Fear and depression during the COVID-19 outbreak in Cameroon: a nation-wide observational study

Siewe Fodjo, Joseph Nelson; Ngarka, Leonard; Njamnshi, Wepnyu Y.; Nfor, Leonard N.; Mengnjo, Michel K.; Mendo, Edwige Laure; Angwafor, Samuel A.; Atchou Basseguin, Jonas Guy; Nkouonlack, Cyrille; Njit, Edith N.; Ahidjo, Nene; Chokote, Eric S.; Dema, Fidèle; Fonsah, Julius Y.; Tatah, Godwin Y.; Palmer, Nancy; Seke Etet, Paul F.; Palmer, Dennis; Nsagha, Dickson S.; Etya’ale, Daniel E.; Perrig, Stephen; Sztajzel, Roman; Annoni, Jean-Marie; Zoung-Kanyi Bissek, Anne-Cécile; Leke, Rose G. F.; Abena Ondoa Obama, Marie-Thérèse; Nkengasong, John N.; Colebunders, Robert; Njamnshi, Alfred K.

BACKGROUND: The COVID-19 pandemic has been associated with significant psychological and social distress worldwide. We investigated fear and depression among adults in Cameroon during different phases of the COVID-19 outbreak. METHODS: An online survey was conducted in Cameroon from June–December 2020 using a structured questionnaire. Socio-demographic data and information regarding COVID-19 history were obtained. Fear and depressive symptoms were assessed using the Fear of COVID-19 score (FCV-19S) and the Patient Health Questionnaire (PHQ-9), respectively. Responses were clustered in weeks to better appreciate their evolution over time. RESULTS: Overall, 7381 responses from all ten regions of Cameroon were analysed (median age: 30 years, 73.3% male). The prevalence of depression (PHQ-9 score ≥ 10) was 8.4%, and that of high fear of COVID-19 (FCV-19S scores ≥19) was 57.4%. These rates were similar across genders, age-groups, and region of residence. While mean weekly PHQ-9 scores remained fairly stable throughout the study period (range: 2.53–3.21; p = 0.101), mean FCV-19S scores were highest during the early weeks but decreased significantly thereafter (from 20.31 to 18.34; p < 0.001). Multivariate analyses revealed that having a postgraduate degree, a history of quarantine, flu-like symptoms during the past 14 days, and higher FCV-19S scores were associated with more severe depressive symptoms, while obtaining COVID-19 information from various sources reduced the odds for depression. CONCLUSION: Depression amidst the COVID-19 crisis is less prevalent in Cameroon than in other countries. Prompt and widespread dissemination of adequate COVID-19 information may reduce the risks for depression by dispelling fear and anxiety among Cameroonians.