The Saudi Ministry of Health announced the first case of COVID-19 on 2 March 2020 [24], after 12 weeks from the spread of the pandemic in sixty-six countries around the globe [5]. Up to 2 July 2020, the total number of cities reporting at least one case was 197 and a total number of deaths up to 1698 cases across the Kingdom. Makkah region has the most cases (57,548 cases) than the capital region Riyadh which had a total of 52,936 cases [23]. In only 1 month (March 2020), the Saudi authorities had restricted sports events; closed educational facilities, parks, and malls; and suspended domestic public transportation, and had started partial curfew [29, 32].
The control measures such as curfew, lockdown, and social distancing had observed differences in controlling the spread of the disease around the Kingdom [32]; however, they contribute to psychological illnesses such as anxiety, depression, panic disorder, and distress [1, 12, 26]. The prevalence of some mental conditions varies from one country to another. In China, in a study of 52,730 participants, psychological distress affected almost 35% of their participants [26]. Similarly, a couple of reviews in Italy found an extremely high range level of depression among 15.4% of Italians, 11.5% extremely anxious, 12.6% extremely stressed [21], 57% with sleeping problems, and 41.8% suffers from high distress [10]. In previous studies, women, elderly, and young are more vulnerable to develop stress and suffer from post-traumatic syndrome after pandemics [21, 26, 28], and it is reported that excessive exposure to news, social media, and TV influences by exuberating stress [1, 26]. The psychological effect of COVID-19 has been also reported in Saudi Arabia. Different ranges of distress were reported among 40% of the general Saudi population as a result of COVID-19 as reported by Al-Hanawi et al. [2]. Moreover, Alkhamees et al. [3] reported moderate to severe psychological impact among 23.6% of the Saudi general public. Both previously mentioned studies found higher rates among females, young people, and health practitioners [2, 3]. While literature established the psychological impact of the pandemic on Saudi population, there was limited discussion of the factors influencing it. Yet, Alkhamees et al. [3] found that commitment to infection control preventive measures is negatively significantly associated with stress and anxiety levels. The psychological distress is a reaction to a stressor that can cause timely or permanent dysfunction [27]. Its combined symptoms such as depression, anxiety, difficulty to sleep, and lethargy, and all may vary from person to person [17]. The person may experience coping difficulty, fluctuations of emotions, and feeling irritable, mostly [27].
The Saudi authorities noted the rise of psychological disorder and several health messages and guidelines distributed to the public. For example, Saudi CDC [11] provided a preventive guide for mental and social health focused on prevention and stress and fear management during the pandemic. They targeted the general population and how to take care of children and the elderly as well as tips for healthcare providers and managers of health facilities. The National Centre for Mental Health Promotion [25] promoted free call counseling center with mental health specialist for help during the pandemic as well as provided some health messages on psychological tips during lockdown such as how to increase resilience and to deal with loneliness and isolation especially with elderly and with special need family members. Some hospitals act by educating the public about mental health, such as King Faisal Specialist Hospital and Research Center had provided social media messages on how to manage stress and anxiety during the pandemic [16].
The aim of this study was to explore the psychological distress and the factors affecting it among residents of Saudi Arabia during the pandemic COVID-19. By understanding the current situation of psychological distress in Saudi Arabia, the health practitioner can develop rapid protection and intervention programs that enhance mental health, especially among the distressed population.