Psychiatric Disturbances and COVID-19 Infection

International outbreak of the novel coronavirus (2019- nCoV) raised intense attention of
specialists worldwide, including psychiatrists. The five stages of shock-denial, anger,
bargaining, depression, and acceptance are experienced by many patients. Coronaphobia is a
novel term referring to excessive fear of being infected by coronavirus. The current pandemic
necessitates research in different areas of psychiatry, including psychosocial and
pharmacological interventions to find evidence-based ways of treatment.

This is a multi-center observational cross-sectional study with consecutive sample that will
include patients quarantined due to COVID-19 infection. Adult Patients will be recruited
consecutively (convenient sample). Data will be collected from patients in the form of:

Demographic data e.g. Age, Gender, Smoking history, exposure to source transmission
Co-morbidities e.g. underlying chronic liver, lung, cardiac or kidney diseases, diabetes
mellitus, hypertension Severity of COVID-19 infection: mild, moderate or severe

Psychiatric assessment of patients:

Patients will be subjected to the following questionnaires:

1. The General Health Questionnaire (GHQ-12), Arabic version:

It is the most extensively used screening instrument for common mental disorders, in
addition to being a more general measure of psychiatric well-being. It asks whether the
respondent has experienced a particular symptom or behavior recently. Each item is rated
on a four-point scale (less than usual, no more than usual, rather more than usual, or
much more than usual); it gives a total score of 36 based on the Likert scoring styles
(0-1-2-3). It is a brief, simple, easy to complete, and its application in research
settings as a screening tool is well documented. GHQ-12 is a consistent and reliable
instrument when used in general population samples.

2. Taylor Manifest Anxiety Scale , Arabic version:

A person answers by reflecting on themselves, in order to determine their anxiety level.
It is used to separate normal participants from those who would be considered to have
pathological anxiety levels. It consists of 50 true or false questions. It has been
proven reliable using test-retest reliability. O'Connor, Lorr, and Stafford found there
were five general factors in the scale: chronic anxiety or worry, increased
physiological reactivity, sleep disturbances associated with inner strain, sense of
personal inadequacy, and motor tension .

3. Beck Depression Inventory (BDI) , Arabic version:

It is a self-report scale designed to assess symptoms of depression such as sadness,
guilt, loss of interest, social withdrawal, increase and decrease in appetite or sleep,
suicidal ideation, and other behavioral manifestations of depression over the previous 2
weeks. It can also be used over time to monitor symptoms and to assess response to
therapeutic interventions. The inventory is composed of 21 groups of statements on a
four-point scale with the patient selecting the one that best matches his or her current
state.

4. The Brief-COPE scale , Arabic version :

It is an abbreviated version of the COPE (Coping Orientation to Problems Experienced)
Inventory. It is a self-report questionnaire developed to assess a broad range of coping
responses. It is one of the best validated and most frequently used measures of coping
strategies. The instrument consists of 28 items that measure 14 factors of 2 items each,
which correspond to a Likert scale ranged from 0 - 3.

from each center included in this study there is a person responsible for checking
completeness of the collected questionnaires

Statistical Analysis Results will be evaluated statistically by the Statistical Package for
the Social Sciences (SPSS) version 20 (IBM, 2011). Normality of data will be tested by
Kolmogorov-Smirnov test. To describe the data, frequency (percent) and mean± SD will be used.
T-test and Pearson correlation test will be used for comparisons and correlations
respectively for normally distributed data. Mann-Whitney U test and Spearman correlation test
will be used for comparisons and correlations respectively for non-normally distributed data.
P-values less than 0.05 will be considered statistically significant and 95 % Confidence
interval (CI) will be calculated.