An Assessment on the Level of Anxiety and Depression Among Millennials on Covid-19

Crisis: Basis for the Development of Online Mental Health Support.

Background of the Study

It’s been a while since humanity experience the terror of a pandemic. The novel severe acute

respiratory syndrome coronavirus 2 (SARS-CoV-2), first broke out in December of 2019 were

several cases of unusual pneumonia were reported from the central city of Wuhan, China. The

coronavirus was publicized in early January, stating that coronavirus is related to the previous

outbreak, the severe acute respiratory syndrome (SARS) (Sanaâ, L. et. al., (June, 2020).

Coronavirus and SARS both have similar clinical symptoms such as fever, dry cough, shortness

of breath. However, there was an important difference isolated from those affected by the

coronavirus such as the runny nose, body ache, sneezing, sore throat, and diarrhea. The

symptoms are mild that an affected person might think of having the flu or cold and

unknowingly becomes the carrier of the virus. In fact, the people outside China don’t grasp the

threat of the new coronavirus and make a pun about it. People failed to realize the panic and

tangible threat of it. Weeks after the first death from China, the transmission surges like a

wildfire affecting many countries around the globe. The World Health Organization (WHO)

declared the coronavirus a “global emergency” raising an outbreak of an infectious disease

known as COVID-19. February 2020, few days after the WHO declaration of global emergency,

the Philippines had its first case of death a Chinese man and a woman from Wuhan, China

admitted to a hospital in Metro Manila. After a month of no known cases, the Philippines

confirmed the first local transmission on March 07, 2020, the next day the country was under the

“State of Public Health Emergency.” The people were alarmed by the news of local transmission
in the country, creating fear of contracting the illness. Medical stores were flocked by the people

buying masks, sanitizers, and alcohol to protect themselves from getting the virus while some

starts to hoard grocery items. Due to the heightened fear, President Rodrigo Duterte stated on

March 16, 2020, that Central Luzon was under the ‘Enhanced Community Quarantine’, were a

full lockdown implemented to lessen the transmission of the virus. It limits the action of the

entire population, little by little businesses started to close, some moved their operation, and

resorted in working from home. Schools and Universities decided to cancel their classes, and

transportation was restricted. More barangays, cities and municipalities issued travel ban in and

out of their community. As the Covid-19 crisis aggravate different sectors of society, the public

began to worry about an abrupt change to their daily lives, job loss, grieve over death of a loved

one, afraid of staying long outside, suspicious of one another, availability of rapid testing kits,

and elevated psychological impact on Covid-19. Anxious about the current health epidemic that

continues to worsen, before it gets better. Social platforms have been the main source of

information of the current cases of people with Covid-19, in relation to this, fake news and

conspiracies has been circulating everywhere (The Lancet,2020). That results in an epidemic

hysteria intensifying anxiety and depression to both with developing and existing illness.

According to Buenaventura, Robert D., Ho, Jacqueline B., & Lapid, Maria I. (April,2020), older

Filipinos are more vulnerable to Covid-19 especially those with existing medical conditions such

cardiovascular disease, diabetes and hypertension. The Covid-19 crisis has taken a toll to the

lives of the older Filipinos, who are coping with mandated isolation and disrupted daily living.

About 37.1% of elderly showed significant level of anxiety and depression (Qui et. al., 2020)

poses negative impact on the psychological health and the tendency to cause the older Filipinos

to fear the uncertainty and pessimistic about the pandemic. Moreover, not only the elderly has a
particular perception about the Covid-19 crisis, the researchers thought that millennials are much

more affected by the current health crisis. The millennials are born between 1981-1996, they are

the Filipinos who constantly connected to the internet and adventurous. Known to have a strong

drive of optimism when it comes to achieving their goals and admirable in self-promotion,

building a huge source of social connections yet they get easily stressed on the continuing

change. Covid-19 have greatly affected people's mindset on the current health situation that may

eventually lead to the development of depressive symptoms which incapacitate them on their

daily activities (Palmer, C. (2020, May). In the same manner, millennials are experiencing

tremendous challenges in their lives right now with the Covid-19 crisis. The new normalcy can

overwhelm a millennial, raising an alarm for more mental health issues. This research seeks to

assess the Level of Anxiety and Depression Among Millennials on Covid-19. To determine the

correlational relationship between anxiety and depression and to be able to develop a proposal

online mental health support designed for millennial.

Theoretical Framework- need improvements

In this paper, it uses two theories, the first theory is the Social Cognitive Theory (SCT) of Albert

Bandura. People have different cognitive perspective on making choices, interpretation of their

situation or events and experiences that affects their cognitive processes (Fiske & Taylor, 1991;

Smith 1998). In this time of the covid-19 crisis people often look for general indications from

the government, health officials, media and other source of information (family and friends). The

uncertainty of life, being quarantined for months anticipating the present and possible threat of

the disease have become reason to feel anxious. Bandura’s theory is a useful framework for the

study to consider how millennials internalize and make sense of the impact of Covid-19. SCT is
focused on how cognitive factors are involved in ways an individual thinks or behave by

observing other people think or behave. Therefore, anxiety is a by-product of social stimuli that

signals intra-specific threat. According to Bavel, J. et. al., (2020) the experience of fear and

threat have consequences in both physical and mental health. For instance, the media reports

negatively on Covid-19, it increases the negative emotion and perception of people about

themselves and how should they react with others. Social experiences play an important role in

the development and recovery from anxiety. As a matter of fact, Jon, I. (2020) emphasized that

people learn to respond in a particular situation through exposure. One example of this is

perceived sense of control over the environment in which people basically like to control things.

Panic buying is a remedial response to alleviate anxiety that brings back the feeling of control

(Yap, 2020).

The second theory is cognitive triad of Dr. Aaron Beck’s cognitive theory for depression, an

individual experience different types of negative thoughts (i.e. self, world and the future). It is

when maladaptive reactions occur over the environmental stimuli such as anxiety in the ongoing

quarantine that later flip into depression. Moilanen (1995) found that the ability to deal with

dysfunctional attitudes and beliefs of an individual was correlated on cognitive thoughts and

results in developing symptoms or occurrences of depression. According to Souvik, D. et. al.

(May,2020) when people have been restricted to stay indoors and a nationwide lockdown was

implemented to prevent further transmission of the Covid-19. People actively interpret and

construct their reactions negatively for themselves, the world and the future as vulnerable in

unpredictable condition. The cognitive theory for depression will be a useful framework to be
able to predict or explain the causal relationship of anxiety and depression and how cognitive

thoughts are associated with depression millennials might experience about the Covid-19 crisis.

Conceptual Framework

Input Process Output

Demographic Profile of
Respondents Assessment on Level of
Anxiety
1.1. Sex Proposed Mental Health
Online Support
1.2. Marital Status

1.3. Highest Educational

Attainment
Assessment on Level of
1.4. Years of Employment Depression

Figure 1. Research Flow of

The Study
The figure above shows the research flow of the study, Respondents will be profiled

according to sex, marital status, highest educational attainment and years of employment. They

will take the assessment on anxiety level and depression level. The study will also check the

relationship between anxiety and depression. From the results and analysis on anxiety and

depression level, the researchers will propose mental health online support designed for

millennials.

Statement of the Problem

1. What is the demographic profile of respondents when they will be grouped according to the

following?
 1.1. Sex

1.2. Marital Status

1.3. Highest Educational Attainment

1.4. Years of Employment

2. What is the level of anxiety when respondents will be grouped according to the demographic

profile?

3. What is the level of depression when respondents will be grouped according to the

demographic profile?

4. Is there a significant difference in the level of anxiety when respondents will be grouped

according to the demographic profile?

5. Is there a significant difference in the level of depression when respondents will be grouped

according to the demographic profile?

6. Is there a significant correlation between level of anxiety and level of depression?

7. What mental health online support can be proposed?

Hypotheses

Ho1. Is there a significant difference in the level of anxiety when respondents will be

grouped according to the demographic profile?

 Ho2. Is there a significant difference in the level of depression when respondents will be

grouped according to the demographic profile?

Ho3. Is there a significant correlation between level of anxiety and level of depression?

Significance of the Study- edit

This research study is carried out by the researchers as it is of great importance to find out the

effects of COVID-19 crisis to mental health. In the end, this would benefit them in terms of

psychological adjustment.

The findings that this study will reveal may benefit certain groups and the benefits that may be

derived from them are as follows.

Millennials will be really helpful for them because they will able to see what psychological

adjustment is necessary and how it responded. May provide some strategies in coping with life

challenges that would benefit for them.will be helpful for them to understand the need to have a

positive mindset. As it will ptovide them some strategies in coping with the challenges in life specially at

this time of the pandemic and other circumstances

Community the result of this study will help communities specially areas that are mostly

affected by the lockdown and the most vulnerable individuals, who experiences anxiety or

distressweb-based mental health support, in which they can readily access mental health support

at the convenience of their home.

Future Researchers the findings about this study can be used for future investigation either part

of the Covid-19 or future pandemic.

Scope and limitations

First, this study seeks to assess the level of anxiety and depression among millennials. Second, to

determine the relationship between anxiety and depression. Lastly, to develop online mental

health support. The respondents of the study are chosen based on their age and socio-

demographic profile such as sex, education, marital status and employment. The researchers self-

created the research instruments that will be used in this study. The first questionnaire is a 21-

item Quarantine Anxiety Scale (QAS) that will measure the level of anxiety experience by the

respondents about the Covid-19. The scale is adapted from Generalized Anxiety Disorder

Assessment (GAD-7). Covid-19 Depression Questionnaire (CovDQ) is a 15-item self-created

questionnaire that measures the level of depression felt about the Covid-19. Also, adapted from a

standardized test the Patient Health Questionnaire (PHQ-9). Data collection will be rolled out via

online survey form like Google Forms. Restriction to social contact and limited time are the

limitations of this study as it needs to be done within one semester.

Operational Definition of terms

Anxiety is a common emotion among Millenials when dealing with daily stresses and problems

that prevents them to function this pandemic.

Depression is an emotional state experienced by the Millenials which leads to a constant feeling

of sadness and lack of interest during this COVID-19 pandemic which affects how they feel,

think and behave and can lead to a variety of emotional and physical problems.

COVID-19 an infectious disease that suddenly changed the life of the Millennials which affects

their work and lifestyle and lead them in anxiety and depression.

Millennial is the term used to identify a person who reached adulthood and was born in 1981-

1996 as group of people heavily affected by the COVID-19 pandemic.

Online Mental Health Support a web-based mental health intervention that aims to provide an

online support for individuals with developing and existing psychological issues especially at

this time of the pandemic.

Literature Review- edit

This chapter provides a solid foundation for the study. Literature and studies both local and

foreign that aims to conduct: An Assessment on the Level of Anxiety and Depression Among

Millennials on Covid-19 Crisis: Basis for the Development of Online Mental Health Support.

The researchers gathered the following insights from foreign to local public publications and

shed information on the problem at hand.

Anxiety

Anxiety is the natural warning system of the body indicating the imminent danger and

corrective action to be taken (Hooley et al. 2016). Anxiety is a future response and often shows

up when people face a new situation or when there are some significant changes in their lives.

Increased number of heartbeats, sweating, feeling of tension, and the thought that something

undesirable will happen are common symptoms of anxiety. In most cases, the symptoms that

emerge are time-limited and disappear when the event ends (Beidel et al. 2014). However,

individuals with anxiety disorders experience extreme fear and/or anxiety, and this often leads to

a discordant avoidance model (Dozois and Rnic 2019).

Foreign

Lockdown, a term conventionally used as surrogate for “mass quarantine”, is typically based

on “stay-athome” or “shelter-in-place” ordinances given by a public (either national or regional)

government or authority, for imposing social distancing and hence limiting or completely

abolishing the movement of the population inside and outside a specific area. It is hence mostly

used as for counteracting an ongoing outbreak, mandating residents to stay inside their homes,

except for carrying out essential activities (health visits, tending to a vulnerable person,
purchasing medicines, food and beverages) or providing essential work (e.g. healthcare and

social care sectors, police and armed forces, firefighting, water and electricity supply, critical

manufacturing). Other nonessential activities are hence stopped or carried out from home.

Social isolation is related to numerous symptoms. It is known that epidemics can elicit anxiety

and anticipation of possible infection, which sometimes manifests itself as health anxiety. It is an

exaggerated preoccupation with one‘s own health and usually presents itself with some type of

body vigilance in which the subject focuses excessively on body signs such as, palpitations,

respiratory rate, and so on.

As the outbreak progresses with an increasing number of countries implementing restrictive

measures, the number of people isolated at home increases in parallel. It is now established that

social isolation must be regarded as a primary public health concern in the elderly, as it amplifies

the burden of neurocognitive, mental, cardiovascular and autoimmune problems, as well as

depression and anxiety. Moreover, recent evidence has demonstrated that sedentary behaviors in

the youth may also be an important cause of depression and anxiety. As such, self-isolation

should be seen as a global healthcare and societal issue. Besides the need to find some reliable

and sustainable means for delivering adequate amounts of groceries and essential medicines to

those who may be unable to leave their homes autonomously during prolonged lockdown

periods, counteracting the mounting burden of depression and anxiety becomes vital. Direct

contact with relatives and friends is unfeasible where very restrictive measures have been

applied, such that other forms of social contact should be urgently established for alleviating the

unfavorable psychological consequences. This would also enable the timely identification of any

potential health deteriorations, espe

cially among individuals with pre-existing diseases.

Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019

(COVID-19). Rertrieved from https://www.researchgate.net/publication/340174330 DOI:

10.1515/dx-2020-0041

There is need to differentiate that in this particular crisis of pandemic, we have to face two

bitter realities: first is the pandemic itself; a deadly condition which has a high mortality rate,

second is the impact of negative emotions like fear and anxiety causing mental illness (Courier,

2020).

Self isolation is such a critical phenomenon, which also brings certain anxieties and fears

because people are concerned; they may infect their loved ones. Furthermore, social isolation

and rejection of purpose and lower self-esteem will be a cause of severe mental health problems.

As in this social isolation, there is a wave of desperation at a mass level, the negative emotions of

depression and stress with the elongations of the Centrelink lines, human society will have to

take care of the mental health of the people as it is making the availability of masks, and testing

kits to prevent people from viral disease.

Johnstone (2020) says that people are not confronting pandemic of mental health problems rather

they are all passing through a situation which is horrifying in a true sense and such scenarios, the

negative emotions of anxiety, fear, confusion and despair because this kind of terrible situation

changes people’s ways of living altogether. Nina Kadidiatou Fofana , Faiza Latif , Bilal ,

Muhammad Farhan Bashir , Bushra Komal , Fear and Agony of the Pandemic Leading to Stress

and mental illness: An Emerging Crisis in the Novel Coronavirus (COVID-19) Outbreak,

Psychiatry Research (2020), doi: https://doi.org/10.1016/j.psychres.2020.113230

 Stay-at-home orders or experiencing changes to daily life habits due to COVID-19 may

increase perceptions of risk for harm to one’s physical, social, and financial health, resulting in

increased health anxiety and financial worry. Moreover, stay-at-home orders may result in

sudden changes to one’s social life. Reduced contact with once common social connections may

initially bring about increased feelings of loneliness and social isolation.

Being under a stay-at-home order was associated with greater health anxiety, financial worry,

and loneliness, consistent with the theorized unintended negative consequences of such orders

(Reger et al., 2020) and past research on the psychological consequences of quarantine during a

pandemic (Brooks et al., 2020). Moreover, consistent with research on the psychological

consequences of COVID-19 in China (Cao et al., 2020; Wang et al., 2020; Zhang et al., 2020)

and past research on the psychological consequences of other pandemics (Tausczik et al., 2011;

Wheaton et al., 2011), the perceived impact of COVID-19 on daily life was associated with

greater health anxiety and financial worry. Matthew T. Tull , Keith A. Edmonds , Kayla

Scamaldo , Julia R. Richmond , Jason P. Rose , Kim L. Gratz , Psychological Outcomes

Associated with Stay-at-Home Orders and the Perceived Impact of COVID-19 on Daily Life,

Psychiatry Research (2020), doi: https://doi.org/10.1016/j.psychres.2020.113098

The widespread lockdowns and stringent measures that require or encourage people to stay at

home could result in more time spent on social media, particularly on searching for news or

information about the pandemic. Although the psychological impact of quarantine has been

documented, the mental health consequences of the COVID-19 pandemic, community-wide

nonpharmaceutical interventions NPIs, and social media use during a pandemic are unclear.

Social media could mitigate the mental health impact of COVID-19 and lockdowns by

maintaining social support during physical distancing, as well as providing health information,
telemedicine, and online psychological counseling. Yet social media can also spread negative

emotions, rumors, and fake news during an epidemic.

Social media has a good feature on spreading information, however, there is still a threat of

misinformation that leads to widespread panic due to faulty tweets (Nguyen, Yan, Thai, &

Eidenbenz, 2012). Fake news heightens fear among people, however, reading valid and reliable

source makes it easier to maintain composure.

A total of 1577 community-based adults and 214 health professionals in Wuhan, China

completed the online survey. Among the total 1791 participants, 1341 (74.87%) were members

of the selected WeChat groups. The remaining participants also reported that they were currently

in Wuhan and enrolled via links of the survey forwarded by WeChat group members. The

majority of community-based adults (n=1110, 70.39%) and health professionals (n=131, 61.2%)

reported that they live in neighborhoods with COVID-19 cases. Among community-based adults,

37.16% (n=586) and 18.64% (n=294) of them spent 2 hours or more per day on COVID-19 news

via social media and television, respectively. Similarly, 33.2% (n=71) and 16.4% (n=35) of

health professionals spent 2 hours or more per day on COVID-19 news via social media and

television, respectively. Of the 1577 community-based adults, around one-fifth of respondents

reported probable anxiety (n=376, 23.84%) and probable depression (n=303, 19.21%, 95%).

Similarly, of the 214 health professionals, about one-fifth of surveyed health professionals

reported probable anxiety (n=47, 22.0%) or probable depression (n=41, 19.2%). The

multivariable logistic regression analysis showed that close contact with individuals

with COVID-19 and spending ≥2 hours daily on COVID-19 news via social media were

associated with probable anxiety and depression in community-based adults. The study shows
that online platforms such as WeChat can be leveraged to survey community-based adults and

health professionals during an epidemic and lockdown.

Ni MY, Yang L, Leung CMC, Li N, Yao XI, Wang Y, Leung GM, Cowling BJ, Liao Q Mental

Health, Risk Factors, and Social Media Use During the COVID-19 Epidemic and Cordon

Sanitaire Among the Community and Health Professionals in Wuhan, China: Cross-Sectional

Survey JMIR Ment Health 2020;7(5):e19009. Retrieved from

https://mental.jmir.org/2020/5/e19009 Doi: 10.2196/19009

The isolation resulted in significant negative impacts on mental health and well-being within

a short time of policy implementation, mainly in those with low paid or precarious employment.

Reduced social interaction, economic losses, and routine changes led to psychological and

emotional impact, as demotivation, loss of meaning and decreased self-worth (Williams et al.,

2020). Torales et al. (2020) have discussed the impact of the pandemic in mental health and

provided information about previous experiences of epidemics and social isolation. According to

the World Health Organization (WHO), social distancing represents an important strategy to

prevent the increase in cases and deaths by COVID-19, leading to subsequent overburdening of

the health care systems (Jacobson et al., 2020). Despite some evidence about the psychological

impact of quarantine in previous situations, little is known about the consequences of social

distancing for the hundreds of millions of people under lockdown in the current scenario (Brooks

et al., 2020; Venkatesh & Edirappuli, 2020).

A US study investigated more than 10 million Google searches and assessed the changes in

mental health search queries after stay-at-home measures. Topics related to anxiety, negative

thoughts, sleep disturbances, and suicidal ideation increased dramatically before stay-at-home

orders with a levelling of the curve after implementation (Jacobson et al., 2020). A British online
qualitative study with 27 participants assessed five focus groups during the early stages of the

social distancing measures (5–12days post lockdown). The isolation resulted in significant

negative impacts on mental health and well-being within a short time of policy implementation,

mainly in those with low paid or precarious employment. Reduced social interaction, economic

losses, and routine changes led to psychological and emotional impact, as demotivation, loss of

meaning and decreased self-worth (Williams et al., 2020).

Another research with 683 US adolescents carried out 2 weeks post lockdown showed that

engagement in social distancing was not significantly associated with their mental health. They

believe that social isolation will probably increase fear, anxiety symptoms, loneliness, and

depressed mood. Humans are social beings, independent of nationality or cultural background,

and maintaining isolation for a long period might create significant psychological distress.

Impact of social distancing on mental health during the COVID-19 pandemic: An urgent

discussion DOI: 10.1177/0020764020927047 journals.sagepub.com/home/isp

The study is aimed to assess the anxiety level of Iranian general population during COVID-

19 outbreak among the general population during the outbreak of coronavirus. The findings of

the present study indicate that approximately one fifth of people have experienced severe/very

severe anxiety and that women feel more anxiety than men. In addition, the level of anxiety

among residents of provinces with a high prevalence of coronavirus infection has been reported

higher. The more people follow COVID-19 news, the more anxious they are, and the anxiety

level among people with someone infected by COVID-19 is higher. Recently, Iranian researchers

have emphasized on paying special attention to providing psychosocial care during COVID-19

prevalence (Zandifar & Badrfam,2020, javadi & et al,2020) and the findings of the present study

addressed the necessity of the provision of such services.

In the study, the anxiety rate was also directly associated with a high prevalence of coronavirus

infection. Although it seems that old age increases the risk of COVID-19-related infection and

mortality, the findings show that anxiety level is significantly higher in 21 to 40 age group,

which seems the main cause to be concerned is about future and economic consequences because

this group is an active force in the society and they are mostly affected by unemployment,

inflation, and business closures. Unfortunately, most of the news broadcast on COVID-19 is

mostly disappointing and frustrating and sometimes such statistics come with some rumors, that

is why when one is constantly exposed to COVID-19 news, the level of anxiety goes higher.

People who reported having a person with coronavirus disease experience higher level of

anxiety, and this can be due to a variety of reasons, first of which can be the increased risk of

contracting the disease because they may have been in contact with the infected person;

secondly, he/she is worried about the health condition of his/her family, friends or colleagues.

The research findings show that people who most follow COVID-19 news experience more

anxiety and as WHO (WHO, 2020b) emphasized the media and the press should not only focus

on the negative aspects of producing and publishing news. Moghanibashi-Mansourieh A,

Assessing the anxiety level of Iranian general population during COVID-19 outbreak, Asian

Journal of Psychiatry (2020), doi: https://doi.org/10.1016/j.ajp.2020.102076

The Coronavirus disease 2019 (COVID-19) pandemic and the governmental restrictions

impact daily life in most parts of the world. Although restrictions are effective to prevent the

uncontrolled spreading of COVID-19, they might negatively affect mental health. It is common

for individuals to feel stressed and worried in times of pandemics, with fears of falling ill or

dying, being socially excluded in quarantine, or losing their work.

So far, there are a few empirical studies with regard to the effect of the pandemic on mental

health, some are already published as final papers and others are available as preprints. Ahmad et

al reported 25% suffering from anxiety in India, whereby work situation, income, gender, and

relationship status were correlated with mental health. A large Italian study including 18,147

individuals found 37% with posttraumatic stress symptoms, 17.3% with depression, 20.8% with

anxiety, 7.3% with insomnia, 21.8% with high stress, and 22.9%with adjustment disorder

whereby women and younger age were risk factors for worse mental health. In Portugal, 7.6%

suffered from severe depression symptoms, 9.1% from severe anxiety symptoms, 9.3% from

severe stress symptoms, and 12.4% from severe obsessive-compulsive symptoms with having

work and being more physical active protecting from mental health problems. In Brazil, mild to

moderate peritraumatic distress was found in 52% of the participants and severe distress in

18.8%. In Japan, 18.1% with moderate to severe depression and 11.4% to moderate to severe

anxiety, whereby younger age and unemployment were risk factors. Wang et al. found higher

mean scores for PTSD symptoms and more than half of the participants rated the psychological

impact of the outbreak as moderate or severe with an increase of 16.5% in moderate to severe

depressive symptoms and 28.8% in moderate to severe anxiety symptoms. Huang & Zhao

reported a higher prevalence of general anxiety disorder (GAD), especially in the younger

population. However, the cut-off score for GAD was set to a GAD-7 score higher or equal 9

points, which might lead to an overestimation of GAD. Patients with GAD have an average sum

score of 14 points, higher or equal 9 points corresponds with mild or moderate anxiety

symptoms. Another study from Spain measured levels of anxiety, stress, and depression during

COVID-19 and found lower levels of depression compared to the Chinese study mentioned

above. Interestingly, they reported higher mean levels of stress, anxiety, and depression in
younger adults. These results are in line with an study from India, which also found high scores

for depression, anxiety and stress in younger adults. Women and younger adults significantly felt

more anxiety about COVID-19 according to a study from Iran. These results suggest that

especially women and younger adults suffer from the COVID-19 crisis. Also, children seem to

suffer heavenly. Over 80% of parents noticed a perceived change in their children’s emotional

state and behavior, with more difficulties in concentrating (76.6%), boredom (52%), followed by

irritability, restlessness, nervousness, or feelings of loneliness. That was shown by a study on

1,143 parents in Italy and Spain, in which results were slightly higher for Spain compared to

Italy [18]. Besides younger individuals, infected individuals, individuals with pre-existing mental

health problems might be other groups more vulnerable to mental health burden due to COVID-

19 [4].

In Austria, measures against COVID-19 became obligatory on 16th of March 2020 (COVID- 19

lockdown). To summarize entering public places was strictly prohibited and only in some

exceptions allowed. The aim of the study was to evaluate mental health in a representative adult

sample in Austria after 4 weeks of lookdown considering relevant influencing factors such as

age, gender, income, and job situation. The current study explored mental health four weeks after

the COVID-19 lockdown in Austria. There are two major findings of this study. First, the

COVID-19 pandemic, as well as the lockdown, seems to have a major impact on mental health.

Second, young adults (<35 years), women, people without work as well as with low income, and

singles are significantly more burdened, physical activity has a positive association

with mental health.The impact of the current situation on mental health is also evident when

examining the number of participants scoring above established cut-offs for depression, anxiety,

and insomnia.
Depressive symptoms (21%) and anxiety symptoms (19 %) are higher during COVID-19

compared to previous epidemiological data. 16% rated over the cut-off for moderate or severe

clinical insomnia. The COVID-19 pandemic and lockdown seems particularly stressful for

younger adults (<35 years), women, singles, people without work, and low income.

C. Pieh, S. Budimir and T. Probst, The effect of age, gender, income, work, and physical activity

on mental health during coronavirus disease (COVID-19) lockdown in Austria, Journal of

Psychosomatic Research (2020), https://doi.org/10.1016/j.jpsychores.2020.110186

Besides the rising number of cases and fatalities with this pandemic, there has also been

significant socio-economic, political and psycho-social impact. Billions of people are

quarantined in their own homes as nations have locked down to implement social distancing as a

measure to contain the spread of infection. Those affected and suspicious cases are isolated. This

social isolation leads to chronic loneliness and boredom, which if long enough can have

detrimental effects on physical and mental well-being. The timelines of the growing pandemic

being uncertain, the isolation is compounded by mass panic and anxiety. Crisis often affects the

human mind in crucial ways, enhancing threat arousal and snowballing the anxiety.The

uncertainty of a new and relatively unknown infection increases the anxiety, which gets

compounded by isolation in lockdown.The modern world has rarely been so isolated and

restricted. Multiple restrictions have been imposed on public movement to contain the spread of

the virus. People are forced to stay at home and are burdened with the heft of quarantine.

Individuals are waking up every day wrapped in a freezing cauldron of social isolation, sheer

boredom

and a penetrating feeling of loneliness. Loneliness is often described as the state of being without

any company or in isolation from the community or society. It is considered to be a dark and
miserable feeling, a risk factor for many mental disorders like depression, anxiety, adjustment

disorder, chronic stress, insomnia or even late-life dementia (Wilson et al., 2007). It has been

well-documented that long periods of isolation in custodial care or quarantine

for illness has detrimental effects on mental well-being (Stickley & Koyanagi, 2016). If this self-

isolation and lockdown is prolonged, it is likely that chronic loneliness will decrease physical

activity leading to increased risk of frailty and fractures (Mushtaq et al., 2014). Similar trends of

increase in isolation and loneliness have been noticed among emergency workers and quaran

tined population in Wuhan, China. This has increased the prevalence of depression, anxiety,

post-traumatic stress disorders and insomnia in the population.

Social isolation in Covid-19:The impact of loneliness. DOI: doi.10.1177/0020764020922269

Local

Here in the Philippines, a significant number of people based on a survey conducted by

Premier Value Provider, Inc. has reported of having experienced high levels of stress, anxiety,

and depression. These mental health factors greatly affected mostly millennials and Gen Z part

of the population [ CITATION One20 \l 13321 ] . Another study by Nicomedes and Avila (2020)

showed that Filipinos exhibited moderate levels of symptoms of hypochondriasis which when

taken in context with avoidance behaviors, respondents living in Metro Manila at the time of the

study demonstrated less avoidance behaviors than those living outside. Furthermore, Baloran

[CITATION Bal20 \n \t \l 13321 ] conducted a cross-sectional study with students as his population

to determine their levels of knowledge, attitudes, anxiety and coping strategies during the

COVID-19 Pandemic. This study discovered Filipino students seem to have satisfactory
knowledge and high risk perceptions resulting in higher anxiety levels. Nicomedes, C. C., &

Avila, R. A. (2020). An Analysis on the Panic of Filipinos During COVID-19 Pandemic in the

Philippines. ResearchGate. doi: 10.13140/RG.2.2.17355.54565

Pandemic-related anxiety seem to vary depending on the degree of perceived of exposure.

Filipino respondents who had direct contact with COVID positive patients reported the higher

level of health anxiety (hypochondriasis) compared to those had no exposure at all (Nicomedes

and Avila, 2020). Their qualitative analysis showed the different negative and positive emotions

that the respondents have reported. The negative emotions include sadness, fear, worry, shock

and others while cautiousness, optimism, health consciousness, and compliance were some of the

positive themes. Other than that, the pandemic seemed to have triggered existential crises among

Filipinos (Nicomedes et al., 2020).

Nonetheless, it is a possibility that older adults reported less stress since Filipinos practice close

family ties (living together with extended family). The presence of the family members in the

household may have been a buffer from developing certain mental health concerns. The findings

in the present study are similar to the findings among Indian (Kazmi et al., 2020) and Italian

respondents (Mazza et al., 2020) who reported that younger participants had higher amount of

anxiety, stress and depression while milder symptoms were displayed by those who are 41 years

old and above.

The present study was able to quantify the COVID stress and determine how its factors relate to

different mental health concerns. The researchers found out that 40.7% percent experienced

moderate to severe stress, 60.3% had moderate to severe anxiety and 53.1% of the respondents

had moderate to severe depression. However, the survey is not a substitute to formal assessment.

Hence, these numbers may be an overestimation or an under estimation. Some of the facets of
CSS were significant predictors of anxiety, stress and depression. In a collectivistic country like

the Philippines, xenophobia was found to be negatively associated with mental health concerns

(e.g. Higher xenophobia scores was related to lower anxiety and vice versa). Interestingly, age is

negatively associated with COVID stress. Older respondents felt more secured against the risk

brought about by the pandemic. Furthermore, they are less likely to report mental health

concerns. There were no significant differences between the COVID stress of males and females.

Students and unemployed individuals are found to be highly vulnerable to COVID stress and its

implications. Employed participants reported lower amount of COVID stress. Those who

reported that they have an infected family member also reported lower COVID stress and they

also scored lower in DASS. Those who do not have an infected significant other did not differ

significantly from those who had an infected friend or relative. Results, especially the ones

involving xenophobia, age, and having an infected family member, can be treated as tentative

until replicated. Montano, R.T., & Acebes, K.L.(2020). Covid stress predicts depression, anxiety

and stress symptoms of Filipino respondents. Retrieved from

https://www.researchgate.net/publication/342335514

Depression

Foreign

Depression is another variable that is thought to be related to positivity. Depression leads to

symptoms related to the emotional domain such as sadness, misery, decreased attention and

desire, not enjoying the activities and life that were previously liked; psychomotor symptoms

such as slowing, fatigue, and agitation; cognitive symptoms such as feelings of guilt, pessimism,
inadequacy, worthlessness, and the thought of death; and vegetative symptoms such as disruption

in sleep and appetite and sexual aversion (Efilti 2018). All these symptoms can seriously impair

individuals’ adaptation to daily life. Depression, which can be seen in any age group and is

referred to as the common cold of psychiatry due to its prevalence, can be examined in several

groups. Severe symptoms of two weeks or more are referred to as major depressive disorder. In

this disorder, individuals may feel completely worthless or overly guilty and may want to harm

themselves. Major depressive disorder can physically affect a person by disrupting sleep,

appetite, and sexual drive (APA 2013; Beidel et al. 2014; Nolen-Hoeksema 2014).

The COVID-19 outbreak has prompted most countries opt for population confifinement and

social distancing measures as a way to control the spread of the virus. However, important

psychological effffects have been pointed out in previous confifinement experiences (Hawryluck

et al., 2004). The current pandemic has already shown signifificant psychological symptoms

related to anxiety, stress and depression (Wang et al., 2020).

The results show that, regarding the initial psychological responses of the members of the

University of Valladolid from March 28 to April 4, 2020, two weeks after the lockdown of the

Spaniard population due to the COVID-19 pandemic, 34.19% of participants reported moderate

to extremely severe depression symptoms; 21.34% of participants reported moderate to

extremely severe anxiety symptoms; and 28.14% reported moderate to extremely severe stress

symptoms. Also, 50.43% of participants obtained a score related to the psychological impact of

outbreak and lockdown as moderate or severe Impact of Event Scale (IES ≥ 26). A higher

prevalence of high scores on psychological impact measured by IES was observed compared to

the prevalence of large scores on depression, anxiety and stress measured by DASS-21. Similar

results were also recently found in China by Wang et al. (2020).

Psychological effffects of the COVID-19 outbreak and lockdown among students and workers of

a Spanish university. Doi: https://doi.org/10.1016/j.psychres.2020.113108

Swinton (2020) states that disasters like pandemics cause depression and complexity, which

happen because we may not be prepared to deal with such pandemic and emotional effects

attached to it.

Further, the overall impact of COVID-19 on the economy, daily life, and social activity, greater

social isolation, and the inability to work were associated with greater psychological difficulties

(Cao et al., 2020; Zhang et al., 2020). Although research on the psychological outcomes

associated with COVID-19 is limited, available findings are consistent with those obtained in

past studies on the psychological consequences of other pandemics. For example, Hawryluck et

al. (2004) found that quarantine during the 2003 SARS outbreak was associated with high rates

of depression (31.2%) and anxiety (28.9%). In addition, the lockdown conditions imposed by

governments are also creating symptoms of depression in the population (Lei et al., 2020; Huang

& Zhao, 2020).

The study aims at assessing the mental health of individuals during lockdown amid Covid-19

pandemic in India. This study aims at finding the prevalence of psychiatric symptoms viz.

Depression, Anxiety and Stress across gender, age etc.

The study revealed that Covid-19 is creating psychological distress among the individuals, as

there are restrictions due to lockdown people are forced to stay home. Individuals are going

through a crisis situation and feeling lack of control on their lives due to lockdown and

restrictions imposed upon them. Young adolescents and adult age group is facing uncertainty

with respect to career and professional life, jobs are at stake. Fear of infection is creating a panic
situation among them. There is increase in levels of Anxiety, Stress and Depression specially

among young group i.e.15-35 years however, the previous studies have shown that the Anxiety,

Stress and Depression are more prevalent in older age group i.e. 40-49 years age range. The

study is in tune with the findings of National Mental Health Survey of India 2016 which

suggested that Anxiety is higher in females whereas males are depressed and stressed as

compared to females. There is a significant difference between those who are employed and

those unemployed in respect to stress and depression whereas in case of anxiety there is no

significant difference between the both. Kazmi, S., Hasan, K., Talib, S., and Saxena, S. COVID-

19 and Lockdown: A study on the Impact on Mental Health. Retrieved from

https://ssrn.com/abstract=3577515

Quarantine or physical isolation, used for centuries to contain the spread of infection,

isolates those who have (or may have) been infected by a contagious disease to control or limit

contamination. Modern quarantine strategies have been imposed globally in an attempt to curtail

the spread of the COVID-19 infection including short- to medium-term lockdowns, voluntary

home curfew, restriction on the assembly of groups of people, cancellation of planned social and

public events, closure of mass transit systems and other travel restrictions. These restrictions

imposed because of the COVID-19 outbreak, have caused significant disruption globally, and to

individuals, families, communities and whole countries. They have affected much (if not all) of

the world's population; drastically altering what is familiar, and complicating aspects of daily life

that were previously simple and uncomplicated. For many people, daily life is changed

dramatically, and the “normal” ways of life as we know them are suspended indefinitely.

Imposed quarantine or isolation is an unfamiliar and unpleasant experience that involves

separation from friends and family, and a departure from usual everyday routines. Many usual
activities are prohibited, and in some settings, such as in corrections and other prison contexts,

isolation is a form of punishment or censure. Isolation is known to cause psychosocial problems,

especially for those recognised as vulnerable. While all humans are at risk of psychological harm

when kept in isolation, the most vulnerable in these situations are children and adolescents, older

adults, minority groups, those from lower socio-economic groups, females and people with pre-

existing mental health conditions (Perrin, McCabe, Everly & Links, 2009). Social isolation

associated with quarantine can be the catalyst for many mental health sequelae, even in people

who were previously well. These can include acute stress disorders, irritability, insomnia,

emotional distress and mood disorders, including depressive symptoms, fear and panic, anxiety

and stress because of financial concerns, frustration and boredom, loneliness, lack of supplies

and poor communication (Bai et al., 2004;Brooks et al., 2020;Cava, Fay, Beanlands, McCay, &

Wignall, 2005;Desclaux, Badji, Ndione, & Sow, 2017;Hawryluck et al., 2004).

Moreover, the longer a person is confined to quarantine, the poorer the mental health outcomes;

specifically, symptoms of post-traumatic stress disorder (PTSD), avoidance behaviour and anger,

may be seen (Brooks et al., 2020). Longer times in quarantine are particularly associated with

increasing symptoms of PTSD, which may indicate that quarantine itself can be perceived and

experienced as a traumatic event (Hawryluck et al., 2004). Other stressors associated with

quarantine can include irregular or less supply of usual supplies, such as food items and

medication, and restriction of routine daily activities (Brooks et al., 2020).

Life in the pandemic: Social isolation and mental health DOI: 10.1111/jocn.15290

Italy was the first European country that entered a nationwide lockdown during the COVID-

19 pandemic. Since quarantine can impact on mental health, the study aimed to estimate the

prevalence of depressive symptoms, anxiety symptoms and sleeping disturbances in the Italian
population during lockdown. The quarantine effects have already been explored during past

outbreaks, such as during the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003

and Ebola in 2014, indicating that the MH impact can be broad, massive and long-lasting.

Among the consequences of quarantine, there are acute stress disorders, anxiety, irritability, poor

concentration and indecisiveness, deteriorating work performance, post-traumatic stress

disorders, high psychological distress, depressive symptoms and insomnia. The psychological

response during the COVID-19 quarantine has been studied more extensively in China, where

several studies have already been carried out. Findings from China have reported a prevalence of

depression during quarantine up to 37%, and a prevalence of anxiety up to 35%. In particular, a

comparison study found significant differences in the prevalence of depression and anxiety

between people in quarantine (22.4% and 12.9%, respectively) and people not in quarantine

(11.9% and 6.7%). The prevalence of Mental Health issues in the present study is higher than the

prevalence recorded in the Italian population before the lockdown: the latest data by the Italian

National Statistical Institute indicated a depressive symptoms prevalence over the last two weeks

of 5.4% and a severe anxiety prevalence over the last year of 4.2% [22]. During the first weeks

of lockdown, the response of the Italian general population was estimated through the

Depression, Anxiety and Stress Scale-21. Moderate to extremely high levels of depression were

reported in 32.4% and 21.2% of the population, while moderate to extremely high levels of

anxiety was reported in 18.7% and 32.6%. Moreover, participants experiencing poor sleep were

40.5% before lockdown and 52.4% during lockdown (Pittsburg Sleep Quality Index).

Furthermore, several pieces of research into Mental Health outcomes among the general

population during the COVID-19 quarantine have been conducted in China and beyond.
Overall, the results fconducted from a national cross-sectional study was performed during the

last 14 days of the Italian lockdown (between April 19th and May 3rd 2020) through an online

questionnaire, distributed through social networks from the institutional pages of the Department

of Public Health Sciences (University of Torino) seem consistent with those studies, which have

reported a prevalence of depressive symptoms from 16.5% to 37%, a prevalence of anxiety

symptoms from 12.9% to 35.1%, and a prevalence of sleep disturbances from 18.2% to 52.4%.

Several studies indicated that females were more prone to report depression and anxiety or

insomnia, while others reported a non-significant interaction of gender with anxiety and

depression and sleep quality, suggesting that men and women might be equally concerned about

this pandemic . Conversely, Wang et al. reported that the male gender was significantly

associated with higher scores of anxiety and depressive symptoms. Young adults have been

reported to be more likely to present depression, anxiety [6,7,24,25] and reduced sleep quality.

Ozamiz-Etxebarria and colleagues suggested that one explanation could be the fact that a section

of young people can be university students, which usually report high levels of mental health

issues [27,28] and might experience additional stress due to the necessity to adapt their

university career [9,26]. Indeed, delays in academic activities due to COVID-19 have been

correlated with anxiety. Besides, young individuals are usually engaged in short-term

employment, this being an additional risk-factor for poor Mental Health outcomes . Lastly,

younger people might experience higher anxiety levels because they are likely to reach a greater

amount of information through social media, which might influence stress.

The study showed that the Italian general population reported a high prevalence of Mental Health

issues during the last weeks of lockdown.

Effects of Covid-19 Lockdown on Mental Health and Sleep Disturbances in Italy.Retrieved from

www.mdpi.com/journal/ijerph doi:10.3390/ijerph17134779

In a study among Chinese population, Gao et al.’s (2020) results show a much higher

prevalence of depression, anxiety and combination of depression and anxiety (CDA) compared

to the national prevalence rates in a 2013 study (Huang et al., 2019). They added that 82% of

their respondents reported frequent usage of social media. Similar findings have been reported by

Mazza et al., (2020) who surveyed Italian respondents. Wang, Pan, Wan, Tan, Xu, McIntyre et

al. (2020) conducted a longitudinal study (from January to March 21, 2020) which showed that

there was no statistically significant difference in the reported levels of depression, anxiety and

stress symptoms despite the sharp increase in the number of COVID-19 cases.

It is important to note that this is the first pandemic wherein people utilize social media as one of

the main channels in disseminating information (Bao et al., 2020). The World Health

Organization (2020b) coined the term “infodemic” which refers to the spread of information,

whether true or false, about the said virus. Torales et al. (2020) specified that people seek

information during a community crisis to stay informed. It has also been observed that people

have two common reactions to exaggerated media reports. Some individuals may react with

excessive fear while some others may dismiss the information, calling it absurd (Taylor, 2019 p.

73). Other than the spreading virus, fear may also be contagious. Montano, R.T., & Acebes, K.L.

(2020). Covid stress predicts depression, anxiety and stress symptoms of Filipino respondents.

Retrieved from https://www.researchgate.net/publication/342335514.

Local
The management of lockdown presents a perfect storm for mental distress for older people by

enforcing isolation and heightening perceptions of risk of death and illness. While gradual

release from lockdown will maintain protection of those most at risk from COVID-19, older

people will experience social isolation for the longest period as the over 75s carry the highest

mortality risk (WHO,2020). Isolation is strongly linked to depression, anxiety and cognitive

decline, and reduces resilience factors such as self-worth, sense of purpose and feeling valued

(Novotney, 2019).

The impact of COVID-19 on the mental health of older Filipinos, who are more vulnerable to the

effects of COVID-19, and describe ways that healthcare workers can help alleviate the negative

impact on their mental health to the extent possible within the limited resources available in the

Philippines. Since the spread of COVID-19 is related to population density (Rocklov and Sjodin,

2020), the high densities in the Philippines where people are in relatively close contact with each

other in both personal and public spaces make social distancing difficult, facilitate virus spread

more easily, and lead to higher rates of infection and death. Adults 65 years and older and those

with underlying medical conditions such as cardiovascular disease, hypertension and diabetes are

at higher risk for developing more serious complications from COVID-19 (Applegate and

Ouslander, 2020; Rocklov and Sjodin, 2020). It is unclear yet whether the Philippine lockdown

is working as the health system in the country is further strained with continued growing crisis.

While the lockdown and other public health measures are designed to keep individuals from

getting infected with COVID-19, there are unintended consequences on the mental health of

older individuals who are at most risk and in whom the strictest quarantine measures apply. The

onset of a new pandemic for which people had no prior experience in dealing with has wrought

fear on the population, particularly for older people because they are considered at higher risk for
the disease. This has led them to be housebound, venturing out only when extremely necessary.

It is not easy to cope with prolonged confinement, and amidst mandated isolation, seniors may

experience depressive symptoms, loneliness, pessimism, deteriorations in cognition, and

disruption in sleeping patterns (Avasthi and Grover, 2018). These are consistent with the known

psychological reactions of stress, anxiety, loneliness and agitation in a pandemic (Meng et al.,

2020). A survey showed that 37.1% of elderly amidst the COVID-19 pandemic in China showed

significant depression and anxiety (Qiu et al., 2020).The disruption of important day-to-day

activities for older individuals can pose negative impacts on elderlies’ cognitive impairment,

leading to poorer mental health, low quality of life (Santini et al., 2020), and anxiety (World

Health Organization, 2020). During quarantine, persistent symptoms include regular and

debilitating worry about routine activities (Subramanyam et al., 2018), and lack of social events

and support also heighten stress and decrease coping skills (Avasthi and Grover, 2018);

therefore, older individuals tend to fixate on the uncertainty of this pandemic and feel agitated

(Huang and Zhao, 2020). Overall, community quarantine poses symptoms associated with late-

life anxiety and depression. Older Filipinos are disproportionately affected by COVID-19. While

they constitute less than 8% of the total population, they comprise one-third of all cases and

more than half of all deaths related to COVID-19. This underscores what is widely known that

older individuals are at a higher risk for COVID-19, with greater morbidity and mortality for this

disease. Older Filipinos not only suffer physically but also emotionally, spiritually, and socially.

COVID-19 and Mental Health of Older Adults in the Philippines: A Perspective from a

Developing Country. Retrieved from https://www.cambridge.org/core/terms.

doi.org/10.1017/S1041610220000757
Synthesis

There is no question that novel diseases like COVID-19 will cause widespread fear, panic,

anxiety and depression. Pandemic and quarantine may have a negative impact on mental health.

As this pandemic and associated quarantine , self- isolation and social distancing interventions

continue, the number of cases of mental health related such as anxiety and depression will

increase and there is also a need for systematic action to foster mental health and well-being

among most needed individuals.

The studies give us a deeper insight into the research, from the experiences of the respondents

during COVID-19 crisis, how they responded to the experiences as cited in the various

literatures.

Research Design and Methodology

This chapter presents the necessary approaches, methods and procedures in meeting the

objectives of this study. It includes the research method, the respondents, the research instrument

used, sampling and the data-gathering procedure.

Research Design

The researcher will use descriptive- correlational with quantitative approach. (Please look for

literature that will conceptually define descriptive-correlational and quantitative approach in

research

Respondents of the Study

In this study, respondents are between 23-39 years old. They are given a short aim of the study

before the data collection. Socio-demographic profile such as sex, education, marital status and

employment were also collected to be able to identify if such information affects or contribute to

level of anxiety and depression.

Sampling Procedure

Purposive Sampling technique is utilized in this study. The researchers choose this technique

because its economical, uncomplicated and can be done without delay. Purposive sampling is a

non-probability sampling technique where the researchers choose an individual within their

network that fits the criteria for the study. Like in this case, people are restricted to move outside

their homes due to the fast spreading disease the Covid-19, having a face-to-face data collection

is impossible. Purposive sampling is a good choice for study because it’s convenient, well-suited

in high frequency of population and easy to administer.

Research Instrumentation

An online questionnaire is a practical way to quantify information collected from the respondents

to validate objectively the research hypotheses. The questions are all associated with anxiety and

depression that the millennials feel or experience. The respondents shall engage in the survey

that has three (3) parts. Part one is the presentation of the aim of the study, consent in

participating to the study and short data collection of the demographic of the respondents that

will depict the socio-characteristic such as age, sex, education, marital status, and employment.

The second part is the assessment relative to the level of anxiety.--- edit please In this paper, the

researchers choose the 7-item General Anxiety Disorder scale (GAD-7; Spritzer et. al., 2006)
have a 13-item based on the criteria for general anxiety disorder that assess: anxiousness, able to

stop or control worrying, too much worrying about different things, unable to relax, restless,

easily annoyed or irritable and feeling afraid but some of the questions have been modified to

achieve what is being measured as the study wanted to determine the level of anxiety of the

given population about the Covid-19 crisis. GAD-7 have a good reliability score (Cronbach's

alpha= 0.89), good criterion, factorial and procedural validity based on a comparison of scores

derived from the self-report scales from the clinician-administered versions of the same scales

(Spitzer et. al., 2006). The third part is the assessment relative to the level of depression. To

assess the level of depression this study uses the 9-item Patient Health Questionnaire (PHQ-9),

that predict the presence and severity of depression. PHQ-9 have a good reliability and validity

score of Cronbach's alphas= 0.86-0.89, were two different patient population involved. Internal

consistency of the tool shown to be high (Kroenke, K. & Spitzer, R.L. & Williams, Janet. (2001).

Both the GAD-7 and PHQ-9 developed to asked questions about the experiences of the

respondents how often they feel anxious and depressive during the last two weeks. A 4-point

Likert-scaling method is used to determine the weight of each item in the questionnaire.

Data Gathering Procedure

The selection of the respondents is done through purposive sampling. Each respondent needs to

answer a three-form survey questionnaire: (1) a short introduction of the aim of the study and

consent in which they can decide to participate or not. (2) Socio-demographic collection that

includes age, sex, marital status, education and employment. (3) Quarantine Anxiety Scale and

Covid-19 Depression Questionnaire, two self-made tests in which the respondents rate their

feelings or emotional state that measures the level of anxiety and depression about the Covid-19
c. (4) Delivered and collected via google forms, only completely answered forms is used in

analyzing the data. (5) The data from the questionnaires is analyzed using SPSS.

Statistical Treatment

The following statistics will be utilize based on the conduct of the research

Percentage. Proportion or representation in relation to a whole.

Mean. This will be used to get the average anxiety level and depression level per demographic profile.

T-Test for Independent Samples. This inferential statistic will be used to check for significant

difference between 2 groups such as sex (male versus female)

One-Way Analysis of Variance. This inferential statistic will be used to check for significant for

more than 2 groups such as highest educational attainment (elementary graduate vs. high school

graduate vs college graduate).

Pearson’s r Correlation Coefficient. This inferential statistic will be used to check significant

difference between anxiety and depression.