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Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender
Open accessAbstract
Background: The COVID-19 pandemic is having negative effects on societies’ mental health. Both the pandemic and the measures taken to combat it can affect individuals’ mental health. Aims: The purpose of this study was to evaluate the levels of depression, anxiety and health anxiety in Turkish society during the COVID-19 pandemic, and to examine the factors affecting these. Method: The study was performed using an online questionnaire. Participants were asked to complete a sociodemographic data form, the Hospital Anxiety and Depression Scale (HADS) and the Health Anxiety Inventory (HAI). The effects on depression, anxiety and health anxiety levels of factors such as age, sex, marital status, living with an individual aged above 60, the presence of a new Coronavirus+ patient among friends or relatives, previous and current psychiatric illness and presence of accompanying chronic disease were then investigated. Results: In terms of HADS cut-off points, 23.6% ( n = 81) of the population scored above the depression cut-off point, and 45.1% ( n = 155) scored above the cut-off point for anxiety. In regression analysis, female gender, living in urban areas and previous psychiatric illness history were found as risk factors for anxiety; living in urban areas was found as risk factor for depression; and female gender, accompanying chronic disease and previous psychiatric history were found as risk factors for health anxiety. Conclusion: The results of this cross-sectional study suggest that the groups most psychologically affected by the COVID-19 pandemic are women, individuals with previous psychiatric illness, individuals living in urban areas and those with an accompanying chronic disease. Priority might therefore be attached to these in future psychiatric planning.
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“Current medical disease (including psychiatric disorders and substance abuse) (Zhang et al., 2020b, Wang et al., 2020a, Ozdin and Bayrak Ozdin, 2020), and a past medical history (including psychiatric history and substance abuse) (Wang et al., 2020a, Mazza et al., 2020, Li et al., 2020c, Ozdin and Bayrak Ozdin, 2020) were associated with/increased the risk of depression and/or anxiety.”
From COVID-19 pandemic and mental health consequences: Systematic review of the current evidence (2020) · cites this paper as Ozdin and Bayrak Ozdin, 2020
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“Furthermore, mental health issues including depression, stress, anxiety (3-8), fear (9-11), physical isolation and feeling alone (12), behavioral issues (4,13), possible posttraumatic stress disorders (3), and burnout (14) can affect large numbers of individuals if these issues are not well addressed.”
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“This finding differs from previous studies which found females to be more prone to feeling anxious (Ebrahim et al., 2020; Liu N. et al., 2020; Özdin and Bayrak Özdin, 2020) and depressed (Özdin and Bayrak Özdin, 2020) during COVID-19.”
From Knowledge of COVID-19 and Its Influence on Mindfulness, Cognitive Emotion Regulation and Psychological Flexibility in the Indian Community (2020) · cites this paper as Özdin and Bayrak Özdin, 2020
In the citing paper
“women experienced higher prevalence rates of anxiety, depressive, and eating pathology symptoms even prior to the pandemic”
From Prevalence rates of anxiety, depressive, and eating pathology symptoms between the pre- and peri-COVID-19 eras: A meta-analysis (2022) · cites this paper as Özdin and Bayrak Özdin, 2020
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“This contrasts with previous studies from Turkey conducted in April 2020 [24], from Spain conducted in March 2020 [25] and from Italy conducted in March 2020 [26], which all reported that chronic disease was associated with higher levels of psychological distress.”
From Worry and mental health in the Covid-19 pandemic: vulnerability factors in the general Norwegian population (2021) · cites this paper as [24]
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“Health anxiety is a condition characterized by excessive preoccupation with an individual’s health [3], defined as a state consisting of psychological and physical symptoms brought about by a sense of apprehension about a perceived health threat.”
BackgroundSevinç, M., Hasbal, N. B., Şakacı, T., Baştürk, T., Ahbap, E., Ortaboz, M., Mazı, E. E., Aydın, E. P., Ling, J., & Ünsal, A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0244347 · Cited by 15
Qu, P.-F., Zhao, D.-D., Jia, P., Dang, S., Shi, W.-H., Wang, M., & Shi, J.-Z. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.645421 · Cited by 11
Patrono, A., Renzetti, S., Manco, A., Brunelli, P., Moncada, S. M., Macgowan, M. J., Placidi, D., Calza, S., Cagna, G., Rota, M., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19148587 · Cited by 14
“This finding was consistent with the existing literature, which shows that women are more prone to anxiety [27,28], depression [29], and a fear of COVID-19 [30].”
ResultChankasingh, K., Booth, A., Albert, A., Kaida, A., Smith, L., Racey, C. S., Gottschlich, A., Murray, M. C. M., Sadarangani, M., Ogilvie, G. S., et al. (2022) · Heliyon · doi:10.1016/j.heliyon.2022.e10880 · Cited by 16
Ciułkowicz, M., Misiak, B., Szcześniak, D. M., Grzebieluch, J., Maciaszek, J., & Rymaszewska, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912962 · Cited by 13
“Additionally, internet use and health anxiety patterns may also be related to gender and education [42,43].”
BackgroundWang, H., Zhang, Q., Lin, Y., Liu, Y., Xu, Z., & Yang, J. (2023) · Behavioral Sciences · doi:10.3390/bs13020140 · Cited by 17
“The definition also includes persistent fear that one may develop a severe illness, even after one has been cleared by a formal medical examination [20].”
BackgroundPanchal, U. R., Vaquerizo‐Serrano, J., Conde-Ghigliazza, I., Genç, H. A., Marchini, S., Pociūtė, K., Ocakoğlu, B. K., Sanchez-Roman, S., Őri, D., Catalán, A., et al. (2023) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2023.06.003 · Cited by 17
Agarwal, N., Harikar, M. M., Shukla, R., & Bajpai, A. (2020) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-020-00869-6 · Cited by 14
Alqahtani, S. S., Banji, D., & Banji, O. J. F. (2021) · Saudi Pharmaceutical Journal · doi:10.1016/j.jsps.2021.04.031 · Cited by 14
“Our results indicated that women were taking more time to fall asleep than men plausibly because of their heightened anxiety about exposure to potential stress (Mohit Varshney 2020; Özdin and Bayrak Özdin 2020).”
Alrashed, F. A., Sattar, K., Habib, S. R., Ahmad, T., Rashoud, A. S. A., Safhi, T. A., Almajed, A. H. M., Alnafisah, H. A., Alharbi, N. H., & Alsubiheen, A. M. (2021) · Psychology Research and Behavior Management · doi:10.2147/prbm.s317641 · Cited by 14
Miragall, M., Herrero, R., Vara, M. D., Galiana, L., & Baños, R. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1918900 · Cited by 16
THE EFFECT OF SELF-REGULATED LEARNING ON STUDENTS’ PROBLEM-SOLVING ABILITIES
Rahayuningsih, S., Hasbi, M., Mulyati, M., & Nurhusain, M. (2021) · AKSIOMA Jurnal Program Studi Pendidikan Matematika · doi:10.24127/ajpm.v10i2.3538 · Cited by 14
Preti, E., Pierro, R. D., Perego, G., Bottini, M., Casini, E., Ierardi, E., Madeddu, F., Mazzetti, M., Crugnola, C. R., Taranto, P., et al. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114206 · Cited by 16
“…and variables related to the level of exposure to the disease, such as the use of precautionary measures (Qiu et al., 2020; Wang et al., 2020), having affected family members (Cao et al., 2020), or living in urban or afflicted areas (Ozdin and Ozdin, 2020; Qiu et al., 2020; Tang et al., 2020).”
BackgroundInfluentialLoneliness and Depression among Women in Poland during the COVID-19 Pandemic
Idzik, A., Leńczuk-Gruba, A., Kobos, E., Pietrzak, M., & Dziedzic, B. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182010698 · Cited by 16
“disturbances, and chronic diseases were considered to be risk factors for anxiety [67].”
BackgroundPSYCHOLOGICAL FACTORS AND CONSEQUENCES OF PSYCHOSOCIAL STRESS DURING THE PANDEMIC
Maruta, N. A., Маркова, М. В., Kozhyna, H. M., Aliieva, T. А., Yuryeva, L., Abdriakhimova, T. B., Пшук, Н. Г., & Skrypnikov, A. M. (2021) · Wiadomości Lekarskie · doi:10.36740/wlek202109126 · Cited by 14
“People with chronic diseases (somatic / mental) developt more symptoms of anxiety and stress during COVID-19 pandemy [28-30].”
BackgroundValidity and Reliability of the Turkish Version of the COVID Stress Scale
Bal, M. D., Dişsiz, M., & Bingöl, F. B. (2021) · Journal of Korean Academy of Nursing · doi:10.4040/jkan.21106 · Cited by 14
Tumurbaatar, E., Hiramoto, T., Tumur-Ochir, G., Jargalsaikhan, O., Erkhembayar, R., Jadamba, T., & Lkhagvasuren, B. (2021) · Neuroscience Research Notes · doi:10.31117/neuroscirn.v4i3suppl.101 · Cited by 14
Gender-specific psychological and social impact of COVID-19 in Pakistan
Rabbani, F., Khan, H. A., Piryani, S., Khan, A. R., & Abid, F. (2021) · BJPsych Open · doi:10.1192/bjo.2021.1062 · Cited by 14
Şentürk, S., Keskin, A. Y., & Sarızayim, Ş. (2021) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228211054315 · Cited by 15
“Although there are studies in the literature showing that the fear of COVID-19 is high in individuals living in the province (Hossain et al., 2020; Özdin & Bayrak Özdin, 2020), there are also results that indicate high fear of COVID-19 among the elderly living in the countryside (Parmaksız, 2019;…”
BackgroundResultKobos, E., Knoff, B., Dziedzic, B., Maciąg, R., & Idzik, A. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-056368 · Cited by 17
Psychological impacts of COVID-19 pandemic in cancer patients on active treatment
Koca, S., Koca, E. K., Ökten, I. N., Orengul, F. F. C., Öztürk, A., Özçelik, M., Oyman, A., Çil, İ., & Gümüş, M. (2022) · Heliyon · doi:10.1016/j.heliyon.2022.e10142 · Cited by 14
Güner, Ö., & Aydın, A. (2022) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2022.08.002 · Cited by 19
“The high level of depression, anxiety, and health fears among women during the pandemic COVID 19 also show the psychological impact of the epidemic on women (Özdin and Bayrak Özdin, 2020).”
Social Media, Anxiety and COVID-19 Lockdown Measurement Compliance
Rodríguez-Besteiro, S., Beltrán-Velasco, A. I., Tornero-Aguilera, J. F., Martínez–González, M. B., Navarro-Jiménez, E., Sepulveda, R. A. Y., & Clemente‐Suárez, V. J. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20054416 · Cited by 17
“Overall, there are several factors that may increase or decrease the risk of developing symptoms of mental illness because of prolonged exposure to stressful stimuli, such as quarantines [9].”
BackgroundWang, D., Zhao, J., Zhai, S., Chen, H., Liu, X., & Fan, F. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114646 · Cited by 14
Putri, D. U., Tsai, Y.-S., Chen, J.-H., Tsai, C., Ou, C.-Y., Chang, C.-R., Chen, H.-C., Lu, M., Yu, M.-C., & Lee, C. (2021) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2021.02.014 · Cited by 14
Nowrouzi‐Kia, B., Osipenko, L., Eftekhar, P., Othman, N., Alotaibi, S. R., Schuster, A., Suh, H. S., & Duncan, A. (2022) · SAGE Open Medicine · doi:10.1177/20503121221074480 · Cited by 13
Krüger-Malpartida, H., Arévalo-Flores, M., Anculle-Arauco, V., Dancuart-Mendoza, M., & Pedraz‐Petrozzi, B. (2022) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2022.04.004 · Cited by 17
“Hallazgos similares a los de nuestro estudio se reportan en el de Özdin et al. 31 , que reportan corre-laciones significativas entre la enfermedad crónica previa y los síntomas de ansiedad; además, las personas con enfer-medades crónicas previas obtuvieron puntajes más altos de depresión y ansiedad.”
Duru, E., & Balkıs, M. (2022) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-022-00488-6 · Cited by 16
“…countries also confirm that COVID-19 affects the psychological health of people worldwide at different levels (Bäuerle et al., 2020; Choi et al., 2020; Dozois, 2021; Hyland et al., 2020; Mazza et al., 2020; Özdin & Özdin, Özdin & Bayrak Özdin, 2020; Shevlin et al., 2020; Tang et al., 2021).”
Identifying the predictors of severe psychological distress by auto-machine learning methods
Zhang, X., Ren, H.-Y., Gao, L., Shia, B., Chen, M., Ye, L., Wang, R., & Qin, L. (2023) · Informatics in Medicine Unlocked · doi:10.1016/j.imu.2023.101258 · Cited by 14
“Özdin and Bayrak (2020) showed that a chronic medical condition of an individual is a risk factor for anxiety during COVID-19 [8].”
BackgroundSvestkova, A., Kvardová, N., & Šmahel, D. (2023) · Journal of Child and Family Studies · doi:10.1007/s10826-023-02689-8 · Cited by 18
“Studies have suggested that females are generally more prone to anxiety disorders (Eley & Gregory, 2004) and health anxiety speci fi cally (Özdin & Bayrak Özdin, 2020).”
Cheong, C., Park, J., Shim, K., Kim, S. Y., Kim, M. S., Fond, G. B., Boyer, L., Kang, J., Kim, T., & Yon, D. K. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.115919 · Cited by 13
Jafari, M., Nassehi, A., Jafari, J., & Jafari‐Oori, M. (2025) · Archives of Public Health · doi:10.1186/s13690-025-01518-2 · Cited by 13
Zhang, Y., Chen, Y., Wang, J., Deng, Y., Peng, D., & Zhao, L. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.564745 · Cited by 13
Anxiety levels of university hospital nurses during the Covid‐19 pandemic
Yurtseven, Ş., & Arslan, S. (2021) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12719 · Cited by 13
“Some studies conducted on the topic indicate that women have higher anxiety levels.(21,30,31) Unlike these studies, in another study, investigating anxiety and depression symptoms of healthcare personnel working during the Covid‐19 outbreak, the male gender experienced an increase in anxiety, whereas the female gender…”
ResultMarschalkó, E. E., Kotta, I., Kálcza-Jánosi, K., Szabo, K., & Farcas, S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.596543 · Cited by 12
“Gender has been identified as a risk factor for COVID-19 anxiety, women being more exposed to this reaction (Özdin and Özdin, 2020).”
BackgroundResultPsychological Distress in Patients with COVID-19 During Hospitalization
Yıldırım, N., Candan, H. D., & İnan, A. H. (2021) · Clinical Nursing Research · doi:10.1177/10547738211040322 · Cited by 13
Yasmin, F., Jatoi, H. N., Abbasi, M. S., Asghar, M. S., Siddiqui, S. A., Nauman, H., Khattak, A. K., & Alam, M. T. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.830935 · Cited by 14
“Females, students, individuals with underlying comorbidities and a history of mental health issues have shown to be more prone to the negative effects across several studies (Every-Palmer et al., 2020; Khan et al., 2020; Lyons et al., 2020; Özdin and Özdin, 2020; The News International, 2021).”
BackgroundResult
Metadata
- Authors
- Özdin, S., & Bayrak Özdin, Ş.
- Affiliations
- Ondokuz Mayıs University (TR)
- Rasathane Family Health Center, Samsun, Turkey
- Corresponding author
- Özdin, Selçuk
- ORCID
- Özdin, Selçuk
- Venue
- International Journal of Social Psychiatry
- Publisher
- SAGE Publications
- Published
- 2020-05-08
- Volume
- 66
- Issue
- 5
- Pages
- 504-511
- ISSN
- 0020-7640 (ISSN-L)
- 1741-2854
- PMC
- PMC7405629
- OpenAlex
- W3023698214
- Cited by
- 1,405
- References
- 30
- Citations by year
- 2026: 20 · 2025: 67 · 2024: 120 · 2023: 214 · 2022: 397 · 2021: 447 · 2020: 140
- FWCI
- 119.67
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- International Journal of Social Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- 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 › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- COVID-19 pandemic, anxiety, depression, health anxiety, gender differences, risk factors, psychiatric history, chronic disease, urban residence, Turkish population, mental health
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Anxiety, Attitude to Health, Mental Disorders, Cross-Sectional Studies, Depression, Female, Humans, Male, Mental Health, Middle Aged, Pneumonia, Viral, Surveys and Questionnaires, Risk Factors, Self-Assessment, Sex Factors, Socioeconomic Factors, Turkey, Urban Population, Comorbidity, Causality, Coronavirus Infections, Pandemics
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