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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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Citations
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BackgroundYaşlılar ve Yetişkinlerde Koronavirüs (Covid-19) Salgınının Etkileri ve Koronavirüs Korkusu
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COVID-19’un Diş Hekimleri Üzerinde Yarattığı Gelecek Kaygısı ve Stresin Değerlendirilmesi
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“A study of the general population in Turkey during the pandemic found that the participants’ mean anxiety subscale score was 6.8 ± 4.2 and that 45.1% of them were at risk for anxiety (Özdin & Özdin, 2020).”
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“Roy et al. (2020), found that individuals have high anxiety levels in Indian population during COVID-19, Özdin and Bayrak Özdin (2020), determined that Turkish individuals have high anxiety, depression and health anxiety in during COVID-19 pandemic.”
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“In this study, the gender differences regarding the risk of depression in the married group were the same as in other national studies, with women having a higher rate of depressive disorders than men [42–44], and the reasons for this can be explored in three main ways based on previous studies.”
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“Introduction The rapid global spread of Coronavirus Disease 2019 (COVID-19) raised acute concern among the general population [1], especially among people with pre-existing conditions that possibly made them more vulnerable to infection or prone to a severe course of COVID-19 [2, 3].”
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“Thus, pandemic events affect the general population, but many stressors affect especially women, identifying sex as a vulnerability factor (Almeida et al., 2020; Broche- Pérez et al., 2020; Connor et al., 2020; Liu et al., 2020; Özdin & Bayrak Özdin, 2020; Qiu et al., 2020).”
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“However, during the COVID-19, individuals could be stimulated a bunch of pandemic-related subjective feelings (e.g., health anxiety, Özdin & Bayrak Özdin, 2020; job safety, Deldar et al., 2021; job or income security, Almeida & Santos, 2020) and these subjective feelings could also be potential…”
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“This study reported that 45.1% of its sample scored above the cut-off point for anxiety, and women had higher levels of anxiety and health anxiety (Özdin & Bayrak Özdin, 2020).”
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Was the Quality of Sexual Life Affected during the COVID-19 Pandemic?
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“These stressors triggered anxiety and depression, affecting individuals’ mental and physical health, as well as negatively affecting their sex life (Cocci et al., 2020; Ko et al., 2020; Özdin & Bayrak Özdin, 2020; Torales et al., 2020).”
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“The high increase in anxiety and similar emotional responses at the very beginning of the outbreak has been reported in studies conducted during the early stages of COVID-19 outbreak worldwide (Erceg et al., 2020; Garcia de Avila et al., 2020; Lep et al., 2020; Moghanibashi-Mansourieh, 2020; Özdin and Bayrak Özdin, 20…”
ResultImpact of COVID-19 pandemic on mental health across different populations
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Hajj, A., Badro, D. A., Selwan, C. A., Sacre, H., Aoun, R., & Salameh, P. (2020) · Research Square · doi:10.21203/rs.3.rs-122511/v1 · Cited by 5
“Indeed, recent studies highlighted that the female gender was signi cantly associated with a higher risk of developing coronavirus-related sleep disorders [20], distress [20], anxiety [21], post-traumatic stress symptoms [22].”
BackgroundWatkins‐Martin, K., Orri, M., Pennestri, M., Ryan, N. C., Larose, S., Gouin, J., Ouellet‐Morin, I., Chadi, N., Philippe, F. L., Boivin, M., et al. (2021) · medRxiv · doi:10.1101/2021.04.23.21255994 · Cited by 5
How the coronavirus pet adoption boom is reducing stress
Carver, L. F. (2020) · doi:10.64628/aam.dd67fhj7s · Cited by 5
Intimate Partner Violence and Telemedicine Usage and Satisfaction Early in the COVID-19 Pandemic
Fatabhoy, M. G., Zhu, G., Lajaunie, A., Schneiderhan, J. R., & Pierce, J. (2023) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2023.230021r1 · Cited by 6
“COVID-19 led to a sense of loneliness and increased health concerns among many individuals, 8 – 10 and this was likely ampli fi ed for IPV victims.”
BackgroundGoodwin, J., Hawkins, A., Naughton, C., Donovan, A. O., Connolly, A., Hurley, E. J., & Behan, L. (2025) · International Journal of Community Well-Being · doi:10.1007/s42413-025-00249-0 · Cited by 8
“Austria (Nitschke et al., 2021) and Turkey (Özdin & Bayrak Özdin, 2020).”
Fertility preferences of Turkish married women during the COVID-19 pandemic
Akduman, A. T., Türkçapar, A. F., İçöz, T., Özdemir, Ö., & Karaşahin, K. E. (2023) · Eastern Mediterranean Health Journal · doi:10.26719/emhj.23.110 · Cited by 4
“A study in Türkiye suggested that the groups most affected by the pandemic were women, people living in urban areas, and those with previous psychiatric illness or concomitant chronic diseases ( 32 ).”
BackgroundPlackett, R., & Ferris, E. (2024) · PLOS mental health. · doi:10.1371/journal.pmen.0000120 · Cited by 5
“Svensson et al. [44] reported insufficient data, with the other two studies [47, 48] revealing a non-significant association.”
InfluentialBalasundaram, P. K., Libu, G. K., George, C., & Chandy, A. (2020) · Journal of The Indian Academy of Geriatrics · doi:10.4103/jiag.jiag_3_20 · Cited by 4
Impact of mental health on disease activity in mastocytosis during COVID-19 pandemic
Öztop, N., Demir, S., Beyaz, Ş., Ünal, D., Çolakoğlu, B., Büyüköztürk, S., & Gelincik, A. A. (2021) · Allergology International · doi:10.1016/j.alit.2021.08.002 · Cited by 4
Nabila, R., Syakurah, R. A., & Rosyila, R. (2022) · International Journal of Public Health Science (IJPHS) · doi:10.11591/ijphs.v11i1.20965 · Cited by 5
The Relationship Between Alexithymia and Risk for Postpartum Depression
Stojanov, J., Stanković, M., Žikić, O., & Stojanov, A. (2021) · Psychiatric Annals · doi:10.3928/00485713-20210806-03 · Cited by 4
Knowledge, Attitudes, and Practices toward COVID-19 among Persian Birth Cohort Participants
Mirmohammadkhani, M., Bemanalizadeh, M., Yazdi, M., Goli, P., Mohebpour, F., Saffarieh, E., Danaei, N., Paknazar, F., Daniali, S. S., & Kelishadi, R. (2021) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_1274_20 · Cited by 4
Demirtepe-Saygılı, D., Eşiyok, E., & Turancı, E. (2021) · Türkiye İletişim Araştırmaları Dergisi · doi:10.17829/turcom.862102 · Cited by 5
Yi̇ği̇talp, G., Gümüş, F., & Aydin, L. Z. (2021) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12971 · Cited by 5
Güngör, A. (2022) · Eğitim Bilimleri Dergisi · doi:10.15285/maruaebd.1026649 · Cited by 4
Maatouk, C. M., Aad, A., & Lucero‐Prisno, D. E. (2022) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2022.100323 · Cited by 4
Mudanças alimentares de universitários brasileiros durante a pandemia da COVID-19
Lima, E. R., Matos, T. B., dos Anjos, L. D. A., dos Santos, C. S., Brazil, J. M., Santana, J. D. M., & Milagres, M. P. (2022) · Research Society and Development · doi:10.33448/rsd-v11i7.29733 · Cited by 4
Ouyang, M., Song, S., Ma, H., Yang, H., Leng, J., Zhou, P. H., Teng, C., Hong-xia, O., Li, J., Liu, N., et al. (2022) · Frontiers in Health Services · doi:10.3389/frhs.2022.968025 · Cited by 4
Çağatay, H. T., Salimoğlu, S., Başaran, E., & Elbaş, N. Ö. (2022) · Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi · doi:10.37989/gumussagbil.975859 · Cited by 4
The Drivers of Stress in Women Employees Caused by the Pandemic COVID-2019
Pandita, D., Agarwal, V., & Singh, S. (2023) · Management and Labour Studies · doi:10.1177/0258042x231160974 · Cited by 4
Akbulut, S., Küçükakçalı, Z., Sarıtaş, H., Bozkır, Ç., Tamer, M., Akyuz, M., BAĞCI, N., Ünsal, S., Akbulut, M. S., Şahin, T. T., et al. (2023) · Diagnostics · doi:10.3390/diagnostics13081410 · Cited by 4
College Students' Awareness of the Epidemic and Their Mental Health during the COVID-19 Outbreak
Fang, M., Han, T., Wang, J., Li, H., Li, Z., & Zhou, J. (2023) · Heart and Mind · doi:10.4103/hm.hm_47_22 · Cited by 4
Diao, C., Tan, H., Wen, Y., Zhu, R., Wu, X., Zhang, S., Zhao, Y., Liu, N., Zhou, X., & Hu, Z. Y. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1211614 · Cited by 5
“…such as depression, stress, fear, panic, anger, loneliness, boredom, etc. (Banerjee and Rai, 2020; Esterwood and Saeed, 2020; Özdin and Bayrak Özdin, 2020; Pappa et al., 2020; Pedrosa et al., 2020; Cai et al., 2021; Lindert et al., 2021; Lopez-Leon et al., 2021; Almgren et al., 2022;…”
InfluentialBAŞTÜRK, P., Kunduracılar, Z., Yücel, H., Yılmaz, F. K., & ERİM, A. (2023) · Sağlık Profesyonelleri Araştırma Dergisi · doi:10.57224/jhpr.1293249 · Cited by 4
Hing, N., Russell, A. M. T., Rawat, V., Bryden, G. M., Browne, M., Rockloff, M., Thorne, H. B., Newall, P. W. S., Dowling, N. A., Merkouris, S., et al. (2024) · Journal of Behavioral Addictions · doi:10.1556/2006.2023.00085 · Cited by 5
“Similarly, women, young adults, students, and those with chronic illness and mental health problems re-ported higher levels of health anxiety about COVID-19 (Canli & Karas¸ar, 2020; Özdin & Bayrak Özdin, 2020).”
BackgroundMidilli, T. S., Kalkim, A., & Uslu, B. (2024) · Disaster Medicine and Public Health Preparedness · doi:10.1017/dmp.2024.71 · Cited by 4
Günlü, A. (2024) · Journal of Community Psychology · doi:10.1002/jcop.23134 · Cited by 4
Jia, B., Xie, M., Wu, J., & Zhao, J. (2025) · International Journal of Disaster Risk Reduction · doi:10.1016/j.ijdrr.2025.105239 · Cited by 5
Foláyan, M. O., Zúñiga, R. A. A., Aly, N. M., Ellakany, P., Ezechi, O., Gaffar, B. O., Ibigbami, O. I., Idigbe, I. E., Ishabiyi, A. O., Khader, Y. S., et al. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1550719 · Cited by 4
Ghimire, R., & Sugat, A. (2020) · Archives of Pulmonology and Respiratory Care · doi:10.17352/aprc.000058 · Cited by 4
Aparicio, A. I. Á. (2020) · Revista de Comunicación y Salud · doi:10.35669/rcys.2020.10(2).211-248 · Cited by 4
A Study of Depressive Symptoms in Doctors Working at COVID-19 Hospitals: An Online Survey.
Bashir, M., Ahluwalia, H., Sayeed, S. I., & Salroo, I. N. (2020) · Medeniyet Medical Journal · doi:10.5222/mmj.2020.88614 · Cited by 4
“Another cross-sectional study to assess depressive symptoms using Hospital Anxiety and Depressive Scale (HADS) was done by Ozdin S et al.(15).”
MethodKaur, K., Patel, V. K., Kumar, P., Vasavada, D. A., Nerli, L. M., & Tiwari, D. S. (2021) · Archives of Mental Health · doi:10.4103/amh.amh_72_20 · Cited by 4
Koç, A., Demirkol, M. E., Uzun, L. N., & Tok, H. H. (2021) · Adıyaman Üniversitesi Sağlık Bilimleri Dergisi · doi:10.30569/adiyamansaglik.817512 · Cited by 4
Covid-19 Pandemic: Reflections on Organizational Life and Employee Psychology
Kaptangil, İ. (2021) · Emerald Group Publishing Limited eBooks · doi:10.1108/s1569-375920210000106014 · Cited by 4
Hsieh, K.-Y., Kao, W.-T., Chou, F. H., Hsu, S., Li, D., Chou, L., Lin, G., Chen, W. J., & Huang, J. (2021) · Taiwanese Journal of Psychiatry · doi:10.4103/tpsy.tpsy_7_21 · Cited by 4
Lerthattasilp, T., Kosulwit, L., Phanasathit, M., Nuallaong, W., Tapanadechopone, P., Thanetnit, C., & Charernboon, T. (2021) · Journal of Health Research · doi:10.1108/jhr-01-2021-0044 · Cited by 4
Avci, İ. A., & Hendekçi, A. (2021) · Etkili Hemşirelik Dergisi · doi:10.46483/deuhfed.817275 · Cited by 4
“Literatürde toplum içinde farklı popülasyonlarda endişe, korku ve anksiyete düzeyleri ile ilişkili yapılmış çalışmalara rastlanmaktadır (12-14).”
Domar, A. D., Shah, J. S., Gompers, A. D., Meyers, A. J., Khodakhah, D., Hacker, M. R., Penzias, A. S., Sakkas, D., Toth, T. L., & Vaughan, D. A. (2022) · F&S Reports · doi:10.1016/j.xfre.2022.01.004 · Cited by 4
Impact of the COVID-19 pandemic on mental health among women: An editorial
Amatori, G., Cappelli, A., Carmassi, C., Rodgers, R. F., & Bui, É. (2022) · International Journal of Mental Health · doi:10.1080/00207411.2022.2066299 · Cited by 4
“Several studies have reported evidence indicating that women may experience poorer outcomes with regard to the psychological impact of the pandemic (e.g., Gonz alezSanguino et al., 2020; €Ozdin & Bayrak €Ozdin, 2020).”
Background
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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