HomeHealth Sciences Journalvol. 11 no. 1 (2022)

Moderating effect of the impact of COVID-19 on the relationship of stigma and depression: A public mental health concern

Mildred G. Glinoga | Cely D. Magpantay | Marissa Calleja

 

Abstract:

Introduction The COVID-19 pandemic has led to rising depression rates worldwide. In the Philippines, people with mental disease are highly stigmatized. Students are one of the most vulnerable populations for depression and stigmatization. This study examines the relationship between the effect of the pandemic and depression rate as well as the role of self-stigma among students. Methods A correlational research design was utilized using the online-platform Questback. College students were recruited and answered a questionnaire assessing their depression level, self-stigma towards depression using the Depression Anxiety and Stress Scale and Self-Stigma of Depression Scale, respectively, and how negatively they were affected by the pandemic. Multiple and hierarchal linear regression analyses were done to determine the relationship between impact of the pandemic and selfstigma on depression. Results Of 349 respondents included in the analysis, 60% had moderate to extremely severe depression. Pandemic impact (ß = 0.40) and self-stigma of depression (ß = 0.32) were both positively associated with depression. A moderating effect of Social Inadequacy, a dimension of self-stigma of depression was found. The effect of pandemic impact on depression was stronger on students with higher levels of social inadequacy. Conclusion Students who are less likely to feel socially inadequate when having depression seem to be more resilient against developing depression when coping with distress brought about by the pandemic.



References:

  1. World Health Organization. Mental health atlas 2017 country profile: Philippines [Internet]. 2017. Available from: https://cdn.who.int
  2. Puyat JH, Gastardo-Conaco MC, Natividad J, Banal MA. Depressive symptoms among young adults in the Philippines: Results from a nationwide cross-sectional survey. J Affect Disorders Reports [Internet]. 2021 Jan; 3:100073. Available from: https://doi.org/10.1016/j.jadr.2020.100073
  3. Auerbach RP, Alonso J, Axinn WG, et al. Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychol Med [Internet]. 2016 Oct; 46(14): 2955-70. doi: 10.1017/S0033291716001665. Epub 2016 Aug 3. Erratum in: Psychol Med 2017 Nov; 47(15): 2737.
  4. Mahmoud JSR, Staten R, Hall LA, Lennie TA. The relationship among young adult college students’ depression, anxiety, stress, demographics, life satisfaction, and coping styles. Issues Ment Health Nurs [Internet]. 2012 Mar; 33(3): 149-56. Available from: https://doi.org/10.3109/01612840.2011.632708
  5. Rivas R. Unemployed Filipino down to 3.73 million in May 2021 as lockdown ease. Rappler [Internet]. 2021 Jul 1. Available from: https://www.rappler.com/business/unemployment-rate-philippines-may-2021
  6. Lally J, Samaniego RM, Tully J. Mental health legislation in the Philippines: Philippine Mental Health Act. B J Psych Int [Internet]. 2019 Aug; 16(3): 65-7. doi: 10.1192/bji.2018.33
  7. Tanaka C, Tuliao MTR, Tanaka E, Yamashita T, Matsuo H. A qualitative study on the stigma experienced by people with mental health problems and epilepsy in the Philippines. BMC Psychiatr 2018 Oct 5; 18(1): 325. doi: 10.1186/s12888-018-1902-9
  8. Tuliao AP. Mental health help seeking among Filipinos: A review of the literature. Asia Pacific J Counsel Psychother [Internet] 2014; 5(2): 124–36. Available from: https://doi.org/10.1080/21507686.2014.913641
  9. Abdullah T, Brown TL. Mental illness stigma and ethnocultural beliefs, values, and norms: An integrative review. Clin Psychol Rev [Internet] 2011 Aug; 31(6): 934-48. doi: 10.1016/j.cpr.2011.05.003. Epub 2011 May 31.
  10. Rivera AKB, Antonio CAT. Mental health stigma among Filipinos: Time for a paradigm shift. Phil J Health Res Dev [Internet] 2017 Apr-Jun; 21(2): 20-4. Available from: https://pjhrd.upm.edu.ph/index.php/main/article/view/172
  11. Corrigan PW, Watson A, C, Barr L. The self-stigma of mental illness: Implications for self-esteem and self- efficacy. J Soc Clin Psychol [Internet] 2006; 25(9): 875-84. doi: 10.1521/jscp.2006.25.8.87
  12. Link BG. Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. Am Soc Rev [Internet] 1987; 52: 96–112. Available from: https://doi.org/10.2307/2095395, https://www.jstor.org/stable/2095395
  13. Corrigan PW, Rao D. On the self-stigma of mental illness: Stages, disclosure, and strategies for change. Can J Psychiatr [Internet] 2012 Aug; 57(8): 464-9. doi: 10.1177/070674371205700804
  14. Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World Psychiatry [Internet] 2002 Feb; 1(1): 16-20. PMID: 16946807
  15. Watson AC, Corrigan P, Larson JE, Sells M. Self-stigma in people with mental illness. Schizophr Bull [Internet] 2007 Nov; 33(6): 1312-8. doi: 10.1093/schbul/sbl076. Epub 2007 Jan 25.
  16. Proclamation No. 929 Declaring a state of calamity throughout the Philippines due to corona virus disease 2019. Official Gazette [Internet] 2020 Mar 16. Available from: https://www.officialgazette.gov.ph
  17. Yap KM, Jiao C. Manila enters lockdown for month; Duterte mulls curfew. Bloomberg News [Internet] 2020 Mar 15. Available from: https://www.bloomberg.com/news/articles/2020-03-15/manila-enters-lockdown-for-month-duterte-mulls-curfew-on-virus#xj4y7vzkg
  18. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) Epidemic among the general population in China. Int J Environ Res Public Health [Internet] 2020 Mar 6; 17(5): 1729. doi: 10.3390/ijerph17051729
  19. Wang C, Pan R, Wan X, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behav Immun [Internet] 2020 Jul; 87: 40-8. Available from: https://doi.org/10.1016/j.bbi.2020.04.028
  20. Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet [Internet] 2020 Mar 14; 395(10227): 912-20. doi: 10.1016/S0140-6736(20)30460-8. Epub 2020 Feb 26.
  21. S u n d a r a s e n S, C h i n n a K , K a m a l u d i n K , e t a l . Psychological impact of COVID-19 and lockdown among university students in Malaysia: Implications and policy recommendations. Int J Environ Res Public Health [Internet] 2020 Aug 27; 17(17): 6206. doi: 10.3390/ijerph17176206
  22. Mazza C, Ricci E, Biondi S, et al. A nationwide survey of psychological distress among Italian people during the COVID-19 pandemic: Immediate psychological responses and associated factors. Int J Environ Res Public Health [Internet] 2020; 17(9): 3165. Available from: https://doi.org/10.3390/ijerph17093165
  23. Roma P, Monaro M, Colasanti M, et al. A 2-month follow-up study of psychological distress among Italian people during the COVID-19 lockdown. Int J Environ Res Public Health [Internet] 2020 Nov 5; 17(21): 8180. doi: 10.3390/ijerph17218180
  24. Arpino B, Pasqualini M, Bordone V, Solé-Auró A. Older people’s nonphysical contacts and depression during the COVID-19 lockdown. Gerontologist [Internet] 2021 Feb 23; 61(2):176-86. doi: 10.1093/geront/gnaa144. Erratum in: Gerontologist 2021 Feb 23; 61(2): 294.
  25. Champeaux H, Mangiavacchi L, Marchetta F, Piccoli L. Learning at home: Distance learning solutions and child development during the COVID-19 lockdown 2020 (No. 13819). IZA Discussion Papers [Internet]. Available from: https://www.iza.org/publications/dp/13819/learning-at-home-distance-learning-solutions-and-child-development-during-the-covid-19-lockdown
  26. Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet Child Adolesc Health [Internet] 2020 May; 4(5): 347-9. doi: 10.1016/S2352-4642(20)30096-1. Epub 2020 Mar 27.
  27. Spinelli M, Lionetti F, Pastore M, Fasolo M. Parents’ stress and children’s psychological problems in families facing the COVID-19 outbreak in Italy. Front Psychol [Internet] 2020 Jul 3; 11: 1713. doi: 10.3389/fpsyg.2020.01713
  28. Islam MdA, Barna SD, Raihan H, Khan MdNA, Hossain MdT. Depression and anxiety among university students during the COVID-19 pandemic in Bangladesh: A web- based cross-sectional survey. PLOS ONE [Internet] 2020, 15(8): e0238162. Available from: https://doi.org/10.1371/journal.pone.0238162
  29. Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatr Res [Internet] 2020 May; 287: 112934. doi: 10.1016/j.psychres.2020.112934. Epub 2020 Mar 20.
  30. Beck AT. Depression: Causes and Treatment (2nd Ed.). Philadelphia: University of Pennsylvania Press. (1967).
  31. Yuan Y, Zhao YJ, Zhang QE, et al. COVID-19-related stigma and its sociodemographic correlates: A comparative study. Global Health [Internet] 2021 May 7; 17(1):54. doi: 10.1186/s12992-021-00705-4
  32. Jayaseelan R, Brindha D, Kades W. Social media reigned by information or misinformation about COVID-19: A phenomenological study. Soc Sci Hum Open [Internet] 2020 May 12. Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3596058
  33. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther [Internet] 1995 Mar; 33(3): 335-43. Available from: https://doi.org/10.1016/0005-7967(94)00075-U
  34. Barney LJ, Griffiths KM, Christensen H, Jorm AF. The Self-Stigma of Depression Scale (SSDS): Development and psychometric evaluation of a new instrument. Int J Methods Psychiatr Res [Internet] 2010 Dec; 19(4): 243-54. doi: 10.1002/mpr.325
  35. H aye s A F. Pa r t i a l , c o n d i t i o n a l , a n d m o d e r a t e d mediation: Quantification, inference, and interpretation. Communication Monographs [Internet] 2018; 85: 4-40. Available from: https://doi.org/10.1080/03637751.2017.1352100
  36. Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Rep [Internet] 2018 Feb 12; 8(1): 2861. doi: 10.1038/s41598-018-21243-x
  37. Xiong J, Lipsitz O, Nasri F, et al. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. J Affect Disord 2020 Dec 1; 277: 55-64. doi: 10.1016/j.jad.2020.08.001. Epub 2020 Aug 8.
  38. Shaikh A, Peprah E, Mohamed RH, et al. COVID-19 and mental health: A multi-country study- the effects of lockdown on the mental health of young adults. Middle East Curr Psychiatr [Internet] 2021; 28(1): 51. Epub 2021 Aug 9. doi: 10.1186/s43045-021-00116-6
  39. Li HY, Cao H, Leung DYP, Mak YW. The psychological impacts of a COVID- 19 outbreak on college students in China: A longitudinal study. Int J Environ Res Public Health [Internet] 2020; 17: 3933. doi: 10.3390/ijerph17113933