Health Condition and Test Availability as Predictors of Adults' Mental Health during the COVID-19 Pandemic

Background: Research identifying adults9 mental health during the COVID-19 pandemic relies solely on demographic predictors without examining adults9 health status during the COVID-19 pandemic as a potential predictor. Methods: An online survey of 669 adults in Malaysia was conducted during May 2-8, 2020, six weeks after a Movement Control Order (MCO) was issued. Findings: Adults9 health condition had curvilinear relationships (horizontally reversed J-shaped) with insomnia, anxiety, depression and distress. Reported test availability for COVID-19 (from "strongly disagree" to "strongly agree" ) also had curvilinear relationships (horizontally reversed J-shaped) with anxiety and depression. Younger adults reported worse mental health, but people from various religions and ethnic groups did not differ significantly in reported mental health. Interpretation: Adults with worse health conditions had more mental health problems, especially adults at the lower end of the health spectrum. Test availability negatively predicted anxiety and depression, especially for adults experiencing poor COVID-19 test availability. The significant predictions of health condition and COVID-19 test availability suggest a new direction for the literature to identify psychiatric risk factors directly from health related variables during a pandemic.