COVID-19–Related Functional Impairment in a Community Sample of Korean Adults: Associations With Depression, COVID-19 Infection Fear, and Resilience

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Abstract

Objective

We aimed to determine the effects of depression, COVID-19 infection fear, and resilience on COVID-19–related functional impairment.

Methods

We obtained data from 476 community-dwelling adults aged 20–69 years living in Jeju, South Korea, and evaluated the relationships between COVID-19–related functional impairment (work/school, social, and home life) and sociodemographic and healthrelated characteristics, COVID-19–related life changes (financial difficulties since the pandemic, employment change, interpersonal conflict), and clinical characteristics, including depression, COVID-19 infection fear, and resilience.

Results

Functional impairment in the home life domain was associated with marital status and monthly income. Greater work/school, social, and home life functional impairment was significantly associated with all COVID-19–related life changes. Regression analysis indicated that resilience modulated the positive associations of COVID-19–related functional impairment with symptoms of depression and COVID-19 infection fear when relevant factors were controlled for.

Conclusion

Our results suggest the importance of clinical characteristics, including depression, COVID-19 infection fear, and resilience for understanding functional impairment related to COVID-19. These results have important implications for interventions aimed at reducing depression and COVID-19 infection fear, and enhancing resilience.

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Most cited references 61

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The PHQ-9: validity of a brief depression severity measure.

K Kroenke, R L Spitzer, J B Williams (2001)

While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.

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Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

Kathryn M Connor, Jonathan Davidson (2003)

Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.

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Psychosocial impact of COVID-19

Souvik Dubey, Payel Biswas, Ritwik Ghosh … (2020)

Background Along with its high infectivity and fatality rates, the 2019 Corona Virus Disease (COVID-19) has caused universal psychosocial impact by causing mass hysteria, economic burden and financial losses. Mass fear of COVID-19, termed as “coronaphobia”, has generated a plethora of psychiatric manifestations across the different strata of the society. So, this review has been undertaken to define psychosocial impact of COVID-19. Methods Pubmed and GoogleScholar are searched with the following key terms- “COVID-19”, “SARS-CoV2”, “Pandemic”, “Psychology”, “Psychosocial”, “Psychitry”, “marginalized”, “telemedicine”, “mental health”, “quarantine”, “infodemic”, “social media” and” “internet”. Few news paper reports related to COVID-19 and psychosocial impacts have also been added as per context. Results Disease itself multitude by forced quarantine to combat COVID-19 applied by nationwide lockdowns can produce acute panic, anxiety, obsessive behaviors, hoarding, paranoia, and depression, and post-traumatic stress disorder (PTSD) in the long run. These have been fueled by an “infodemic” spread via different platforms social media. Outbursts of racism, stigmatization, and xenophobia against particular communities are also being widely reported. Nevertheless, frontline healthcare workers are at higher-risk of contracting the disease as well as experiencing adverse psychological outcomes in form of burnout, anxiety, fear of transmitting infection, feeling of incompatibility, depression, increased substance-dependence, and PTSD. Community-based mitigation programs to combat COVID-19 will disrupt children's usual lifestyle and may cause florid mental distress. The psychosocial aspects of older people, their caregivers, psychiatric patients and marginalized communities are affected by this pandemic in different ways and need special attention. Conclusion For better dealing with these psychosocial issues of different strata of the society, psychosocial crisis prevention and intervention models should be urgently developed by the government, health care personnel and other stakeholders. Apt application of internet services, technology and social media to curb both pandemic and infodemic needs to be instigated. Psychosocial preparedness by setting up mental organizations specific for future pandemics is certainly necessary.

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Author and article information

Journal

Journal ID (nlm-ta): Psychiatry Investig

Journal ID (iso-abbrev): Psychiatry Investig

Journal ID (publisher-id): PI

Title: Psychiatry Investigation

Publisher: Korean Neuropsychiatric Association

ISSN (Print): 1738-3684

ISSN (Electronic): 1976-3026

Publication date (Print): November 2022

Publication date (Electronic): 23 November 2022

Volume: 19

Issue: 11

Pages: 919-926

Affiliations

[1 ]Department of Psychiatry, Jeju National University Hospital, Jeju, Republic of Korea

[2 ]Department of Psychiatry, Jeju National University School of Medicine, Jeju, Republic of Korea

[3 ]Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

Author notes

Correspondence: Young-Eun Jung, MD, PhD Department of Psychiatry, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju 63241, Republic of Korea Tel: +82-64-754-8150, Fax: +82-64-717-1861, E-mail: jyejye77@ 123456daum.net

Correspondence: Moon-Doo Kim, MD, PhD Department of Psychiatry, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju 63241, Republic of Korea Tel: +82-64-754-8180, Fax: +82-64-717-1861, E-mail: mdkim0721@ 123456gmail.com

Author information

Yun-ju Park http://orcid.org/0000-0002-8677-6728

Young-Eun Jung http://orcid.org/0000-0001-7608-0009

Moon-Doo Kim http://orcid.org/0000-0002-6441-630X

Won-Myong Bahk http://orcid.org/0000-0002-0156-2510

Article

Publisher ID: pi-2022-0138

DOI: 10.30773/pi.2022.0138

PMC ID: 9708862

PubMed ID: 36444155

SO-VID: 6f25ebc3-3b70-4748-85d9-0b007186ef8f

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 25 May 2022

Date revision received : 25 August 2022

Date accepted : 29 August 2022

COVID-19–Related Functional Impairment in a Community Sample of Korean Adults: Associations With Depression, COVID-19 Infection Fear, and Resilience

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Abstract

Objective

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Novel Coronavirus Disease COVID-19

Most cited references 61

The PHQ-9: validity of a brief depression severity measure.

Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

Psychosocial impact of COVID-19

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