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?:abstract
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BACKGROUND The coronavirus disease (COVID-19) pandemic has had a negative impact on both the physical and mental health of individuals worldwide. Evidence regarding the association between mental health problems and information exposure in Thai citizens during the COVID-19 outbreak is limited. OBJECTIVE This study aimed to explore the relationship between information exposure and mental health problems during the COVID-19 pandemic in Thailand. METHODS Between April 21, 2020 and May 4, 2020, we conducted a cross-sectional, nationwide online survey of the general population in Thailand. We categorized the duration of exposure to COVID-19-related information as <1 h/day (reference group), 1-2 h/day, and ≥3 h/day. Mental health outcomes were assessed using the Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Perceived Stress Scale, and Insomnia Severity Index for symptoms of depression, anxiety, perceived stress, and insomnia, respectively. Multivariable logistic regression models were used to evaluate the relationship between information exposure and the risk of developing the aforementioned symptoms. An ancillary analysis using multivariable multinomial logistic regression models was also conducted to assess the possible dose-response relationship across the severity strata of mental health problems. RESULTS Of the 4,322 participants, 4,004 (92.6%) completed the online survey. Of them, 1,481 (37.0%), 1,644 (41.1%), and 879 (22.0%) participants were exposed to COVID-19-related information for <1 h/day, 1-2 h/day, and ≥3 h/day, respectively. The major source of information related to the COVID-19 pandemic was social media (95.3%), followed by traditional media (68.7%) and family members (34.9%). Those exposed to information for ≥3 h/day had a higher risk of developing symptoms of depression (adjusted odds ratio [OR], 1.35; 95% confidence interval [CI], 1.03-1.76; P=0.031), anxiety (adjusted OR, 1.88; 95% CI, 1.43-2.46; P<0.001) and insomnia (adjusted OR, 1.52; 95% CI, 1.17-1.97; P=0.001) than people exposed to information for <1 h/day. Meanwhile, people exposed to information for 1-2 h/day were only at risk of developing symptoms of anxiety (adjusted OR, 1.35; 95% CI, 1.08-1.69; P=0.008). However, no association was found between information exposure and the risk of perceived stress. In the ancillary analysis, a dose-response relationship was observed between information exposure for ≥3 h/day and the severity of mental health problems. CONCLUSIONS These findings suggest that social media is the main source of COVID-19 related information. Moreover, people who are exposed to information for ≥3 h/day are more likely to develop psychological problems, including depression, anxiety, and insomnia. Longitudinal studies investigating the long-term effects of COVID-19-related information exposure on mental health are warranted. CLINICALTRIAL
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