Prevalence, Psychological Responses and Associated Correlates of Depression, Anxiety and Stress in a Global Population, During the Coronavirus Disease (COVID-19) Pandemic
Open accessAbstract
Uncertainty and isolation have been linked to mental health problems. Uncertainty surrounding the COVID-19 pandemic has the potential to trigger mental health problems, which include anxiety, stress, and depression. This paper evaluates the prevalence, psychological responses, and associated correlates of depression, anxiety, and stress in a global population during the Coronavirus Disease (COVID-19) pandemic. A cross-sectional study design was adopted. 678 completed forms were collected during the COVID-19 quarantine/lockdown. An online questionnaire was designed and DASS-21 was used as the screening tool. A non-probability sampling technique strategy was applied. 50.9% of participants showed traits of anxiety, 57.4% showed signs of stress, and 58.6% exhibited depression. Stress, anxiety, and depression are overwhelmingly prevalent across the globe during this COVID-19 pandemic, and multiple factors can influence the rates of these mental health conditions. Our factorial analysis showed notable associations and manifestations of stress, anxiety, and depressive symptoms. People aged 18-24, females, and people in non-marital relationships experienced stress, anxiety, and depression. Separated individuals experienced stress and anxiety. Married people experienced anxiety. Single and divorced people experienced depression. Unemployed individuals experienced stress and depression. Students experienced anxiety and depression. Canada, the UK, and Pakistan are all countries that are experiencing stress and depression as a whole. An extended number of days in quarantine was associated with increased stress, anxiety, and depression. Family presence yielded lower levels of stress, anxiety, and depression. Lastly, lack of exercise was associated with increased stress, anxiety, and depression.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Uncertainty and isolation have been linked to many mental health problems.
“Uncertainty and isolation have been linked to many mental health problems (Shah et al. 2021).”
From DETERMINING THE RELATIONSHIP BETWEEN HEALTH TECHNICIAN STUDENTS' ATTITUDES TO THE COVID-19 PANDEMIC AND INTOLERANCE OF UNCERTAINTY WITH DEPRESSION, ANXIETY, AND STRESS LEVELS (2023) · cites this paper as Shah et al. 2021
The 18-24 age group has been shown to have higher levels of depression, anxiety, and stress during the pandemic period, and there is a relationship between the quarantine period and depression, anxiety, and stress levels.
“In the literature, the 18-24 age group has been shown to have higher levels of depression, anxiety, and stress during the pandemic period, and there is a relationship between the quarantine period and depression, anxiety, and stress levels (Ghaza -wy et al. 2020, Hyland et al. 2020, Shah et al. 2021).”
From DETERMINING THE RELATIONSHIP BETWEEN HEALTH TECHNICIAN STUDENTS' ATTITUDES TO THE COVID-19 PANDEMIC AND INTOLERANCE OF UNCERTAINTY WITH DEPRESSION, ANXIETY, AND STRESS LEVELS (2023) · cites this paper as Shah et al. 2021
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The psychological impact of quarantine and how to reduce it: Rapid review of the evidence
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30460-8 · Cited by 16,378 · see citing works
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17051729 · Cited by 9,923 · see citing works
Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015) · Perspectives on Psychological Science · doi:10.1177/1745691614568352 · Cited by 6,043 · see citing works
The psychological impact of the COVID-19 epidemic on college students in China
Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112934 · Cited by 5,843 · see citing works
Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2020.05.026 · Cited by 3,617 · see citing works
Leigh-Hunt, N., Bagguley, D., Bash, K., Turner, V., Turnbull, S., Valtorta, N., & Caan, W. (2017) · Public Health · doi:10.1016/j.puhe.2017.07.035 · Cited by 2,158 · see citing works
The prevalence and correlates of depression, anxiety, and stress in a sample of college students
Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.10.054 · Cited by 2,030 · see citing works
SARS control and psychological effects of quarantine, Toronto, Canada
Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., & Styra, R. (2004) · Emerging Infectious Diseases · doi:10.3201/eid1007.030703 · Cited by 1,929 · see citing works
COVID-19 and the consequences of isolating the elderly
Armitage, R., & Nellums, L. B. (2020) · The Lancet Public Health · doi:10.1016/s2468-2667(20)30061-x · Cited by 1,597 · see citing works
Özdin, S., & Bayrak Özdin, Ş. (2020) · International Journal of Social Psychiatry · doi:10.1177/0020764020927051 · Cited by 1,405 · cited 5× · see citing works
“Rates of depression in Spain became higher from March 14th, which is when the lockdown began (OzamizEtxebarria and Dosil-Santamaria 2020).”
ResultInfluentialMental health in the COVID-19 pandemic
Cullen, W., Gulati, G., & Kelly, B. D. (2020) · QJM: An International Journal of Medicine · doi:10.1093/qjmed/hcaa110 · Cited by 1,275 · see citing works
Ozamiz-Etxebarria, N., Dosil-Santamaria, M., Picaza-Gorrochategui, M., & Idoiaga-Mondragon, N. (2020) · Cadernos de Saúde Pública · doi:10.1590/0102-311x00054020 · Cited by 892 · see citing works
Asmundson, G. J. G., & Taylor, S. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102211 · Cited by 786 · see citing works
Social isolation, loneliness and depression in young adulthood: a behavioural genetic analysis
Matthews, T., Danese, A., Wertz, J., Odgers, C. L., Ambler, A., Moffitt, T. E., & Arseneault, L. (2016) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-016-1178-7 · Cited by 534 · see citing works
Health Anxiety: Current Perspectives and Future Directions
Asmundson, G. J. G., Abramowitz, J. S., Richter, A. A., & Whedon, M. (2010) · Current Psychiatry Reports · doi:10.1007/s11920-010-0123-9 · Cited by 309 · see citing works
Dreyer, Z., Henn, C., & Hill, C. (2019) · Journal of Psychology in Africa · doi:10.1080/14330237.2019.1647499 · Cited by 57 · see citing works
Flagged first, then by citations
Research works printed but not linked: 28
- Adhikari SP Meng S Wu YJ Mao YP Ye RX Wang QZ Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review Infect Dis Poverty 2020 9 1 29 10.1186/s40249-020-00646-x 32183901 PMC7079521 · DOI
- Antúnez, Z., & Vinet, E. V. (2012). Escalas de Depresión, Ansiedad y Estrés (DASS- 21): Validación de la versión abreviada en estudiantes universitarios Chilenos. [Depression Anxiety Stress Scales (DASS-21): Validation of the abbreviated version in Chilean university students.]. Terapia Psicológica, 30(3), 49–55.
- Balzarini RN Dharma C Kohut T Campbell L Lehmiller JJ Harman JJ Comparing relationship quality across different types of romantic partners in polyamorous and monogamous relationships Archives of Sexual Behavior 2019 48 6 1749 1767 10.1007/s10508-019-1416-7 31069571 · DOI
- Beaufort IN De Weert-Van Oene GH Buwalda VAJ de Leeuw JRJ Goudriaan AE The Depression, Anxiety and Stress Scale (DASS-21) as a screener for depression in substance use disorder inpatients: A pilot study European Addiction Research 2017 23 5 260 268 10.1159/000485182 29224000 · DOI
- Bohlken J Schömig F Lemke MR Pumberger M Riedel-Heller SG COVID-19 pandemic: Stress experience of healthcare workers: A short current review Psychiatrische Praxis 2020 47 4 190 197 10.1055/a-1159-5551 32340048 PMC7295275 · DOI
- Chatterjee K Chauhan VS Epidemics, quarantine and mental health Medical Journal Armed Forces India 2020 76 2 125 127 10.1016/j.mjafi.2020.03.017 32327877 PMC7176378 · DOI
- Cornine, A. (2020). Reducing nursing student anxiety in the clinical setting: An integrative review. Nurs Educ Perspect. 32102067
- Dar KA Iqbal N Mushtaq A Intolerance of uncertainty, depression, and anxiety: Examining the indirect and moderating effects of worry Asian Journal of Psychiatry 2017 29 129 133 10.1016/j.ajp.2017.04.017 29061409 · DOI · Paper page
- Kasalova P Prasko J Holubova M Vrbova K Zmeskalova D Slepecky M Anxiety disorders and marital satisfaction Neuro Endocrinological Letters 2018 38 8 555 564 29504737
- Kawohl W Nordt C COVID-19, unemployment, and suicide The Lancet Psychiatry 2020 7 5 389 390 10.1016/S2215-0366(20)30141-3 32353269 PMC7185950 · DOI
- Klomek AB Suicide prevention during the COVID-19 outbreak The Lancet Psychiatry 2020 7 5 390 10.1016/S2215-0366(20)30142-5 PMC7185940 32353271 · DOI
- Kumari, U., Dawani, N., Devnani, J., Qureshi, M. F. H., Soleja, F. K., Mohammad, D., … Sadiq, S. (2019). Depression among medical students of Karachi a cross sectional study. MedEdPublish, 8. PMC10712523 38089272
- Liu N Zhang F Wei C Jia Y Shang Z Sun L Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter Psychiatry Research 2020 287 112921 10.1016/j.psychres.2020.112921 32240896 PMC7102622 · DOI · Paper page
- Mæhlisen MH Pasgaard AA Mortensen RN Vardinghus-Nielsen H Torp-Pedersen C Bøggild H Perceived stress as a risk factor of unemployment: A register-based cohort study BMC Public Health 2018 18 1 728 10.1186/s12889-018-5618-z 29895286 PMC5998595 · DOI
- Martín Monzón, I. (2007). Estrés académico en estudiantes universitarios. Apuntes de Psicología, ISSN 0213–3334, Vol. 25, Nº. 1, 2007, pags. 87–99, 25.
- Mogilski JK Reeve SD Nicolas SCA Donaldson SH Mitchell VE Welling LLM Jealousy, Consent, and Compersion Within Monogamous and Consensually Non-Monogamous Romantic Relationships Archives of Sexual Behavior 2019 48 6 1811 1828 10.1007/s10508-018-1286-4 30607710 · DOI
- Nurmela, K., & Mattila, A. (2018). Identification of Depression and Screening for Work Disabilities among Long-Term Unemployed People. 15(5). PMC5981948 29751563
- Oei TPS Sawang S Goh YW Mukhtar F Using the Depression Anxiety Stress Scale 21 (DASS-21) across cultures International Journal of Psychology 2013 48 6 1018 1029 10.1080/00207594.2012.755535 23425257 · DOI · Paper page
- Onrust SA Cuijpers P Mood and anxiety disorders in widowhood: A systematic review Aging Ment Health 2006 10 4 327 334 10.1080/13607860600638529 16798624 · DOI
- Osman A Wong JL Bagge CL Freedenthal S Gutierrez PM Lozano G The Depression Anxiety Stress Scales—21 (DASS-21): Further Examination of Dimensions, Scale Reliability, and Correlates Journal of Clinical Psychology 2012 68 12 1322 1338 10.1002/jclp.21908 22930477 · DOI
- Ozamiz-Etxebarria, N., & Dosil-Santamaria, M. (2020). Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. 36(4), e00054020. 32374806
- Özdin, S., & Bayrak Özdin, Ş. (2020). Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int J Soc Psychiatry, 20764020927051. PMC7405629 32380879
- Pietrucha J Country-specific determinants of world university rankings Scientometrics 2018 114 3 1129 1139 10.1007/s11192-017-2634-1 29491546 PMC5814474 · DOI
- Sareen J Erickson J Medved MI Asmundson GJG Enns MW Stein M Risk factors for post-injury mental health problems Depression and Anxiety 2013 30 4 321 327 10.1002/da.22077 23408506 · DOI
- Shaw T Campbell MA Runions KC Zubrick SR Properties of the DASS-21 in an Australian Community Adolescent Population Journal of Clinical Psychology 2017 73 7 879 892 10.1002/jclp.22376 27774593 · DOI
- Wang C Horby PW Hayden FG Gao GF A novel coronavirus outbreak of global health concern Lancet 2020 395 10223 470 473 10.1016/S0140-6736(20)30185-9 31986257 PMC7135038 · DOI · Paper page
- Wang G Hu M Xiao SY Zhou L Loneliness and depression among rural empty-nest elderly adults in Liuyang, China: A cross-sectional study British Medical Journal Open 2017 7 10 e016091 PMC5639988 28988166
- Xiang Y-T Yang Y Li W Zhang L Zhang Q Cheung T Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed The Lancet Psychiatry 2020 7 3 228 229 10.1016/S2215-0366(20)30046-8 32032543 PMC7128153 · DOI · Paper page
Cited by
Sorted by citations
Jones, R., Mougouei, D., & Evans, S. L. (2021) · Human Behavior and Emerging Technologies · doi:10.1002/hbe2.304 · Cited by 62 · see citing works
Student mental health during the COVID-19 pandemic: are international students more affected?
Kivelä, L., Mouthaan, J., van der Does, W., & Antypa, N. (2024) · Journal of American College Health · doi:10.1080/07448481.2022.2037616 · Cited by 45 · see citing works
Braun, P., Drüge, M., Hennemann, S., Nitsch, F. J., Staeck, R., & Apolinário-Hagen, J. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.840869 · Cited by 27 · see citing works
Du, E., Quayle, E., & Macleod, H. (2021) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x21000210 · Cited by 5 · see citing works
Gao, F., Jia, S., Yin, S., Yin, Z., Guan, W., Ding, F., Wang, X., & Wan, P. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07310-4 · Cited by 5 · see citing works
Vocational School of Health Services, D. E. U., Acikgoz, A., Yoruk, S., School of Health, D. O. M., Toyran, N., Vocational School of Health Services, D. E. U., Guler, D. S., & Training And Research Hospital, S. U. (2023) · Psychiatria Danubina · doi:10.24869/psyd.2023.544
“Uncertainty and isolation have been linked to many mental health problems (Shah et al. 2021).”
- Authors
- Shah, S. M. A., Mohammad, D., Qureshi, M. F. H., Abbas, M. Z., & Aleem, S.
- Affiliations
- Ziauddin University (PK)
- Ziauddin Hospital (PK)
- Corresponding author
- Qureshi, Muhammad Fazal Hussain
- Venue
- Community Mental Health Journal
- Published
- 2020-10-27
- Volume
- 57
- Issue
- 1
- Pages
- 101-110
- ISSN
- 0010-3853 (ISSN-L)
- 1573-2789
- PMC
- PMC7590908
- OpenAlex
- W3097497433
- Cited by
- 554
- References
- 16
- Citations by year
- 2026: 24 · 2025: 48 · 2024: 89 · 2023: 150 · 2022: 154 · 2021: 87 · 2020: 2
- FWCI
- 39.33
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- www.springer.com/tdm (tdm)
- www.springer.com/tdm (vor)
- Locations
- Community Mental Health Journal (publishedVersion, public-domain)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- COVID-19 pandemic, depression, anxiety, stress, mental health, quarantine, lockdown, prevalence, psychological reactions, marital status, unemployment, students, physical activity, family presence, DASS-21
- MeSH terms
- COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Anxiety, Cross-Sectional Studies, Depression, Female, Humans, Male, Mental Health, Middle Aged, Quarantine, Surveys and Questionnaires, Social Isolation, Stress, Psychological, Prevalence, Young Adult, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review