infarction. Arquivos Brasileiros de Cardiologia, 111(5):676-683. https://doi.org/10.5935/abc.20180161

 

Sharma, A., Sharma, S.D., & Sharma, M. (2017). Mental health promotion: A narrative review of emerging trends. Current Opinion in Psychiatry, 30(5):339-345. https://doi.org/10.1097/YCO.0000000000000347

 

Spielberger, C.D. (1999). Manual for the State Trait Anger Expression Inventory-2. Odessa FL: Psychological Assessment Resources.

 

Spitzer, R.L., Kroenke, K., Williams, J.B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10):1092-1097. https://doi.org/10.1001/archinte.166.10.1092

 

Stoddard, A., Harmer, A., & Ryou, K. (2014). Unsafe Passage: Road Attacks and their Impact on Humanitarian Operations. Aid Workers Security Report Humanitarian Outcomes. Washington, DC: USAID.

 

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., et al. (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. https://doi.org/10.3390/ijerph17051729

 

Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020b). Social capital and sleep quality in individuals who self-isolated for 14 days during the coronavirus disease 2019 (COVID-19) outbreak in January 2020 in China. Medical Science Monitor, 26:e923921. https://doi.org/10.12659/MSM.923921

 

Zandifar, A., & Badrfam, R. (2020). Iranian mental health during the COVID-19 epidemic. Asian Journal of Psychiatry, 51:101990. https://doi.org/10.1016/j.ajp.2020.101990

Conflict of interest
The authors declare no conflict of interest.
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