4 DISCUSSION
This study provides important data regarding the impact of the pandemic
in Turkey. First of all, it was detected that the society was
significantly affected by the pandemic. Among the participants in the
study; based on moderate and above psychological effects, anxiety was
found in 15.8%, depression in 22.6%, stress in 12.9%, and trauma in
20.29%. In a study by the American Psychiatric Association, it was
stated that the COVID-19 epidemic caused anxiety in 50% of the society
and more than one-third felt that their mental health was seriously
affected.17 In the study conducted by Wang et al in
the normal population in the second week of the pandemic, it was
observed that 53.8% of the participants had a psychological response,
16.5% with depression, 28.8% with anxiety, and 8.1% with high
stress.8 Although the data obtained were close to the
rates determined in China, they differed in terms of low IES-R rates.
This result is probably related to the reduction of the acute effect of
the pandemic in the community since the study was performed at the 6th
week of the epidemic. On the other hand, the fact that Turkey was not
one of the first countries experiencing the outbreak, and had time to
establish certain infrastructure related to the outbreak may be
associated with lower trauma scores. However, since there is no previous
study in our country, such a comparison is not possible to be made.
Epidemiological studies on epidemics or disasters have shown that
sociodemographic variables are associated with different levels of
psychological response. Women,18-20 young
people,21 people with higher
education,22 health workers,23students,24 those with low economic
income,25 people with or without a history of any
disease26 and smokers27 are
emphasized in the literature for having higher rates of psychological
response.
In our study, in accordance with the literature, young age, being
single, an excessive number of people living together, presence of
psychiatric disease history, and female gender were identified as higher
risk conditions in terms of high psychological responce. However,
contrary to the literature, high education levels significantly reduced
the risk of anxiety and depression, while smoking, lack of health
insurance, or low level of economic income were not associated with
psychological exposure. This result may be due to the effects of
cultural and/or religious differences among communities on human
behavior and perceptions.
While studies in the literature have shown that societies use the
internet and social media as a general information source and the posts
here play a role in psychological influence.6,28 In
our study, it was seen that most of the participants use
television/radio as a source of information and this fact is not related
to psychological influence. Although Turkish society has high levels of
internet usage, the fact that the main source of information is
expressed as TV/radio may be due to the low belief in the news on the
internet. On the other hand, the feeling of trust towards TV may be
resulted from the fact of authorized institutions’ regular and effective
TV use during the pandemic. As a matter of fact, the high degree of
satisfaction and belief in the information obtained supports this
relationship.
Another conclusion drawn from our study is; although very few of the
participants were diagnosed with COVID-19, contrary to the
literature,29 interestingly, it has been found that
being treated for COVID-19 infection is not related to psychological
affect. Moreover, being quarantined and having a test reduced the level
of psychological response.
On the other hand, although there was no diagnosis of COVID-19, the
presence of symptoms suggestive of any infection, and a history of
contact with an individual or object infected with COVID-19 were also
factors that increased the risk of psychological response in
individuals. This result seems to be a reflection of the anxiety
developed in accordance with the nature of “uncertainty”. In the
literature, “uncertainty” is accepted as causing a series of
cognitive, emotional, and behavioral damage in the process of time. It
is also considered as a “basic component of all anxiety disorders”
which reduces problem-solving ability.30 Accordingly,
taking precautions such as regular sharing of information that will
eliminate this uncertainty during the days of pandemic intensification,
dissemination of diagnostic tests can contribute positively to the
mental health of the society.
According to previous studies, despite social differences, there is a
relationship between compliance with the measures taken and
psychological impact.23 In the study of Wang et al.,
compliance with precautionary measures has been shown to reduce the
psychological response.8 In our study which is
consistent with the literature, it was found that the majority of the
participants to be complying with the measures taken although Turkish
society has been facing such a pandemic for the first time in its
history. It has been also remarkable that people’s adaptation with the
rules to have a positive effect on psychological response. It is an
expected result for a society in which people state that they pay more
attention to the health of their relatives rather than their own and
that they do not feel psychologically uncomfortable. In addition, it has
been observed that regular exercise, a balanced diet, and attention to
sleep patterns are protective factors in psychological response.
However, it was found that most of the participants complied with these
measures at a lower rate. Therefore, raising awareness of the society
for these measures which are effective in psychological and biological
empowerment seems to provide significant benefits in combating
pandemics.
When the areas where the participants are concerned are evaluated,
similar to previous pandemic studies,31 the first 3
places respectively were the health of family and relatives, anxiety to
infect others, and going to health controls. However, it was seen that
the characteristics of the individuals during the pandemic caused
anxiety about different issues. For example, academic anxiety was the
primary concern among young people aged 18-25. The individuals with the
most economic concerns were those with a monthly income of 2500-5000 TL
and university graduates. A remarkable result here was that people’s
anxiety about taking medications that they had to take constantly
increased their stress levels by 75.5%. Biologically at risk of further
damage than COVID-1932 this anxiety of the people is
an important situation in terms of disruption of the treatments and
subsequent serious health problems. Unfortunately, our study on why
people bear this concern has not been able to provide a clear
explanation. However, in our opinion, presenting information that has
not been confirmed about whether or not some drugs can be taken in the
media seems to cause more confusion and anxiety. Therefore, preventing
information pollution about COVID-19 and making necessary explanations
to these people at risk, will contribute to the reduction of anxiety
levels, and it seems to contribute positively to the lives of these
people with physical illness.