Prevalence of distress symptoms during COVID-19 pandemic- a comparative community study from South India

Geetha Rajasekar, Ramakrishnan Krishnan, Arunkumar Nagasundaram, Karan Louis John, Dheenadahyalan Nagarajan


Background: After the reported first case of COVID-19, all the existed preventive measures were augmented in the country.2The state had a lockdown from 23 March 2020 onwards with various phases of unlocking. The study aimed to compare the mental health symptoms among urban and rural populations experiencing the pandemic and lockdowns.

Methods: This was a community-based cross-sectional study done in the Trichirapalli district in south India. 503 participants were selected by random sampling stratified for gender, rural area, urban area, and age. The study was done in June and July 2020 with the Depression anxiety stress scale (DASS21) questionnaire.

Results: The DASS21 questionnaire elicited depressive symptoms, anxiety symptoms, and stress symptoms. The prevalence of nil symptoms among the study population was 26.2%, 4.6% had any one symptom, 12.5% had any two symptoms, 56.7% had all three symptoms. Among the depressive symptoms, 8.3% had mild, 13.3% moderate, 6.6% severe, and 1.4% extremely severe symptoms. 10.5% had mild symptoms, 15.9% moderate, 4.6% severe, and 6% extremely severe anxiety symptoms. About 8% experienced mild symptoms, 5.2% moderate, 2.2% severe, and 0.2% extremely stress symptoms. Age less than or equal to 42 years had twice the odds OR 2.02, 95% CI (1.328 to 3.074) of having three symptoms. The rural population had twice OR 2.32, 95% CI (1.526 to 3.540) the odds of having all three symptoms. The upper socioeconomic status (SES) had 0.384 times lesser odds of developing all three symptoms and is a protective factor with OR 0.616, 95% CI (0.397 to 0.956).

Conclusions: The rural population, age less than or equal to 42 years had high odds of having all three symptoms of distress. The high-income group had less odds of having the symptoms compared to other income groups.


Community study, Comparative community, COVID-19, DASS21, Depression, Psychological

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