The Psychological Impact of COVID-19: A Comparative Analysis of Pre-Lockdown and During-Lockdown Periods Among Saudi General Population

Junaid Amin,1 Ammar Ahmed Siddiqui,2 Muhammad Ilyas,3 Salman Amin,4 Mishal M Aldaihan,5 Hamayun Zafar5 1Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, 2440, Saudi Arabia; 2Preventive Dental Sciences, College of Dentistry, University of Ha’il, Ha’il, 2440, Saudi Arabia; 3Department of Management & MIS, College of Business Administration, University of Hail, Ha’il, 2440, Saudi Arabia; 4Department of Oral and Maxillofacial Surgery, University College of Medicine and Dentistry,The University of Lahore, Lahore, Pakistan; 5Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi ArabiaCorrespondence: Junaid Amin, Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, 2440, Ha’il, Saudi Arabia, Tel +966-580931017, Email [email protected]: Prior research has revealed substantial psychological impacts of COVID-19 among the general population. However, there is a noticeable gap in studies addressing the enduring anxiety levels before and during lockdown periods of the COVID-19 pandemic.Objective: The study assessed and compared the psychological impact of the COVID-19 pandemic before and during lockdown periods among the general population in Saudi Arabia.Methods: A validated and reliable General Anxiety Disorder (GAD)-7 instrument was used to quantify stress levels by measuring anxiety. Nonprobability snowball sampling was used to collect data from 516 participants residing in Saudi Arabia. The difference in scores for each of the seven related questions of GAD-7 was determined using a non-parametric Wilcoxon rank test.Results: A mild level of anxiety was consistently observed both before and during the lockdown, as indicated by GAD-7 scores of 6.17 (SD = 5.5) before the lockdown and 6.42 (SD = 5.7) during the lockdown. There were no differences in GAD-7 scores before 6.17 (SD = 5.5) and during 6.42 (SD = 5.7) the lockdown periods. However, levels of moderate anxiety increased by 5% during the lockdown period. Anxiety levels before and during lockdown were significantly associated with gender (χ 2 (3, n = 516) =11.23 p = 0.01) and employment status (χ 2 (3, n = 516) = 9.41 p = 0.024). Among the GAD-7 questionnaire items, item number 1 (“Feeling nervous, anxious, or on edge”) (p= 0.00) and item number 7 (“Feeling afraid as if something awful might happen”) (p= 0.025) showed a significant association with anxiety levels before and during the lockdown periods.Conclusion: The enduring prevalence of mild anxiety, persisting both before and during the lockdown periods, underscores the profound impact of COVID-19 on the mental health of the general population in Saudi Arabia.Plain Language Summary: This study aimed to understand how the COVID-19 pandemic affected the mental well-being of people in Saudi Arabia, specifically looking at anxiety levels before and during lockdown. We used a survey with 516 participants and found that, overall, people reported mild anxiety both before and during the lockdown. However, there was a 5% increase in moderate anxiety during the lockdown.Interestingly, we discovered that gender and employment status were linked to anxiety levels. Women and those with certain employment statuses reported different anxiety levels. Specific questions in the survey, such as feeling nervous or afraid, were mainly associated with anxiety during both periods.In conclusion, even though anxiety levels were generally mild, some groups and specific concerns showed differences. This information can help us understand how to better support people’s mental health during challenging times like a pandemic.Keywords: anxiety, COVID-19, GAD-7, general population, psychological impact, Saudi Arabia