Tee Michael, Wang Cuiyan, Tee Cherica, Pan Riyu, Reyes Patrick W, Wan Xiaoyang, Anlacan Joseph, Tan Yilin, Xu Linkang, Harijanto Chloe, Kuruchittham Vipat, Ho Cyrus, Ho Roger
College of Medicine, University of the Philippines Manila, Manila, Philippines.
Faculty of Education, Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei, China.
Front Psychiatry. 2021 Feb 9;11:568929. doi: 10.3389/fpsyt.2020.568929. eCollection 2020.
The differences between the physical and mental health of people living in a lower-middle-income country (LMIC) and upper-middle-income country (UMIC) during the COVID-19 pandemic was unknown. This study aimed to compare the levels of psychological impact and mental health between people from the Philippines (LMIC) and China (UMIC) and correlate mental health parameters with variables relating to physical symptoms and knowledge about COVID-19. The survey collected information on demographic data, physical symptoms, contact history, and knowledge about COVID-19. The psychological impact was assessed using the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety, and Stress Scale (DASS-21). The study population included 849 participants from 71 cities in the Philippines and 861 participants from 159 cities in China. Filipino (LMIC) respondents reported significantly higher levels of depression, anxiety, and stress than Chinese (UMIC) during the COVID-19 ( < 0.01) while only Chinese respondents' IES-R scores were above the cut-off for PTSD symptoms. Filipino respondents were more likely to report physical symptoms resembling COVID-19 infection ( < 0.05), recent use of but with lower confidence on medical services ( < 0.01), recent direct and indirect contact with COVID ( < 0.01), concerns about family members contracting COVID-19 ( < 0.001), dissatisfaction with health information ( < 0.001). In contrast, Chinese respondents requested more health information about COVID-19. For the Philippines, student status, low confidence in doctors, dissatisfaction with health information, long daily duration spent on health information, worries about family members contracting COVID-19, ostracization, and unnecessary worries about COVID-19 were associated with adverse mental health. Physical symptoms and poor self-rated health were associated with adverse mental health in both countries ( < 0.05). The findings of this study suggest the need for widely available COVID-19 testing in MIC to alleviate the adverse mental health in people who present with symptoms. A health education and literacy campaign is required in the Philippines to enhance the satisfaction of health information.
在新冠疫情期间，生活在中低收入国家（LMIC）和中高收入国家（UMIC）的人群在身心健康方面的差异尚不明确。本研究旨在比较来自菲律宾（中低收入国家）和中国（中高收入国家）的人群的心理影响水平和心理健康状况，并将心理健康参数与身体症状及新冠病毒相关知识的变量进行关联。该调查收集了人口统计学数据、身体症状、接触史以及新冠病毒相关知识等信息。使用事件影响量表修订版（IES-R）评估心理影响，通过抑郁、焦虑和压力量表（DASS-21）评估心理健康状况。研究人群包括来自菲律宾71个城市的849名参与者和来自中国159个城市的861名参与者。在新冠疫情期间，菲律宾（中低收入国家）受访者报告的抑郁、焦虑和压力水平显著高于中国（中高收入国家）受访者（<0.01），而只有中国受访者的IES-R得分高于创伤后应激障碍症状的临界值。菲律宾受访者更有可能报告类似新冠病毒感染的身体症状（<0.05），近期使用过医疗服务但信心较低（<0.01），近期有过与新冠病毒的直接和间接接触（<0.01），担心家庭成员感染新冠病毒（<0.001），对健康信息不满意（<0.001）。相比之下，中国受访者要求获取更多关于新冠病毒的健康信息。对于菲律宾而言，学生身份、对医生信心低、对健康信息不满意、每天花费在健康信息上的时间长、担心家庭成员感染新冠病毒、被排斥以及对新冠病毒不必要的担忧与不良心理健康状况相关。在两个国家，身体症状和自我健康评价差均与不良心理健康状况相关（<0.05）。本研究结果表明，在中低收入国家需要广泛开展新冠病毒检测，以缓解出现症状人群的不良心理健康状况。菲律宾需要开展健康教育和提高健康素养运动，以提高对健康信息的满意度。
