Obse a ional S udy
1
Medicine®
Anxie y and ea o COVID-19 in he UK gene al
popula ion
A c oss-sec ional s udy
C is inaMo gado-Toscano, RNa,b, JuanGómez-Salgado, PhDc,d,* , Ja ie Fagundo-Ri e a, PhDe,
YolandaNa a o-Abal, PhD , LucasRod íguez-Jiménez, RNg, José An onioClimen -Rod íguez, PhD ,
ReginaAllande-Cussó, PhDh
Abs ac
The e is s ill a gene alized eeling o unce ain y in he popula ion due o he co ona i us disease 2019 (COVID-19) pandemic, as
es ic ions on daily ou ines and social con ac , accompanied by a la ge numbe o in ec ions, nega i ely a ec di e en a eas
o people’s li es and, he e o e, hei men al heal h. The aim o he p esen s udy was o assess he p esence o anxie y and ea
o COVID-19 in he gene al UK popula ion, using he Anxie y and Fea o COVID-19 Assessmen Scale (Ansiedad y Miedo al
COVID-19) (AMICO) scale. A desc ip i e, c oss-sec ional s udy based on a ques ionnai e was conduc ed in a sample o he UK
gene al popula ion in 2021. Socio-demog aphic and employmen a iables we e included. The AMICO scale was included o
measu e ea and anxie y abou COVID-19. The ela ionship be ween a iables was s udied wi h a ca ego ical eg ession analysis.
In gene al, pa icipan s ega ded hemsel es as well-in o med abou he pandemic, al hough 62.6% had only ecei ed 1 dose o
he accine. Rega ding he AMICO scale he o al sco e was 4.85 (ou o 10; s anda d de ia ion 2.398). Women showed highe
sco es o he AMICO han men. The bi a ia e analysis e ealed s a is ically signi ican di e ences in ela ion o sel -con idence,
amoun o in o ma ion ecei ed, and accina ion a iables as ela ed o he mean AMICO sco es. An a e age le el o anxie y and
ea o COVID-19 is shown in he gene al UK popula ion, which is lowe han mos o he s udies ha assessed he impac o he
pandemic on he gene al popula ion.
Abb e ia ions: AMICO = Anxie y and Fea o Co id-19 Assessmen Scale (Ansiedad y Miedo al COVID-19), COVID-19 =
co ona i us disease 2019, EFA = explo a o y ac o analysis, FCV-19 = ea o COVID-19.
Keywo ds: anxie y, COVID-19, ea , psychological dis ess, UK
1. In oduc ion
In Decembe 2019, he i s case o pneumonia caused by he
new o m o co ona i us was de ec ed in Wuhan, China, wi h
se e e acu e espi a o y synd ome co ona i us 2 con i med as
he causa i e agen on Janua y 7, 2020.[1] The eme gence o his
new i us igge ed a con using si ua ion, as i quickly sp ead
o o he p o inces and egions o he coun y and subsequen ly
wo ldwide and was cha ac e ized by an ex emely high in ec-
ion a e and ela i ely high mo ali y.[2]
Thus, on Janua y 30, 2020, he Wo ld Heal h O ganiza ion
decla ed his disease a “public heal h eme gency o
in e na ional conce n.”[3] The UK was one o he i s coun-
ies a ec ed in Eu ope, wi h i s i s 2 con i med cases o
co ona i us disease 2019 (COVID-19) de ec ed on Janua y
31, 2020.[4] F om his poin onwa ds, cases began o inc ease
exponen ially, leading o he decla a ion o a lockdown o
he en i e UK popula ion om Ma ch 23, 2020, un il July 31,
2020.[5] Howe e , he UK’s ini ial esponse o he pandemic
was slow.[6] Due o he la ge olume o in ec ed people, he e
was e en a need o c ea e hospi als wi h he speci ic pu pose
o ea ing hese pa ien s, as was he case o he “Nigh ingale
Hospi al,” which was buil in London o ecei e up o 4000
The au ho s ha e no unding o disclose.
The au ho s ha e no con lic s o in e es o disclose.
The da ase s gene a ed du ing and/o analyzed du ing he cu en s udy a e
a ailable om he co esponding au ho on easonable eques .
Pe mission o conduc his s udy was ob ained om he Na ional Heal h Se ice
(NHS) Heal h Resea ch Au ho i y, IRAS p ojec ID 283849, REC e e ence 20/
HRA/3997. This s udy also complied wi h he guidelines se in he Decla a ion
o Helsinki ega ding e hical p inciples o medical esea ch in ol ing human
subjec s.
a Heal h Sciences Doc o a e School, Uni e si y o Huel a, Huel a, Spain, b
Heal h Sciences Resea ch Uni : Nu sing, Uni e si y o Coimb a, Coimb a,
Po ugal, c Depa men o Sociology, Social Wo k and Public Heal h, Facul y
o Labou Sciences, Uni e si y o Huel a, Huel a, Spain, d Sa e y and Heal h
Pos g adua e P og amme, Uni e sidad Espí i u San o, Guayaquil, Ecuado , e
Cen o Uni e si a io de En e me ía C uz Roja, Uni e si y o Se ille, Se ille, Spain,
Facul y o Educa ion Science, Uni e si y o Huel a, Huel a, Spain, g Eme gency
Depa men , Royal F ee London NHS Founda ion T us , h Depa men o Nu sing,
Uni e si y o Se ille, Se ille, Spain.
* Co espondence: Juan Gómez-Salgado, Depa men o Sociology, Social Wo k
and Public Heal h, Facul y o Labou Sciences, Uni e si y o Huel a, A enida T es
de ma zo, s/n, Huel a 21007, Spain (e-mail: [email p o ec ed]).
Copy igh © 2023 he Au ho (s). Published by Wol e s Kluwe Heal h, Inc.
This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion-Non Comme cial License 4.0 (CCBY-NC), whe e i is
pe missible o download, sha e, emix, ans o m, and buildup he wo k p o ided
i is p ope ly ci ed. The wo k canno be used comme cially wi hou pe mission
om he jou nal.
How o ci e his a icle: Mo gado-Toscano C, Gómez-Salgado J, Fagundo-Ri e a
J, Na a o-Abal Y, Rod íguez-Jiménez L, Climen -Rod íguez JA, Allande-Cussó
R. Anxie y and ea o COVID-19 in he UK gene al popula ion: A c oss-sec ional
s udy. Medicine 2023;102:10(e33045).
Recei ed: 18 Oc obe 2022 / Recei ed in inal o m: 30 Janua y 2023 / Accep ed:
31 Janua y 2023
h p://dx.doi.o g/10.1097/MD.0000000000033045
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Mo gado-Toscano e al. • Medicine (2023) 102:10 Medicine
pa ien s wi h COVID-19.[6] Since hen, up o 6 wa es o in ec-
ions ha e occu ed in Eu ope, o cing coun ies such as he
UK o ake d as ic measu es o cu b he numbe o in ec ed
people. Cu en ly, 11,518,255 cases and 147,723 dea hs ha e
been con i med.[7]
To add ess his si ua ion, on Decembe 8, 2020, he UK
became he i s coun y o ini ia e a COVID-19 accina ion
p og am. Ini ially, accina ion was p io i ized o he elde ly
o e 80 yea s o age and on line heal hca e wo ke s,[8] each-
ing 47,051,876 people who a e cu en ly ully accina ed, ha
is, 70.40% o he UK popula ion.[7]
Howe e , al hough accina ion has conside ably educed he
likelihood o de eloping se e e disease om he i us, i has no
p o ed o be an e ec i e measu e o educe he numbe o in ec-
ions due o he mul iple mu a ions he i us has unde gone. All
his leads o a gene alized eeling o unce ain y in he popula-
ion, inc eased by he es ic ions on mobili y and social con ac
imposed in all coun ies, hus nega i ely a ec ing di e en a eas
o people’s li es and men al heal h.[9]
In gene al, he e ec s caused by COVID-19 on he physical
and men al heal h o he popula ion ha e been and con inue o
be s udied. Apa om he medical consequences o COVID-19,
his pandemic has also been cha ac e ized by i s p opaga ion
o e ime, hus de ining he e m “co onaphobia” o designa e
he long- e m men al illnesses ela ed o he pandemic.[10]
This aises he need o enewal and o he de elopmen o
ools ha measu e speci ically pandemic- ela ed ea and anx-
ie y in he gene al popula ion. One o he i s scales designed
o his pu pose was he ea o COVID-19 (FCV-19).[11] The
Anxie y and Fea o Co id-19 Assessmen Scale (Ansiedad y
Miedo al COVID-19) (AMICO) was designed ollowing he
me hodology p oposed by Eps ein e al.[12] Ini ially, i was
based on he 10 i ems o he FCV-19 scale, which we e e alu-
a ed by a panel o expe s p io o he psychome ic analyses
conduc ed o ha s udy.[11] Wi h hese 10 i ems, a ansla-
ion/back- ansla ion p ocess was applied and he c oss-cul-
u al adap a ion was s udied by a panel o expe s. I was
made up o 10 subjec s, namely p o esso s and esea che s
om di e en Spanish uni e si ies, wi h he academic le el
o Doc o o O icial Mas e and whose a eas o knowledge
we e public heal h, amily medicine, clinical psychology, nu s-
ing, and social wo k. In addi ion o he 10 i ems, he panel
o expe s p oposed and ag eed, using he Delphi echnique,
o conside 8 new i ems measu ing he anxie y cons uc . The
18 i ems we e hen submi ed o a new Delphi ound. The
explo a o y ac o analysis (EFA) p oduced a dimensional
ma ix o 16 i ems and 2 ac o s, explaining 64.8% o he
a iance (Kaise -Meye -Olkin es = 0.94; Ba le es : P =
.001). The eliabili y s udy p o ided a C onbach α alue o
0.92. The esponse op ions o he AMICO scale ange om 1
o 10 poin s, whe e 1 co esponds o “s ongly disag ee” and
10 o “s ongly ag ee.”[10] Likewise, he AMICO scale was
alida ed concu en ly wi h he S a e-T ai Anxie y In en o y
ques ionnai e.[13]
As in Spain, nu ses in he UK ha e el o e whelmed by he
hea y wo kload. Likewise, he gene al popula ion has also been
se e ely a ec ed in his espec . The AMICO scale has p o ed
o be a alid and eliable ool in he Spanish gene al popula-
ion o iden i y he ex en o which he COVID-19 pandemic
has a ec ed he men al heal h o he popula ion and hus o e
speci ic in e en ions o add ess a global popula ion p oblem.
The e o e, he e is a need o alida e his scale in he UK popu-
la ion as well.
Wi h ega d o he so-called ad e se e ec s, o e he las
40 yea s, wi h he i s In e go e nmen al Panel on Clima e
Change in 1988, a consensus has eme ged on he ole o
human ac i i y in inc easing global empe a u e and accele -
a ing clima e change, ac o s ha signi ican ly h ea en public
heal h.[14] These h ea s ha e a di ec impac on heal h and
a e expec ed o cause 250,000 dea hs pe yea wo ldwide
be ween 2030 and 2050, mainly om malnu i ion, in ec-
ious diseases, and hea s ess, acco ding o he Wo ld Heal h
O ganiza ion.[15]
Fu u e esea ch on ad e se e ec s also helps o p edic in ec-
ious espi a o y diseases, including COVID-19, and o he
non- espi a o y diseases.[16] Gi en hese possible ad e se e ec s
and in an a emp o an icipa e he p oblem in o de o p e en
possible ela ed men al heal h condi ions, i would be ad is-
able o de elop new s udies ha assess he p esence o anxi-
e y and ea in speci ic popula ion g oups such as he elde ly,
child en, people wi h men al heal h p oblems, and ail people
wi h he aim o explo ing wha hey expe ience when aced
wi h ce ain heal h si ua ions. Knowing how ce ain popula-
ion g oups beha e in he ace o an ad e se e ec o his ype,
such as he COVID-19 pandemic, can be o g ea help o u u e
in e en ions.[17]
In his con ex , he aim o he p esen s udy was o assess he
p esence o anxie y and FCV-19 in he gene al UK popula ion,
using he AMICO scale.
2. Ma e ials and me hods
2.1. Design
A desc ip i e, c oss-sec ional s udy based on a ques ionnai e
was conduc ed acco ding o he He zog e al classi ica ion,[18]
which was dissemina ed be ween Ap il and June 2021.
2.2. Popula ion and sample
This s udy was conduc ed in he UK, a coun y wi h a popula-
ion o 67,025,542 as o 2019.[19] A sample o a leas 239 peo-
ple was es ima ed o his s udy, wi h a con idence le el o 95%,
a p ecision o 3%, and an expec ed loss a io o 15%. Finally,
he o al sample o his s udy was 657.
2.3. Pa icipan s and public in ol emen
This s udy de eloped i s esea ch ques ion wi h a basis on expe-
iences and psychological needs exp essed by he public. The
public was no in ol ed in he design o he s udy. Pa icipan s
we e encou aged o dissemina e he ques ionnai e o ela i es
who li ed in he UK. The pa icipan s could ag ee on ecei ing
he in es iga ion esul s, once he s udy had concluded and ou -
comes we e published.
2.4. Va iables
Socio-demog aphic a iables such as sex, age, egion o esi-
dence, ma i al s a us, le el o educa ion, numbe o cohabi an s,
size o he dwelling, heal h s a us, diagnosis and hospi al admis-
sions o COVID-19, olun a y sel -con inemen o a oid in ec-
ion, accina ion, and side e ec s we e included. Employmen
a iables we e also included, such as employmen s a us, wo k
sec o , and sala y. Finally, he AMICO scale a iable was
included o measu e ea and anxie y abou COVID-19.
2.5. Ins umen s
The Anxie y and Fea o COVID-19 Assessmen (AMICO) scale
was used. This scale was al eady designed and alida ed in p e-
ious s udies. The alida ion o he AMICO_UK scale was ca -
ied ou in a p e ious s udy. Fo he adap a ion o he AMICO
scale o he UK con ex , a p ocess o di ec ansla ion in o
English and back- ansla ion in o Spanish was ca ied ou in
o de o e i y ha he ansla ed e sion e lec ed he same con-
en as he o iginal e sions.[20] This double ansla ion p ocess
was pe o med by 2 ansla o s who we e na i e Spanish speak-
e s, bu who esided and wo ked in he UK and had a minimum
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o a Mas e ’s deg ee. The ansla ed e sion was e alua ed by a
panel o 10 expe s.[21]
Subsequen ly, a pilo es was ca ied ou wi h 20 subjec s o
de ec unde s anding p oblems, a e which he ield s udy was
ini ia ed wi h a sample o subjec s li ing in he UK.
P io o he EFA, a Kaise -Meye -Olkin measu e o 0.961
and a signi icance le el o 0.000 in he Ba le es o sphe ici y
we e ob ained. Wi h hese esul s, he EFA was implemen ed in
acco dance wi h he c i e ia o p incipal componen s analysis
and a imax o a ion, which yielded a ac o ial solu ion o 2
dimensions and 16 i ems. This ac o ial solu ion explained 76%
o he a iance.
A eliabili y s udy was also ca ied ou , p o iding an o e all
C onbach α alue o 0.964, and 0.90 and 0.92 o each o he
ac o s.
A e ha , con i ma o y ac o analysis was pe o med o
assess cons uc alidi y, which o e ed he ollowing alues: dis-
c epancy di ided by deg ee o eedom = 4.59 (P = .17; No med
Fi Index = 0.97; Tucke -Lewis index = 0.956; compa a i e i
index = 0.976; oo mean squa e e o o app oxima ion = 0.07;
and Quad a ic s anda dized esidual = 0.04).
2.6. P ocedu e/se ings
A non-p obabilis ic snowball sampling was ca ied ou . Fo he
ec ui men o he sample subjec s, an online ques ionnai e was
elabo a ed using Qual ics©, which included in o ma ion abou
he s udy and he i ems ela ed o he a iables o said s udy.
The ques ionnai e was sen o he popula ion h ough social
ne wo ks.
All pa icipan s we e duly in o med o he pu pose o he
s udy, as well as o he possibili y o pa icipa ing olun a ily,
anonymously, and con iden ially. To pa icipa e, subjec s had o
ick a box o g an pa icipa ion on a olun a y and anonymous
basis. Once his box was icked, pa icipan s had access o he
ques ionnai es. O he wise, hey could no be accessed.
2.7. Da a analysis
The Kolmogo o –Smi no es was i s applied o es no mal-
i y, ob aining a P < .005 and allowing he use o non-pa ame ic
es s. Con as es s we e pe o med wi h he Mann–Whi ney U
and K uskal–Wallis es . The co ela ion be ween quan i a i e
a iables was checked wi h he Kendall au b es .
The ela ionship be ween quali a i e a iables was checked
wi h a ca ego ical eg ession analysis, which included a iance,
coe icien o de e mina ion (R2), eg ession analysis, and signi -
icance o model pa ame e s.[22]
Uni a ia e and bi a ia e desc ip i e analyses we e pe o med
using he SPSS© s a is ical so wa e[23] (IBM, A monk, NY). Fo
he calcula ion, he op imal scaling op ion was chosen in he
so wa e.
2.8. E hical aspec s
This s udy in he UK is pa o he IMPACTCOVID-19 in e -
na ional in es iga ion p ojec , which ollowed he me hodology
o a p e ious in es iga ion in Spain consis ing o he alida ion
and c oss-cul u al adap a ion o he AMICO scale[12] and con-
sequen ly assessmen in a speci ic popula ion.[24] As men ioned
be o e, he AMICO scale was designed by a eam o di e en
p o essionals,[17] based on he FCV-19 scale.[11] No pe missions
no licenses we e equi ed o i s use.
Pe mission o conduc his s udy was ob ained om he
Na ional Heal h Se ice Heal h Resea ch Au ho i y, IRAS p oj-
ec ID 283849, REC e e ence 20/HRA/3997. This s udy also
complied wi h he guidelines se in he Decla a ion o Helsinki
ega ding e hical p inciples o medical esea ch in ol ing
human subjec s.[25]
All indi iduals in he sample ag eed o pa icipa e on a
olun a y basis by eading and signing in o med consen .
Con iden iali y o da a and anonymi y o pa icipan s was
ensu ed, always espec ing he p o ec ion o he igh s o he
pa icipan s o he s udy.
3. Resul s
3.1. Desc ip i e analysis
The sample selec ed o he s udy consis ed o 657 people li ing
in he UK. As can be seen in Table1, o he o al sample, 80.5%
we e women, wi h a mean age o 48.25 yea s (Table1).
As ega ds income, 71.7% said hey had su icien esou ces
o make ends mee .
Wi h ega d o gene al heal h s a us, he mean sco e o his
a iable was 6.67. Also, 58.8% had ne e sel -con ined o p o-
ec hemsel es, al hough he majo i y did conside hemsel es
o be a isk o one eason o ano he .
In gene al, pa icipan s ega ded hemsel es as well-in o med
abou he pandemic, wi h a mean sco e o his a iable o 7.94
poin s. Also, a he ime o he su ey, only 14.5% o he sam-
ple had been accina ed wi h bo h doses and 62.6% had only
ecei ed 1 dose; on he o he hand, 6.2% claimed hey did no
wan o ge he accine. O hose who had been accina ed,
35.6% had had no side e ec s a e he adminis a ion bu jus
pain a he injec ion spo (Table1).
Rega ding he AMICO scale a iable, he mean AMICO o al
sco e was 4.85 (SD = 2.398), wi h a ange o sco es om 1 o
10.
On he o he hand, he Kolmogo o –Smi no es , wi h a
signi icance o 0.000, e ealed ha he dis ibu ion o sco es
ob ained on he AMICO scale did no ollow a no mal dis ibu-
ion, so non-pa ame ic es s we e pe o med.
The bi a ia e analysis e ealed s a is ically signi ican di -
e ences in ela ion o sex, end-o -mon h income, heal h s a us
sco e, sel -con idence, amoun o in o ma ion ecei ed, and ac-
cina ion a iables ela ed o he mean AMICO sco es (Table2).
Thus, women showed highe sco es on he AMICO scale han
men. In e ms o income, hose who did no make ends mee
showed highe le els o ea and anxie y abou COVID-19. In
addi ion, hose who had no sel -con ined o p o ec hemsel es
agains he disease go he highes sco es on his scale. On he
o he hand, hose who had no ye been accina ed wi h any
dose we e he mos ea ul and anxious (Table2).
3.2. Reg ession analysis
The calcula ion o he ca ego ical eg ession was implemen ed,
i s , wi h he mean o al sco e o he AMICO ques ionnai e
as he dependen a iable and he es o he a iables ha
showed signi ican di e ences in he desc ip i e bi a ia e anal-
ysis (Table3). In his sense, he esul s sugges ha women who
epo ed no ecei ing enough money o make ends mee , who
did no sel -con ine, and who had been accina ed wi h only 1
dose p esen ed highe le els o anxie y and FCV-19.
4. Discussion
The alida ion o he AMICO_UK scale was ca ied ou in a
p e ious s udy. Fo he adap a ion o he AMICO scale o he
UK con ex , a p ocess o di ec ansla ion in o English and
back- ansla ion in o Spanish was ca ied ou . The ansla ed
e sion was e alua ed by a panel o 10 expe s. Subsequen ly, a
pilo es was ca ied ou wi h 20 subjec s o de ec unde s and-
ing p oblems.[21]
On he o he hand, he s udy o pe cen iles and qua iles wi h
espec o he dis ibu ion o mean scale sco es allowed iden-
i ying 3 p oposed le els o anxie y using a box-and-whiske
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Mo gado-Toscano e al. • Medicine (2023) 102:10 Medicine
plo . Le els we e iden i ied as low, wi h sco es anging om 0 o
4.7 poin s, in e media e, wi h sco es anging om 4.71 o 6.7
poin s, and high, wi h sco es anging om 6.71 o 10 poin s.
The analysis o he s a is ical signi icance o he di e ences
be ween he iden i ied le els, using he Mann–Whi ney U s a is-
ic o each pai o le els es ed, always ga e a alue o P = .000;
hus, i can be concluded ha he e a e signi ican di e ences
be ween he iden i ied le els, and he ele ance o hese di e -
ences is con i med by he Mann–Whi ney U s a is ic o each
pai o le els es ed.[17]
The esul s o he s udy showed an a e age le el o anxie y
and FCV-19 in he gene al UK popula ion, as measu ed by he
AMICO_UK scale. Howe e , mos o he e iewed s udies p o-
ide e idence o he high impac o he COVID-19 pandemic
Table 1
Desc ip ion o he sample p o ile.
Quan i a i e a iables Value Resul Range
Age Mean
S anda d de ia ion
48.25
14.861
Minimum = 16
Maximum = 80
No o co-dwelle s Mean
S anda d de ia ion
2.58
1.3
Minimum = 1
Maximum = 10
Heal h s a e sco e Mean
S anda d de ia ion
6.67
2.061
Minimum = 0
Maximum = 10
Le el o in o ma ion Mean
S anda d de ia ion
7.94
2.078
Minimum = 1
Maximum = 10
Quali a i e a iables Value Resul To al
Sex Male
Female
n = 120 (18.3%)
n = 529 (80.5%)
To al sample
657
Ma i al s a us Ma ied
Single
Widow/e
Sepa a ed/di-
o ced
Doesn’ say
O he
n = 318 (48.4%)
n = 174 (26.5%)
n = 25 (3.8%)
n = 63 (9.6%)
n = 17 (2.6%)
n = 60 (9.1%)
Educa ional le el Seconda y
Highe seconda y
Uni e si y
(Mas e ’s o
Doc o a e)
Uni e si y (deg ee)
Wi hou s udies
Doesn’ say
O he
n = 120 (18.3%)
n = 108 (16.4%)
n = 97 (14.8%)
n = 263 (40%)
n = 8 (1.2%)
n = 21 (3.2%)
n = 40 (6.1%)
Wo k si ua ion S udying
Doesn’ say
Full- ime ou side
o home
Full- ime om
home
Pa - ime ou side
o home
Pa - ime om
home
On sick lea e
Re i ed
Unemployed
O he
n = 14 (2.1%)
n = 13 (2%)
n = 134 (20.4%)
n = 116 (17.7%)
n = 81 (12.3%)
n = 50 (7.6%)
n = 21 (3.2%)
n = 135 (20.5%)
n = 39 (5.9%)
n = 54 (8.2%)
Su icien income Yes
No
No always
Doesn’ say
O he
n = 471 (71.7%)
n = 58 (8.8%)
n = 103 (15.7%)
n = 20 (3%)
n = 5 (0.8%)
COVID-19 diagnosis Yes
No
n = 69 (10.5%)
n = 586 (89.2%)
Sel -con inemen Yes
No
n = 264 (40.2%)
n = 386 (58.8%)
Vaccina ion Yes, wi h 2 doses
Yes, wi h 1 dose
No
No, I e use
accina ing
Doesn’ say
n = 95 (14.5%)
n = 411 (62.6%)
n = 105 (16%)
n = 41 (6.2%)
n = 5 (0.8%)
COVID-19 = co ona i us disease 2019.
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Table 2
Bi a ia e desc ip i e analysis.
Va iables To al sample (n = 657) Mean AMICO sco e Con as hypo hesis
Sex
Male
Female
n = 120 (18.3%)
n = 529 (80.5%)
4.15
5.09
P = .000*
Ma i al s a us
Ma ied
Single
Widow/e
Sepa a ed/
di o ced
Doesn’ say
O he
n = 318 (48.4%)
n = 174 (26.5%)
n = 25 (3.8%)
n = 63 (9.6%)
n = 17 (2.6%)
n = 60 (9.1%)
4.82
4.89
4.83
4.81
4.6
5.55
P = .426‡
Educa ional le el
Seconda y
Highe
seconda y
Uni e si y
(Mas e ’s o
Doc o a e)
Uni e si y
(deg ee)
Wi hou s udies
Doesn’ say
O he
n = 120 (18.3%)
n = 108 (16.4%)
n = 97 (14.8%)
n = 263 (40%)
n = 8 (1.2%)
n = 21 (3.2%)
n = 40 (6.1%)
4.84
4.85
4.46
5.02
6.44
4.77
5.20
P = .239‡
Wo k si ua ion
S udying
Doesn’ say
Full- ime ou side
o home
Full- ime om
home
Pa - ime ou side
o home
Pa - ime om
home
On sick lea e
Re i ed
Unemployed
O he
n = 14 (2.1%)
n = 13 (2%)
n = 134 (20.4%)
n = 116 (17.7%)
n = 81 (12.3%)
n = 50 (7.6%)
n = 21 (3.2%)
n = 135 (20.5%)
n = 39 (5.9%)
n = 54 (8.2%)
5
4.81
4.55
5.4
4.55
5.25
5.93
4.75
5.09
5.47
P = .165‡
Su icien income
Yes
No
No always
Doesn’ say
O he
n = 471 (71.7%)
n = 58 (8.8%)
n = 103 (15.7%)
n = 20 (3%)
n = 5 (0.8%)
4.61
5.94
5.64
4.93
5.03
P = .000‡
COVID-19 diagnosis
Yes
No
n = 69 (10.5%)
n = 586 (89.2%)
4.44
4.96
P = .127*
Sel -con inemen
Yes
No
n = 264 (40.2%)
n = 386 (58.8%)
4.31
5.76
P = .000*
Vaccina ion
Yes, wi h 2 doses
Yes, wi h 1 dose
No
No, I e use
accina ing
Doesn’ say
n = 95 (14.5%)
n = 411 (62.6%)
n = 105 (16%)
n = 41 (6.2%)
n = 5 (0.8%)
4.60
5.16
5.11
2.53
4.00
P = .000‡
Age
Signi icance (SD) 48.25 (14.861) Tau b = −0.047†
No o co-dwelle s
Signi icance (SD) 2.58 (1.3) Tau b = 0.008†
Heal h s a e sco e
Signi icance (SD) 6.67 (2.061) Tau b = −0.2757†
Le el o in o ma ion
Signi icance (SD) 7.94 (2.078) Tau b = −0.120†
AMICO = Anxie y and Fea o COVID-19 Assessmen Scale (Ansiedad y Miedo al COVID-19), COVID-19 = co ona i us disease 2019, SD = s anda d de ia ion.
* Mann–Whi ney U. † Kendall au b. ‡ Analysis o a iance (ANOVA).
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on he men al heal h o he gene al popula ion. This is he case
o a s udy in Romania whe e, al hough olde people a e mo e
likely o ha e se ious p oblems associa ed wi h COVID-19 han
younge people, he esul s showed ha people cope wi h his
ea ega dless o age.[26] Ano he s udy conduc ed in Ge many
posi i ely ela ed FCV-19 o he pe cei ed isk o con ac ing
he disease.[27]
In line wi h he esul s o a e iew ha was de eloped
du ing he i s pandemic,[28] his s udy highligh ed ha hose
who habi ually wo e masks epo ed highe le els o FCV-19
han hose who did no comply wi h mask egula ions. This
ac could e eal ha COVID-19 is commonly associa ed wi h
se e e ad e se eelings, including ea , ange , o dep ession, bu
he in luence o indi iduals’ emo ional s eng h and con ic ions
is essen ial o deepen he unde s anding o he psychia ic and
psychological consequences o he pandemic.[29]
On he o he hand, a s udy conduc ed in New Zealand,
a coun y ha sha es his o ical ies wi h he UK, ound ha
dep ession and anxie y we e nega i ely a ec ed du ing he i s
en weeks o social dis ancing o he COVID-19 pandemic.
This was e iden in he mean sco es ob ained in ha s udy o
dep ession and anxie y du ing he COVID-19 pandemic, which
signi ican ly exceeded hose ob ained in no mal epidemiological
si ua ions.[30]
Al hough age was no a de e mining ac o in he p esen
s udy, da a om he Eu opean COVID Su ey highligh ed ha
in coun ies such as I aly o he UK, people aged 18 o 29 yea s
who had been in ec ed wi h he new co ona i us had high p e -
alence a es o dep ession and anxie y in all wa es.[31]
Wi h ega d o age, a s udy in New Zealand, men ioned
abo e, e ealed ha , al hough he mos se e e symp oms o he
disease end o de elop in olde people, i was a g oup o young
people aged 18 o 24 yea s who we e disp opo iona ely mo e
a ec ed and mo e likely o su e anxie y, s ess, and dep ession
associa ed wi h COVID-19. One explana ion o his phenom-
enon could be ha many young s uden s expe ienced academic
delays and signi ican changes in daily ou ine du ing he.[32]
O he esea ch highligh s ha younge popula ions end o ha e
poo e men al heal h ou comes in gene al.[33]
Wi h ega d o he sex a iable, i is wo h men ioning ha in
all he a icles e iewed as well as in he p esen s udy, he le el
o anxie y and, in gene al, men al heal h p oblems, was highe
in women han in men. Fo example, a s udy by Zanino o e
al epo ed a g ea e de e io a ion o men al heal h in he gen-
e al popula ion in he UK[34] in line wi h a s udy conduc ed in
Spain[17] based on he AMICO scale, which concluded ha he
p e alence o symp oms o psychological dis ess and a ec i e
diso de s in Spain p o es ha women p esen some ype o
men al heal h p oblem in 14% o he popula ion, compa ed o
7.2% o men. This may be due o he ac ha a ound 70% o
ca e wo k ends o all on women, which may ha e inc eased
due o he si ua ion o con inemen expe ienced wi h he conse-
quen closu e o schools and elewo king.[17]
As o he sala y a iable, which has also been signi ican
in he p esen s udy, an analysis conduc ed in he UK e ealed
ha he es ic ions also impac ed people’s socioeconomic
posi ion, wi h an inc ease in po e y.[34,35] In addi ion o his,
i was also ound ha people wi h men al heal h p oblems a e
subs an ially mo e likely o de elop in ec ious diseases such
as pneumonia and o su e cogni i e impai men ,[36] so lowe
socioeconomic s a us no only a ec s he quali y o men al
heal h bu also goes hand in hand wi h being mo e p one o
illness. When he in luence o socio-demog aphic a iables
dec eases, hose indi iduals who showed highe le els o dis-
ess also epo ed ha ing had COVID-19 and a g ea e num-
be o se e e symp oms.[37]
On he o he hand, he g ea e impac o li ing wi h es ic-
ions had a di ec impac on de e io a ing physical and men al
heal h, and social isola ion exace ba ed he poo men al heal h
s a us ha al eady exis ed in he UK popula ion.[38] In his
sense, he indings by Jani i e al con i m he need o be con-
ce ned no only wi h p o ec ing he physical heal h o heal h
p o essionals bu also wi h he e ec s on hei men al heal h,
some hing ha has been con i med by a la ge numbe o s ud-
ies.[39] Res ic ions also impac ed people’s socioeconomic posi-
ion, so i is no su p ising ha he majo i y o he sample
ep esen ed in his s udy chose no o sel -con ine.[40] Las ly,
al hough only 14.5% o he sample was accina ed wi h bo h
doses a he ime o he ques ionnai e, a UK s udy ound ha
a ound 82% o UK adul s a e willing o ecei e a COVID-19
accine i o e ed.[41]
Limi a ions o he p esen s udy include he ac ha
non-p obabili y sampling p ecludes accu a e knowledge o he
ep esen a i eness o he sample. On he o he hand, esea che s
mus ely on he e aci y o he da a p o ided by pa icipan s,
as hese we e sel -adminis e ed ques ionnai es. Also, du ing
he pandemic, he e ha e been si ua ions o g ea e es ic ions
depending on he cumula i e incidence o COVID-19, so he
esponse o he pa icipan s may ha e also been in luenced by
he ime a which he ques ionnai es we e comple ed. Besides, as
he da a collec ion ool is elema ic, he e may ha e also been an
accessibili y bias, as olde people and/o people a isk o social
exclusion may no ha e been able o answe he ques ionnai e.
On he o he hand, he highe numbe o women in he sam-
ple implies ano he limi a ion in i sel . The e o e, i is necessa y
o examine, h ough a new ield s udy, whe he he “sex” a i-
able may ha e such an e ec on he cons uc alida ion o he
AMICO_UK scale om a sex pe spec i e.
5. Conclusion
This s udy highligh s he need o ac ion by heal h manage s o
p o ide ca e and suppo o he gene al popula ion o he UK
in o de o mi iga e he nega i e men al heal h e ec s caused by
COVID-19.
The esul s o he p esen s udy ha e shown an a e age le el
o anxie y and FCV-19 in he gene al UK popula ion, as mea-
su ed by he AMICO UK scale.
In addi ion, he eg ession s udy showed ha women who
epo ed no ea ning enough o make ends mee , who had no
sel -con ined, and who had ecei ed only 1 dose o he accine
had highe le els o anxie y and FCV-19.
Table 3
Model adjus men and signi icance o he eg ession analysis.
S anda dized coe icien s
d F Sig. Be a Boo s apping (1000) o s anda d e o
Sex −.126 .038 1 11.121 .001
Su icien income −.170 .042 4 16.123 .000
Sel -con inemen .221 .053 2 17.212 .000
Vaccina ion .259 .111 1 5.466 .020
d = deg ee o eedom, Sig = signi icance.
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Au ho con ibu ions
Concep ualiza ion: C is ina Mo gado-Toscano, Juan Gómez-
Salgado, Ja ie Fagundo-Ri e a, Yolanda Na a o-Abal, Lucas
Rod íguez-Jiménez, José An onio Climen -Rod íguez, Regina
Allande-Cussó.
Da a cu a ion: C is ina Mo gado-Toscano, Juan Gómez-
Salgado, Lucas Rod íguez-Jiménez, Regina Allande-Cussó.
Fo mal analysis: C is ina Mo gado-Toscano, Juan Gómez-
Salgado, Ja ie Fagundo-Ri e a, Yolanda Na a o-Abal,
Lucas Rod íguez-Jiménez, José An onio Climen -Rod íguez,
Regina Allande-Cussó.
In es iga ion: C is ina Mo gado-Toscano, Juan Gómez-Salgado,
Ja ie Fagundo-Ri e a, Yolanda Na a o-Abal, Lucas
Rod íguez-Jiménez, José An onio Climen -Rod íguez, Regina
Allande-Cussó.
Me hodology: C is ina Mo gado-Toscano, Juan Gómez-
Salgado, Ja ie Fagundo-Ri e a, Yolanda Na a o-Abal,
Lucas Rod íguez-Jiménez, José An onio Climen -Rod íguez,
Regina Allande-Cussó.
P ojec adminis a ion: C is ina Mo gado-Toscano, Juan
Gómez-Salgado, Regina Allande-Cussó.
Resou ces: C is ina Mo gado-Toscano, Juan Gómez-Salgado,
Ja ie Fagundo-Ri e a, Yolanda Na a o-Abal, Lucas
Rod íguez-Jiménez, José An onio Climen -Rod íguez, Regina
Allande-Cussó.
So wa e: C is ina Mo gado-Toscano, Juan Gómez-Salgado,
Lucas Rod íguez-Jiménez, Regina Allande-Cussó.
Supe ision: C is ina Mo gado-Toscano, Juan Gómez-Salgado,
Ja ie Fagundo-Ri e a, Yolanda Na a o-Abal, Lucas
Rod íguez-Jiménez, José An onio Climen -Rod íguez, Regina
Allande-Cussó.
Valida ion: C is ina Mo gado-Toscano, Juan Gómez-Salgado,
Ja ie Fagundo-Ri e a, Yolanda Na a o-Abal, Lucas
Rod íguez-Jiménez, José An onio Climen -Rod íguez, Regina
Allande-Cussó.
Visualiza ion: C is ina Mo gado-Toscano, Juan Gómez-
Salgado, Ja ie Fagundo-Ri e a, Yolanda Na a o-Abal,
Lucas Rod íguez-Jiménez, José An onio Climen -Rod íguez,
Regina Allande-Cussó.
W i ing – o iginal d a : C is ina Mo gado-Toscano, Juan
Gómez-Salgado, Ja ie Fagundo-Ri e a, Yolanda Na a o-
Abal, Lucas Rod íguez-Jiménez, José An onio Climen -
Rod íguez, Regina Allande-Cussó.
W i ing – e iew & edi ing: C is ina Mo gado-Toscano, Juan
Gómez-Salgado, Ja ie Fagundo-Ri e a, Yolanda Na a o-
Abal, Lucas Rod íguez-Jiménez, José An onio Climen -
Rod íguez, Regina Allande-Cussó.
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