Abstract
Background & Objectives: Many people with COVID–19 have mild to moderate symptoms and can recover on their own. However, COVID–19 can be a serious illness and lead to death in some people. People at higher risk include older adults, and the risk increases with age. Also, people with existing medical conditions are at higher risk for serious illness. COVID–19 has brought physical risks as well as psychological challenges to the whole world. Stressful events and diseases have potent adverse environmental factors that can predispose individuals to psychiatric disorders, in particular depression. During an epidemic outbreak, COVID–19 causes moderate–to–severe symptoms of anxiety and depression in people. Generalized Anxiety Disorder (GAD) is one of the most common disorders characterized by persistent, excessive, and unrealistic concerns about everyday issues. Depression is a common mental disorder that involves a depressed mood or loss of pleasure or interest in activities for long periods. Therefore, this study aimed to examine the association of GAD and depression among high school female students during the COVID–19 pandemic in Shiraz City, Iran.
Methods: The present study was cross–sectional and correlational. The study's statistical population consisted of all high school female students residing in Shiraz City, Iran, during the 2020 academic year. The study participants consisted of 395 high school female students, selected using a convenience sampling method. The inclusion criteria were as follows: being teenagers (12–18 years old), living in Shiraz, having full consent to participate in the study, and not using drugs or psychotropic drugs. The exclusion criterion was the incomplete completion of the questionnaires. The objectives and ethical considerations of the study were explained to the participants. To comply with ethical principles, the participants provided informed consent and completed the questionnaires. The participants were assured that their information would remain confidential, and there was no need to write down personal details. They were free to refrain from completing the questionnaires if they did not wish to do so. To collect the data, the Generalized Anxiety Disorder 7–item scale (GAD–7) (Spitzer et al., 2006) and the Patient Health Questionnaire 9–item scale (PHQ–9) (Kroenke et al., 2001) were used. In statistical analysis, the symptom scores for GAD and depression were dichotomized into binary variables, guided by their designated cut–off scores. A score of GAD–7 ≥10 and a score of PHQ–9 ≥14 marked the threshold for potential GAD and depression cases, respectively. The descriptive statistics (frequency tables and mean and standard deviation) and inferential statistics, including the Pearson correlation coefficient, were used to analyze the data. All statistical analyses were performed using SPSS software version 26. The significance level in this study was set at 0.05.
Results: The prevalence rates of GAD and depression symptoms among high school students during the COVID–19 pandemic in Shiraz were 55.69% and 42.27%, respectively. The results of the Pearson correlation coefficient showed a significant and positive relationship between symptoms of GAD and depression (r=0.768, p<0.001).
Conclusion: The average symptoms of generalized anxiety disorder and depression in students were significantly high during the COVID–19 pandemic, and there was a positive and significant correlation between symptoms of generalized anxiety disorder and depression in students during the COVID–19 pandemic. Therefore, adopting a comprehensive approach, including management policies, psychosocial interventions, and education, is very important to reduce symptoms of generalized anxiety disorder and depression in students during the COVID–19 pandemic.
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