PTSS in COVID-19 survivors peritraumatic stress symptoms among COVID-19 survivors in Iraq

Current Psychology https://doi.org/10.1007/s12144-023-04291-z ORIGINAL ARTICLE PTSS in COVID-19 survivors peritraumatic stress symptoms among COVID-19 survivors in Iraq Parzheen J. Mohammad1 · Dyari S. Hama amin2 S. Abdullah5 · Pshtiwan F. Mohammed3 · Hawkar A. Hussein4 · Omiad Accepted: 19 January 2023 © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023 Abstract The COVID-19 pandemic became a source of psychological distress worldwide. People infected with the disease faced the possibility of losing their lives, and due to the high number of people with the disease, hospitals were overburdened. Therefore, the situation had characteristics of a traumatic event; this is especially true in Iraq since the healthcare system is on the brink of failure, and the hospitals are a place of low-quality service. Consequently, the current study aims to explore peritraumatic stress symptoms among survivors of COVID-19 in Iraq. Moreover, group differences based on several variables and the associated factors with peritraumatic stress are also investigated. The post-traumatic stress disorder checklist for DSM-5 was used as a measurement tool. A total of 370 survivors of COVID-19 from the different governorates of Iraq participated in this study; 148 females and 22 males. 51, 70, 165, and 84 participants were aged 18–25, 26–30, 31–40, and above 40, respectively. The results revealed that 31.1% of the participants had probable PTSD since they scored above the cut-off of the score of 23. Significant differences between males and females were not found. Regarding associated factors, education level was a significant predictor (i.e., no education, primary school, secondary school, diploma, bachelor’s degree, and postgraduate degree). Compared to primary school education and no education, postgraduate education was significantly associated with probable PTSD. Furthermore, the longer duration of being infected with COVID-19 was associated with higher odds of having probable PTSD. This was one of the first studies in Iraq to explore peritraumatic stress symptoms following COVID-19 infection using standardized instruments and investigate the associated factors. The results have various implications for developing the healthcare system of Iraq and the need to have social workers and psychologists trained in psychological first aid available in the hospital to manage the patients’ distress. Keywords PTSS · Trauma · COVID-19 · Iraq · Pandemic Background Dyari S. Hama amin 1 College of Education and Language, Department of Special Education, Charmo University, Chemchemal, Kurdistan Region, Iraq 2 SEED foundation, Sulaimani Center, New chwarchra main road, house A1-352, Sulaymaniyah, Kurdistan Region, Iraq 3 Directory of International Relations, Charmo University, Chemchemal, Kurdistan Region, Iraq 4 Directory of Health/Chamchamal, Shahid Peshraw Outpatient Clinic, Chemchemal, Kurdistan Region, Iraq 5 College of Administration and Economics, Statistics Department, Salahaddin University, Erbil, Kurdistan Region, Iraq The initial outbreak of Coronavirus Disease of 2019 (COVID-19) dates back to December 2019, when cases of pneumonia with no clear etiology were identified. Soon it was discovered that the disease was caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and a novel coronavirus was recognized (World Health Organization, 2020). As of July 30, 2021, around the world, more than 196 million cases of COVID-19 have been recorded, with approximately 4.2 million deaths; in Iraq, the number of confirmed cases of COVID-19 is more than 1.6 million, and 18,595 people have lost their lives (Dong et al., 2020). It has been reported in previous studies (e.g., Jalloh et al., 2018; Zürcher et al., 2020) that after the outbreak of infectious diseases, survivors, families of survivors, medical 13 Current Psychology practitioners, and community individuals may experience elevated rates of mental health issues. Epidemics such as Ebola, SARS, MERS, H1N1, and flu lead to higher rates in the prevalence of mental health problems. However, after the epidemic, most of these problems disappear, except the symptoms of Post-Traumatic Stress Disorder (PTSD), which may last for a prolonged period (Xiao et al., 2020). In a systematic review by Luo et al. (2020), the psychological impacts of viral respiratory epidemics were explored in particular. This review reported that depression, anxiety, and PTSD symptoms were the most common mental health outcomes. Additionally, it was revealed that certain subgroups, such as females, elderlies, people with chronic illnesses, students, and migrant workers are more vulnerable to negative mental health outcomes. According to the American Psychiatric Association (APA), PTSD is characterized by an extreme response to a stressor that is severe. The symptoms category of the disorder includes intrusive symptoms (i.e., flashbacks and nightmares), negative alterations in cognition and mood, alterations in arousal and reactivity, and avoidance of stimuli, all of which are associated with the traumatic event or events. The symptoms have to be present for more than one month for PTSD to be diagnosed (American Psychiatric Association, 2013). Furthermore, the disorder’s diagnosis is only considered in the context of serious traumas. Serious traumas entail the individual experiencing or witnessing an event that has led to actual or threatened death, severe injuries, or violations that are sexual in nature (Kring et al., 2014). Concerning the prevalence of PSTD among survivors of infectious diseases, one study explored the long-term psychiatric issues among survivors of SARS in Hong Kong. 90 patients participated in the study, which was conducted 30 months after the outbreak of the disease. The results showed that at the time of assessment, 33.3% of the SARS survivors had psychiatric disorders. Furthermore, 25.5% of the participants had PTSD (Mak et al., 2009). Another study by Hong et al. (2009), which was a 4-year longitudinal study, explored the incidence of PTSD among a sample consisting of 70 patients with SARS. The first assessment, done two months after hospital discharge, showed that 40% of the participants had PTSD. In the last assessment that was performed 46 months after discharge from the hospital, the prevalence rate of PTSD was 42.1% among the 57 patients that had remained in the study. As for the Ebola virus, a cross-sectional study was performed on 114 Ebola virus survivors to assess the mental health impacts of the disease. The authors reported that the prevalence rate of PTSD among the sample was 24.3%, and that male gender and being young (i.e., 18–24 years old) were associated with the PTSD diagnosis (Kaputu-Kalala-Malu et al., 2021). Regarding MERS, a prospective study in South 13 Korea was conducted 12 months after the disease outbreak, in which 73 survivors participated. It (...truncated)