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1 Determinant Of Mental Health Disorders During The COVID-19

2 Pandemic
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4 Article Category: Systematic Review

5 Abstract Word Count: 195 Words
6 Manuscript Word Count: 3145 Words
7 Number of References: 14 Articles
8 Number of Tables: 1 Table
9 Number of Figures: 1 Figure
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12 Abstract
13 Objective: Many people experienced mental health disorders due to the Covid-19 pandemic
14 and if not treated immediately, it will cause serious problems. The aim of this article was to
15 determine the determinants of mental health disorders during a pandemic.
16 Methods: A systematic approach in this review used the PRISMA approach and journal
17 sources from several databases including Scopus, Science Direct, SAGE, NCBI, ProQuest in
18 the 3 last years from 2020 to 2022. Boolean operators within search process used AND and
19 OR. The inclusion criteria were the general public, aged more than 17 years. Exclusion
20 criteria were people with chronic disease and schizophrenia. Literature review, editorial,
21 critical synthesis, and the like were also exclusion criteria for this review.
22 Results: Overall, this review consisted of 13 articles and all of article designs were cross
23 sectional. Respondents in all articles were the general public, the age of 17-60 years. The
24 determinant of mental health disorders were female gender, older age, history of chronic
25 diseases, exposure to media reporting COVID-19, education, job loss and marital status,
26 especially those who were married.
27 Conclusion: Overall, the community experienced mental health problems during the
28 pandemic.
29 Keywords:
30 determinants; factors; mental health disorders; covid-19
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32
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33 Introduction
34 COVID-19 or Corona Virus Disease 2019 was a new type of virus that was originally
35 discovered in 2019 in the city of Wuhan, China. WHO declared the status of COVID-19 as a
36 pandemic or global epidemic so that it was necessary to implement and prevented the
37 massive spread of the virus (Analysis et al., 2021). This was proven by the implementation of
38 several rules in various countries, including in Indonesia, namely the use of masks, hand
39 sanitizers, disinfectants, regular hand washing and the implementation of physical distancing.
40 The increasing number of positive cases of COVID-19 and the number of victims who died
41 has made people feel anxious, restless and afraid (Lai et al., 2020). This condition was
42 happened a very long time and caused mental health problems in the community. Mental
43 health disorders for a long time will cause disturbances in the individual's daily life (Ettman
44 et al., 2020).
45 Many factors caused that some people experienced mental health disorders. Based on
46 research conducted by Maroufizadeh et al., (2020) the factors that caused a person's mental
47 health disorders during the COVID-19 pandemic were losing his job, losing a family
48 member, carrying out several regulations from the government such as lockdown (Ahmed et
49 al., 2020). Some of these rules also made the community bored in dealing with the COVID-
50 19 pandemic because people's activities and mobility were very limited (Burhamah et al.,
51 2020). The saturation experienced by society changed lifestyle such as high alcohol use,
52 increased smoking consumption and increased consumption of fast food (Rossi et al., 2020).
53 Some of the factors above that caused mental health disorders that were experienced by many
54 people include anxiety, depression and sleep disorders. Mental health disorders experienced
55 by the community vary widely, ranging from mild, moderate to severe (Peng et al., 2020).
56 Global data in 2020 cases of major depressive disorder and anxiety disorders increased
57 by 28% and 26%, respectively. Women were more affected than men and younger people
58 were more affected than older age groups. Other disturbances are in the form of post-
59 traumatic stress symptoms of the pandemic which is 24.1%, other psychological disorders are
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60 50.0 and for sleep problems it was 27.6% (WHO., 2020). Countries with high rates of
61 COVID-19 infection and restrictions on community movement, enforcement and school
62 closures had the greatest increases in the prevalence of major depressive disorder and anxiety
63 disorders. Based on data from The Lancet (2020 ) a survey in various countries in Europe
64 with a respondent of 220,800 states that the symptoms of severe insomnia were 36.7% and
65 17.4% for moderate insomnia disorders. Anxiety disorders 25.6% and 23.1% with depressive
66 symptoms. Insomnia symptoms by 40% and insomnia disorders (>25%) were significantly
67 higher in younger women.
68 Survey conducted on 2,364 respondents by Perhimpunan Dokter Spesialis Kedokteran
69 Jiwa Indonesia (PDSKJI) in May 2020, showed that 69% of respondents experienced
70 psychological problems during Covid-19. The most experienced psychological problems
71 were 67% experiencing depression, 68% experiencing anxiety, 77% experiencing post-
72 traumatic stress and 32% thinking of choosing death or hurting themselves in any way. Based
73 on data from the Ministry of Health (2020). There was an increase in cases of mental
74 disorders due to the COVID-19 pandemic from the previous year. In 2019 the number of
75 people with mental disorders was 197,000 people, while in 2020 it was 277,000 people.
76 Other data states that based on BPS data, people aged 17-30 years are easily angry in the face
77 of the COVID-19 situation, as many as 11.9%, in despair as many as 21%, in anxiety by
78 25.6% and in excessive fear by 5.5%.
79 The Corona virus has infected various countries must be concerned (Bogg and Milad,
80 2020). The characteristic of this virus which was easy to transform made this pandemic last
81 for a long time with uncertain conditions. Several policies in various countries have carried
82 out infection prevention and control to reduce the spread of the virus, such as in America,
83 Italy, France, Canada, India, of course, Indonesia (Shereen et al., 2020). The Indonesian
84 government has also imposed policies on the Indonesian people in an effort to reduce the
85 spread of the virus, namely in the form of movement restrictions, stay at home, social
86 distancing and lock down in various regions. This of course causes people to be
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87 psychologically depressed to the point of being disturbedmental health in various societies.

88 The COVID-19 pandemic has certainly had many unusual impacts and influences on people's
89 lives.
90 The impact experienced by the community were not only on the physical impact but also
91 on the psychological impact. Rossi et al., (2020) in his research mentioned that there were
92 several psychological impacts when a pandemic occured and was felt by the community,
93 namely post-traumatic stress disorder (post-traumatic stress disorder), confusion, anxiety,
94 frustration, fear of affection, insomnia, feeling helpless, anxious to depression. Anxiety was
95 basically a common response that occured in humans. Anxiety was a reaction from the
96 human instinct to survive (Ahmed et al., 2020). When a person feels anxious, then in fact he
97 is facing something that he perceives as something that endangers or threatens his life
98 (Ettman et al., 2020). The emergence of this feeling of anxiety affects our biological
99 condition. The body given various reactions that warn that something was threatening (Huang
100 and Zhao, 2020). Physical reactions that can be felt naturally when someone was in a state of
101 anxiety are heart palpitations, sweating, and so on(Wang et al., 2020).
102 Some of the factors that caused mental health problems in the community were when
103 several companies and factories close, so they have to reduce many of their employees. Based
104 on research conducted by Huang and Zhao (2020) unemployment was one of the factors that
105 caused mental health disorders. Other studies also suggested that the declined in opinion
106 during the pandemic can also caused people to experience mental health problems (Fu et al.,
107 2020). Fear of being infected with COVID-19 was also a very important factor in
108 contributing to a person's mental health disorder. This condition can trigger excessive anxiety
109 in everyone because they were afraid that they will be infected and experience terrible things
110 to death (Lai et al., 2020). The most traumatic factor was the loss of a family member due to
111 COVID-19. Based on research conducted by Burhamah et al., (2020) losing a family member
112 was a very forgotten moment, causing anxiety to depression, especially if you lose several
113 members at almost the same time.
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114 Understanding some of the factors that influence a person's mental health was important.
115 The COVID-19 pandemic has not only caused physical problems but also mental health
116 problems for sufferers and family members. Mental health was a problem that often arises
117 during the COVID-19 pandemic but was often neglected and does not receive special
118 attention. It was important for health workers, especially nurses, to understand the problem of
119 mental health disorders because the interventions that will be given will also have different
120 approaches. So this systematic review will discuss the factors that affected the mental health
121 disorders of the community during the pandemic.
122 Material And Methods

123 Guidelines used for achieving a systematic review. These guidelines cover the reasons
124 and objectives of the research, eligibility criteria for studies to be included in the article,
125 sources of information, search strategy used, article selection and data collection process,
126 results obtained, methods for assessing the results of data synthesis. This systematic review
127 followed the preferred reporting item guidelines for systematic reviews and meta-analyses
128 (PRISMA).

129 The literature searched in this study begins with obtaining research journals from

130 several databases including, SCOPUS, CINAHL/EBSCO, PubMed, SAGE and Science

131 Direct. The search for scientific journals or articles starts from the last 3 years from 2020 to

132 2022 with the equivalent keywords ('determinants', 'factors', mental health disorders', and

133 covid-19). Boolean operators in the search process use AND and OR. Article search was

134 limited to types that provide full English text.

135 The inclusion criteria used the population, intervention, comparison, outcome and

136 timing (PICOT) framework, where the populationthe general public, both men and women,
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137 aged 18-80 years who experienced mental health disorders during the Covid-19 pandemic.

138 The interventions provided were focused on population-based surveys. The main outcome of

139 this study was to determine the determinants that could lead to mental health disorders during

140 a pandemic. The articles were taken from the last three years using a cross-sectional study

141 method.

PICOT Inclusion Criteria

the general public, both men and women, aged 18-80

Population years who experience mental health disorders during the
Covid-19 pandemic

Intervention population-based surveys

No comparison intervention
comparison

to determine the determinants of mental health disorders

Outcomes
during a pandemic.

time 2020-2022

Study Design cross-sectional study

Laguage English

Articles that did not discuss mental health disorders

during a pandemic, articles without full text and
Exclusion
abstracts without intervention details, and studies
criteria:
conducted in languages other than English, as well as
non-cross-sectional study designs were excluded.

142 Table-1 : PICOT Framework

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143 According to PRISMA guidelines, the first step was to search for articles that match

144 the topic based on electronic data. After getting the article, it was selected and then the same

145 article will be deleted. titles and abstracts were screened for eligibility criteria. The entire text

146 of each selected article that met the inclusion criteria was taken for further examination. A

147 secondary search was carried out from the reference list articles to identify additional records.

148 The final stage included articles that were relevant and met all inclusion criteria in the

149 systematic review.

150 The statistical method used in this study uses data extraction and structured forms to

151 extract information from the articles included starting from the author, year, country, method,

152 sample, age, intervention, influencing factors, the purpose of the article results to evaluate the

153 effect. intervention.

154
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155 Results:
156 Study Selection

157 The total articles obtained from search results with keywords that have been
158 determined were 1914 articles from 5 databases, namely 319 articles from Scopus, 353
159 articles from PubMed, 396 from Ebsco/Chinal, 374 from Sciene Direct and the last 472
160 articles from Sage. Then 255 were excluded because of duplication of articles and screening
161 based on the title, there were 126 articles that were not appropriate and 1533 were also
162 excluded because they did not match the topic and inclusion criteria, then a total of 78 articles
163 were also excluded because they did not match the abstract and content of the study. The total
164 of articles that have passed the screening were 13articles
165
Study Identity through database Additional Studies Identified
SearchingScience Direct,
Identification

Through other Sources

PubMed, CINAHL, SCOPUS (n=0)
and SAGE
(n = 1914)

Studies after duplicate removed

(n=1659)
Screening

Records excluded as
Title Screened
not related to the
(n=126)
topic
(n = 1533 articles)
Elibility

Full-text articles Studies excluded

assessed for reliability (n=78)
(n=48)

Studies included in the

Included

qualitative synthesis
(n=13)

Figures. 1 Flow chart of study selection

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166 Article Characteristics

167 Several parameters were used to assess mental health disorders during the pandemic in
168 various communities affected by COVID-19, almost entirely using a web-based approach
169 with a number of (n: 10 articles) 1,2,3,4,6,8,9,11, 12,13,wechat (n : 3)5,7,10 online (n :
170 12 )1,2,3,4,5,6,7,8,10,11,12,13, mixed online and face-to-face interview (n: 1) 9.

171 The methods that given was variation, the focus was given on social media platforms
172 using questionnaires (n: 10)1,3,5,6,8,9,10,11,12,13, ), from the team or hospital members (n:
173 3)2 ,4,7. Questionnaire measuring instrument PHQ-9 (n : 8)1, 3, 4, 8,9,10,11, 13, GAD-7 (n:
174 8)1,4,5,8,9,10,11,13 , WEMWBS (n :1 )2, AUDIT (n :1 )2, BAI (n:1 )2, BDI (n:1 )2,
175 COVID-19 Stressors Score (n : 1)3, NHANES (n : 1 )3, CLIMB (n : 1)3, CES-D (n : 1)5,
176 DASS-21 (n : 2)6,12, IES-R (n : 5 )6,7,9,10,12 SAS (n : ), SDS (n : 1) 7, PSQI (n : 1) 7,
177 PTSS (n : 1) 7, PSS (n : 1) 8, IADQ (n : 1) 8, IES (n : 1) ), ISI-7 (n : 1 )9, SCSQ (n : 1)13,
178 AIS (n : 1)13.

179 Of the overall identified younger people showed a much higher prevalence than older
180 people. Therefore, some of the main focus of research is age. From age 18 (n :
181 8 )3,5,6,7,8,9,11,12 , age 19 (n : 1 )10, age 21 (n : 2)1,2, age 26 (n : 1 ) 4, age 30 (n : 1)13.
182 Lockdown

183 Determinants Of Mental Health Disorders

184 Determinants that can lead to mental health disorders during a pandemicin the
185 community varies, age (n: 4)1,7,8,13, history of chronic disease (n: 4)1,6,10,11, job loss (n:
186 6) 1,3,4,8,11 ,13, students (n : 2) 1,6, Exposure to excessive media about covid-19 news (n :
187 4) 1,5,6,12, Living with family members infected with Covid-19 (n : 5 )1 ,9,101,11,12,
188 female (n: 8) 2,4,6,8,9,10,11,12,, Low education (n:1) 7, have family members infected with
189 covid-19 (n: 7) 1,2 6,9,10,11,12,lockdown (n : 5)1,2,8,9,12
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190

191 Discussion:
192 The purpose of this systematic review was to find several articles that identify the
193 factors that influence someone with mental health disorders. The majority of the main factors
194 were gender, namely women. Almost all articles mentioned that women experienced mental
195 health problems more than men. That's because women were too heavy in thinking about
196 their health conditions (Zhu et al., 2020). In another article, it was stated that the burden of
197 housework and loneliness were triggers for women (Wang et al., 2020). Another factor was
198 having a family member who was infected with COVID-19. Almost all articles explain this,
199 especially if there were family members who live in the same neighborhood. This will lead to
200 mental health disorders (Maroufizadeh et al., 2020). Another factor that was no less important
201 was a history of chronic disease. Individuals who have a history of chronic disease will easily
202 experience mental health disorders. This was because individuals with chronic diseases were
203 more vulnerable and dangerous if they were infected with COVID-19 (Huang and Zhao,
204 2020). This was also related to other factors, namely the news in the media. People who were
205 often exposed to media reports about COVID-19 will tend to be more prone to mental health
206 disorders (Peng et al., 2020). This means that the individual was not ready to face COVID-
207 19. The interesting thing was the education factor (Burhamah et al., 2020). People with
208 higher education were actually more at risk of experiencing mental health disorders, it was
209 inversely proportional to people with low education who were not easy to experience mental
210 health disorders (Rossi et al., 2020). Loss of work, being laid off, salary cuts and several
211 things related to income were factors that were widely discussed in the articles above. This
212 will also aggravate a person's condition if the individual was already married or married and
213 has children(Ahmed et al., 2020).
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214 Conclusion:
215 This systematic review showed that the factors that influence individuals experience health

216 problems mental were female gender, older age, history of chronic disease, exposure to media

217 reporting COVID-19, education, job loss and marital status, namely those who were married.

218 Acknowledgement: None

219 Disclaimer: None
220 Conflict of interest: None
221 Funding disclosure: None
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222 References:
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