Fear and Depression during the COVID-19 Outbreak in Cameroon: A Nation-wide Observational Study

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. Findings: 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. Interpretation: 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. Funding Statement: ERC Advanced Grant (671055) and VLIRUOS (Flemish University cooperation). Declaration of Interests: The authors have no conflicts of interest to declare. Ethics Approval Statement: This study was approved by the National Ethics Committee of Cameroon (Ref: 2020/05/1229/CE/CNERSH/SP of 06·5·20) as well as the Ethics Committee of the University of Antwerp, Belgium (Ref: 20/13/148).