Mental health of COVID-19 recovered individuals: A national study from Jordan
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Department of Maternal and Child Health, Jordan University of Science and Technology, Irbid, JORDAN
Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, JORDAN
Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, JORDAN
Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, JORDAN
Faculty of Medicine, Jordan University of Science and Technology, Irbid, JORDAN
Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, JORDAN
Online publication date: 2023-01-14
Publication date: 2023-03-01
Electron J Gen Med 2023;20(2):em451
To investigate the relationship between COVID-19 infection and subsequent long-term mental consequences among patients recovering from the disease.

A cross-sectional and survey-based study was conducted in Jordan using Google Forms during the period from March to July of 2022. The requirement to participate was that individuals be at least 18 years old and have at least one symptomatic COVID-19 infection. A total of 2,055 subjects recruited in the study. Mental health was assessed using mental health inventory-38 (MHI-38).

Females represent 64.8% (n=1,182) of the sample. The mean age of the participants was 39.9±14.4 years. Subjects who recovered from COVID-19 scored slightly higher than moderate on different scales of MHI-38. These include anxiety, depression, loss of behavioral and emotional control, general positive affect, emotional ties, and life-satisfactions. The prevalence of depression among participants was 46.3% (n=952). The prevalence of anxiety among participants was 45.8% (n=942). The prevalence of loss of physical and emotional control was 47.2% (n=970). Multiple regression showed that employment status, tobacco use, and severe COVID-19 infection were associated with mental illness. Not working, using tobacco, and having severe COVID-19 infection were more likely to develop mental illness (p<0.01).

Individuals who recover from COVID-19 are susceptible to developing mental illnesses. Factors associated with such susceptibility include employment status, tobacco use and severity of infection. The current findings can be used in mental health interventions targeting individuals who recovered from COVID-19.

Proto E, Quintana-Domeque C. COVID-19 and mental health deterioration by ethnicity and gender in the UK. PloS One. 2021;16(1):e0244419. https://doi.org/10.1371/journa... PMid:33406085 PMCid:PMC7787387.
Zhai Y, Du X. Addressing collegiate mental health amid COVID-19 pandemic. Psychiatry Res. 2020;288:113003. https://doi.org/10.1016/j.psyc... PMid:32315885 PMCid:PMC7162776.
Usher K, Durkin J, Bhullar N. The COVID‐19 pandemic and mental health impacts. Int J Ment Health Nurs. 2020;29(3):315-8. https://doi.org/10.1111/inm.12... PMid:32277578 PMCid:PMC7262128.
Kumar A, Nayar KR. COVID-19 and its mental health consequences. J Ment Health. 2021;30(1):1-2. https://doi.org/10.1080/096382... PMid:32339041.
Shanbehzadeh S, Tavahomi M, Zanjari N, Ebrahimi-Takamjani I, Amiri-Arimi S. Physical and mental health complications post-COVID-19: Scoping review. J Psychosom Res. 2021;147:110525. https://doi.org/10.1016/j.jpsy... PMid:34051516 PMCid:PMC8133797.
Campion J, Javed A, Sartorius N, Marmot M. Addressing the public mental health challenge of COVID-19. Lancet Psychiatry. 2020;7(8):657-9. https://doi.org/10.1016/S2215-... PMid:32531299.
Pereira-Sanchez V, Adiukwu F, El Hayek S, et al. COVID-19 effect on mental health: Patients and workforce. Lancet Psychiatry. 2020;7(6):e29-30. https://doi.org/10.1016/S2215-... PMid:32445691.
Pfefferbaum B, North CS. Mental health and the COVID-19 pandemic. N Engl J Med. 2020;383(6):510-2. https://doi.org/10.1056/NEJMp2... PMid:32283003.
Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020;52:102066. https://doi.org/10.1016/j.ajp.... PMid:32302935 PMCid:PMC7151415.
Bo H-X, Li W, Yang Y, et al. Posttraumatic stress symptoms and attitude toward crisis mental health services among clinically stable patients with COVID-19 in China. Psychol Med. 2021;51(6):1052-3. https://doi.org/10.1017/S00332... PMid:32216863 PMCid:PMC7200846.
Zhang W-R, Wang K, Yin L, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. Psychother Psychosom. 2020;89(4):242-50. https://doi.org/10.1159/000507... PMid:32272480 PMCid:PMC7206349.
Fernández‐Aranda F, Casas M, Claes L, et al. COVID‐19 and implications for eating disorders. Eur Eat Disord Rev. 2020;28(3):239-45. https://doi.org/10.1002/erv.27... PMid:32346977 PMCid:PMC7267370.
Zhou Y, Zhou Y, Song Y, et al. Tackling the mental health burden of frontline healthcare staff in the COVID-19 pandemic: China’s experiences. Psychol Med. 2021;51(11):1955-6. https://doi.org/10.1017/S00332... PMid:32398180 PMCid:PMC7417977.
Andrade BS, Siqueira S, de Assis Soares WR, et al. Long-COVID and post-COVID health complications: An up-to-date review on clinical conditions and their possible molecular mechanisms. Viruses. 2021;13(4):700. https://doi.org/10.3390/v13040... PMid:33919537 PMCid:PMC8072585.
Meherali S, Punjani N, Louie-Poon S, et al. Mental health of children and adolescents amidst COVID-19 and past pandemics: A rapid systematic review. Int J Environ Res Public Health. 2021;18(7):3432. https://doi.org/10.3390/ijerph... PMid:33810225 PMCid:PMC8038056.
Bourmistrova NW, Solomon T, Braude P, Strawbridge R, Carter B. Long-term effects of COVID-19 on mental health: A systematic review. J Affect Disord. 2022;299:118-25. https://doi.org/10.1016/j.jad.... PMid:34798148 PMCid:PMC8758130.
Ahmed GK, Khedr EM, Hamad DA, Meshref TS, Hashem MM, Aly MM. Long term impact of COVID-19 infection on sleep and mental health: A cross-sectional study. Psychiatry Res. 2021;305:114243. https://doi.org/10.1016/j.psyc... PMid:34673325 PMCid:PMC8507572.
Tleyjeh IM, Saddik B, Ramakrishnan RK, et al. Long term predictors of breathlessness, exercise intolerance, chronic fatigue and well-being in hospitalized patients with COVID-19: A cohort study with 4 months median follow-up. J Infect Public Health. 2022;15(1):21-8. https://doi.org/10.1016/j.jiph... PMid:34861604 PMCid:PMC8600938.
Aiyegbusi OL, Hughes SE, Turner G, et al. Symptoms, complications and management of long COVID: A review. J R Soc Med. 2021;114(9):428-42. https://doi.org/10.1177/014107... PMid:34265229 PMCid:PMC8450986.
Kirby T. COVID-19 survivor experiencing long-term symptoms. Lancet Respir Med. 2021;9(6):570-2. https://doi.org/10.1016/S2213-... PMid:33587889.
Bil JS, Buława B, Świerzawski J. Mental health and the city in the post-COVID-19 era. Sustainability. 2021;13:7533. https://doi.org/10.3390/su1314....
Hartwell CA, Devinney T. Populism, political risk, and pandemics: The challenges of political leadership for business in a post-COVID world. J World Bus. 2021;56(4):101225. https://doi.org/10.1016/j.jwb.....
Veit CT, Ware JE. Mental health inventory. APA PsycTests. 1983. https://doi.org/10.1037/t02354....
Al Mutair A, Al Mohaini M, Fernandez R, Moxham L, Lapkin S, Ham-Baloyi WT. Psychometric testing of the mental health inventory in an Arabian context: Cross-cultural validation study. Nurs Open. 2018;5(3):376-83. https://doi.org/10.1002/nop2.1... PMid:30062032 PMCid:PMC6056453.
Al Mutair A, Alhajji M, Shamsan A. Emotional wellbeing in Saudi Arabia during the COVID-19 pandemic: A national survey. Risk Manag Healthc Policy. 2021;14:1065-72. https://doi.org/10.2147/RMHP.S... PMid:33737847 PMCid:PMC7966358.
Santos AMS, Novo RF. Mental health inventory: Sensitivity and specificity of the Portuguese version of the MHI-38 and MHI-5. Psychol Rep. 2020;123(4):1452-69. https://doi.org/10.1177/003329... PMid:31126225.
Matsumoto K, Hamatani S, Shimizu E, Käll A, Andersson G. Impact of post-COVID conditions on mental health: a cross-sectional study in Japan and Sweden. BMC Psychiatry. 2022;22(1):237. https://doi.org/10.1186/s12888....
Mazza MG, De Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain Behav Immun. 2020;89:594-600. https://doi.org/10.1016/j.bbi.... PMid:32738287 PMCid:PMC7390748.
Jia R, Ayling K, Chalder T, et al. Mental health in the UK during the COVID-19 pandemic: Cross-sectional analyses from a community cohort study. BMJ Open. 2020;10(9):e040620. https://doi.org/10.1136/bmjope... PMid:32933965 PMCid:PMC7493070.
Taquet M, Luciano S, Geddes JR, Harrison PJ. Bidirectional associations between COVID-19 and psychiatric disorder: Retrospective cohort studies of 62 354 COVID-19 cases in the USA. Lancet Psychiatry. 2021;8(2):130-40. https://doi.org/10.1016/S2215-... PMid:33181098.
Ismael F, Bizario JCS, Battagin T, et al. Post-infection depressive, anxiety and post-traumatic stress symptoms: A prospective cohort study in patients with mild COVID-19. Prog Neuropsychopharmacol Biol Psychiatry. 2021;111:110341. https://doi.org/10.1016/j.pnpb... PMid:33940097 PMCid:PMC8086265.
Ali UA, Iftikhar N, Amat-Ur-Rasool H, Ahmed M, Hafeez J, Carter WG. The psychological impact of coronavirus disease 2019 on patients attending a tertiary healthcare facility in Pakistan: A cross-sectional study. Healthcare (Basel). 2022;10(6):1049. https://doi.org/10.3390/health... PMid:35742100 PMCid:PMC9223015.
Colizzi M, Peghin M, De Martino M, et al. Mental health symptoms one year after acute COVID-19 infection: Prevalence and risk factors. Rev Psiquiatr Salud Ment. 2022. https://doi.org/10.1016/j.rpsm... PMid:35755492 PMCid:PMC9212931.
Van Barneveld K, Quinlan M, Kriesler P, et al. The COVID-19 pandemic: Lessons on building more equal and sustainable societies. Econ Labour Relat Rev. 2020;31(2):133-57. https://doi.org/10.1177/103530....
Vasiliadis H-M, Chudzinski V, Gontijo-Guerra S, Préville M. Screening instruments for a population of older adults: The 10-item Kessler psychological distress scale (K10) and the 7-item generalized anxiety disorder scale (GAD-7). Psychiatry Res. 2015;228(1):89-94. https://doi.org/10.1016/j.psyc... PMid:25956759.
Abuhammad S, Khabour OF, Alomari MA, Alzoubi KH. Depression, stress, anxiety among jordanian people during COVID-19 pandemic: A survey-based study. Inform Med Unlocked. 2022;30:100936. https://doi.org/10.1016/j.imu.... PMid:35399332 PMCid:PMC8977212.
AlAzzam M, Abuhammad S, Abdalrahim A, Hamdan-Mansour AM. Predictors of depression and anxiety among senior high school students during COVID-19 pandemic: The context of home quarantine and online education. J Sch Nurs. 2021;37(4):241-8. https://doi.org/10.1177/105984... PMid:33563066.
AlAzzam M, Abuhammad S, Tawalbeh L, Dalky H. Prevalence and correlates of depression, anxiety, and suicidality among high school students: A national study. J Psychosoc Nurs Ment Health Serv. 2021;59(8):43-51. https://doi.org/10.3928/027936... PMid:34110946.
Abuhammad S, Hamaideh S. Nursing students’ attitudes toward seeking professional psychological help before and after attending a mental health course. Nurs Educ Perspect. 2022;43(2):129-31. https://doi.org/10.1097/01.NEP... PMid:33660683.
Abuhammad S, Hatamleh R, Howard K, Ahmad MM. Correlates and predictors of stigmatization of patients with mental illness among nursing students. J Psychosoc Nurs Ment Health Serv. 2019;57(1):43-51. https://doi.org/10.3928/027936... PMid:30272809.
Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet. 2020;395(10227):912-20. https://doi.org/10.1016/S0140-... PMid:32112714.
Karasneh R, Al-Mistarehi A-H, Al-Azzam S, et al. Physicians’ knowledge, perceptions, and attitudes related to patient confidentiality and data sharing. Int J Gen Med. 2021;14:721-31. https://doi.org/10.2147/IJGM.S... PMid:33688243 PMCid:PMC7936708.
Abuhammad S, Alzoubi KH, Al-Azzam SI, Karasneh RA. Knowledge and practice of patients’ data sharing and confidentiality among nurses in Jordan. J Multidiscip Healthc. 2020;13:935-42. https://doi.org/10.2147/JMDH.S... PMid:32982270 PMCid:PMC7502382.