COVID-19: Factors associated with psychological distress, fear, and coping strategies among community members across 17 countries

Muhammad Aziz Rahman, Sheikh Mohammed Shariful Islam, Patraporn Tungpunkom, Farhana Sultana, Sheikh M. Alif, Biswajit Banik, Masudus Salehin, Bindu Joseph, Louisa Lam, Mimmie Claudine Watts, Sabria Jihan Khan, Sherief Ghozy, Sek Ying Chair, Wai Tong Chien, Carlos Schönfeldt-Lecuona, Nashwa El-Khazragy, Ilias Mahmud, Adhra Hilal Al Mawali, Turkiya Saleh Al Maskari, Rayan Jafnan AlharbiAmr Hamza, Mohamad Ali Keblawi, Majeda Hammoud, Asmaa M. Elaidy, Agus Dwi Susanto, Ahmed Suparno Bahar Moni, Alaa Ashraf AlQurashi, Almajdoub Ali, Amit Wazib, Cattaliya Siripattarakul Sanluang, Deena H. Elsori, Farhana Yasmin, Feni Fitrani Taufik, Manal Al Kloub, Mara Gerbabe Ruiz, Mohamed Elsayed, Nael Kamel Eltewacy, Nahed Al Laham, Natalia Oli, Ramy Abdelnaby, Rania Dweik, Ratree Thongyu, Sami Almustanyir, Shaila Rahman, Sirirat Nitayawan, Sondos Al-Madhoun, Suwit Inthong, Talal Ali Alharbi, Tamanna Bahar, Tribowo Tuahta Ginting, Wendy M. Cross

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


Background: The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. Objectives: We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping. Methods: We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. Results: A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). Conclusions: The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements.

Original languageEnglish
Article number117
JournalGlobalization and Health
Issue number1
Publication statusPublished - Dec 2021


  • coping
  • coronavirus
  • COVID-19
  • fear
  • mental health
  • psychological distress
  • resilience


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