Prevalence and determinants of anxiety and stress in the general population during COVID-19 pandemic in Iraq: A cross-sectional study

Background: The COVID-19 pandemic and its prevention and control measures, such as social distancing, self-isolation, and quarantine, have a negative impact on the population’s mental health. This study aimed to determine the prevalence of anxiety and stress among the general population during the outbreak of COVID-19 and assess their associated factors. Methods: We carried out a cross-sectional study in Erbil governorate, Iraqi Kurdistan Region, from July 18 to September 12, 2020. We used an online survey questionnaire to collect data from a sample of Erbil population. The 10-items Perceived Stress Scale and the 7-item Generalized Anxiety Disorder scale were used to measure the levels of stress and anxiety. Results: A total of 851 persons responded to the survey. The prevalence of moderate and high perceived stress was 59.6% and 16.6%, respectively. The prevalence of moderate and severe anxiety was 24.7% and 22.7%, respectively. Age, gender, economic level, having contact with COVID-19 patients, and following COVID-19 news were independent variables significantly associated with stress levels. Age, gender, economic level, employment status, having symptoms of COVID-19, having contact with COVID-19 patients, and following COVID-19 news were independent variables significantly associated with anxiety levels. Conclusion: A high proportion of people experienced stress and anxiety during the COVID-19 outbreak in Erbil, Iraqi Kurdistan Region. Females, younger age, poor, and unemployed reported significantly higher stress and anxiety levels. There is a need to establish mechanisms at the population level to decrease the stress and anxiety risks and provide mental health coping measures in times of crisis, such as education about positive thinking, stress management programs, and the role of social support.