Fear of COVID-19 and its association with mental health-related factors: systematic review and meta-analysis

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Abstract

Background

The severity of COVID-19 remains high worldwide. Therefore, millions of individuals are likely to suffer from fear of COVID-19 and related mental health factors.

Aims

The present systematic review and meta-analysis aimed to synthesize empirical evidence to understand fear of COVID-19 and its associations with mental health-related problems during this pandemic period.

Method

Relevant studies were searched for on five databases (Scopus, ProQuest, EMBASE, PubMed Central, and ISI Web of Knowledge), using relevant terms (COVID-19-related fear, anxiety, depression, mental health-related factors, mental well-being and sleep problems). All studies were included for analyses irrespective of their methodological quality, and the impact of quality on pooled effect size was examined by subgroup analysis.

Results

The meta-analysis pooled data from 91 studies comprising 88 320 participants (mean age 38.88 years; 60.66% females) from 36 countries. The pooled estimated mean of fear of COVID-19 was 13.11 (out of 35), using the Fear of COVID-19 Scale. The associations between fear of COVID-19 and mental health-related factors were mostly moderate (Fisher's z = 0.56 for mental health-related factors; 0.54 for anxiety; 0.42 for stress; 0.40 for depression; 0.29 for sleep problems and –0.24 for mental well-being). Methodological quality did not affect these associations.

Conclusions

Fear of COVID-19 has associations with various mental health-related factors. Therefore, programmes for reducing fear of COVID-19 and improving mental health are needed.

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The Fear of COVID-19 Scale: Development and Initial Validation

Daniel Ahorsu, Chung-Ying Lin, Vida Imani … (2020)

Background The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases. Methods The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results After panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α = .82) and test–retest reliability (ICC = .72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459). Conclusion The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals.

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Assessing heterogeneity in meta-analysis: Q statistic or I2 index?

Tania Huedo-Medina, Julio Sánchez-Meca, Fulgencio Marín-Martínez … (2006)

In meta-analysis, the usual way of assessing whether a set of single studies is homogeneous is by means of the Q test. However, the Q test only informs meta-analysts about the presence versus the absence of heterogeneity, but it does not report on the extent of such heterogeneity. Recently, the I(2) index has been proposed to quantify the degree of heterogeneity in a meta-analysis. In this article, the performances of the Q test and the confidence interval around the I(2) index are compared by means of a Monte Carlo simulation. The results show the utility of the I(2) index as a complement to the Q test, although it has the same problems of power with a small number of studies.

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Functional Fear Predicts Public Health Compliance in the COVID-19 Pandemic

Craig Harper, Liam Satchell, Dean Fido … (2020)

In the current context of the global pandemic of coronavirus disease-2019 (COVID-19), health professionals are working with social scientists to inform government policy on how to slow the spread of the virus. An increasing amount of social scientific research has looked at the role of public message framing, for instance, but few studies have thus far examined the role of individual differences in emotional and personality-based variables in predicting virus-mitigating behaviors. In this study, we recruited a large international community sample (N = 324) to complete measures of self-perceived risk of contracting COVID-19, fear of the virus, moral foundations, political orientation, and behavior change in response to the pandemic. Consistently, the only predictor of positive behavior change (e.g., social distancing, improved hand hygiene) was fear of COVID-19, with no effect of politically relevant variables. We discuss these data in relation to the potentially functional nature of fear in global health crises.

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Journal

Journal ID (nlm-ta): BJPsych Open

Journal ID (iso-abbrev): BJPsych Open

Journal ID (publisher-id): BJO

Title: BJPsych Open

Publisher: Cambridge University Press (Cambridge, UK )

ISSN (Electronic): 2056-4724

Publication date (Electronic, collection): March 2022

Publication date (Electronic): 21 March 2022

Publication date PMC-release: 21 March 2022

Volume: 8

Issue: 2

Electronic Location Identifier: e73

Affiliations

[1]Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences , Iran

[2]Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University , California, USA

[3]International Gaming Research Unit, Department of Psychology, Nottingham Trent University , UK

[4]Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University , Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University , Taiwan; and Department of Occupational Therapy, College of Medicine, National Cheng Kung University , Taiwan

[5]Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences , Iran; and Department of Nursing, School of Health and Welfare, Jönköping University , Sweden

Author notes

Correspondence: Chung-Ying Lin. Email: cylin36933@ 123456gs.ncku.edu.tw

Author information

Zainab Alimoradi https://orcid.org/0000-0001-5327-2411

Maurice M. Ohayon https://orcid.org/0000-0002-2757-5440

Mark D. Griffiths https://orcid.org/0000-0001-8880-6524

Chung-Ying Lin https://orcid.org/0000-0002-2129-4242

Amir H. Pakpour https://orcid.org/0000-0002-8798-5345

Article

Publisher Item ID: S2056472422000266

DOI: 10.1192/bjo.2022.26

PMC ID: 8943231

PubMed ID: 35307051

SO-VID: 795758c4-e171-444e-9a9d-5d046f888cfc

License:

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

History

Date received : 10 September 2021

Date revision received : 05 January 2022

Date accepted : 07 February 2022

Page count

Figures: 26, Tables: 6, References: 146, Pages: 26

Funding

Funded by: Qazvin University of Medical Sciences, doi http://dx.doi.org/10.13039/501100006396;

Fear of COVID-19 and its association with mental health-related factors: systematic review and meta-analysis

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Novel Coronavirus Disease COVID-19

Most cited references 142

The Fear of COVID-19 Scale: Development and Initial Validation

Assessing heterogeneity in meta-analysis: Q statistic or I2 index?

Functional Fear Predicts Public Health Compliance in the COVID-19 Pandemic

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