PONE-D-22-24670Prevalence and determinants of anxiety and stress in the general population during COVID-19 pandemicPLOS ONE

Dear Dr. Nazar P. Shabila,

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear Author,

This article entitled Prevalence and determinants of anxiety and stress in the general population during COVID-19 pandemic is interesting. I have read the paper and found it as a potential article for consideration for publication. However, there are some specific points that should be corrected before taken such decision.

1. The title should contain study type and place of the study, for example; Prevalence and determinants of anxiety and stress in the general population during COVID-19 pandemic in Iraq: A cross-sectional study

2. Average scores of mental health status presented in abstract do not make any sense rather the authors are suggested to present them as their significance/indications whether these values tell us about the mental health condition of participants.

3. The presented data are more than two years old and what about the current mental health status in Iraq that was supposed to disturbed by the pandemic. Because perception/experience about Covid-19 and associated matters are quickly evolving, therefore, the authors are asked to present similar findings from others studies in Iraq/similar demographics by detail literature review. This discussion/information would justify the need for publication of their own data. For these discussion the authors are suggested to discuss and cite the following articles in their article, but not limited to-

- Das R, Hasan MR, Daria S, Islam MR. Impact of COVID-19 pandemic on mental health among general Bangladeshi population: a cross-sectional study. BMJ Open. 2021;11(4):e045727. Published 2021 Apr 9. doi:10.1136/bmjopen-2020-045727

-Islam MR, Daria S, Das R, Hasan MR. A nationwide dataset on the mental health of the Bangladeshi population due to the COVID-19 pandemic. Data Brief. 2021;38:107347. doi:10.1016/j.dib.2021.107347

- Islam MR, Qusar MMAS, Islam MS. Mental Health of Children Amid COVID-19 Pandemic in Bangladesh: An Exploratory Observation. Asia Pac J Public Health. 2021;33(4):469-470. doi:10.1177/10105395211004371

-Nahar Z, Sohan M, Supti KF, et al. Prevalence and associated risk factors for mental health problems among female university students during COVID-19 pandemic: A cross-sectional study findings from Dhaka, Bangladesh. Heliyon. 2022;8(10):e10890. doi:10.1016/j.heliyon.2022.e10890

- Islam MR, Nahar Z, Hossain MS, et al. Prevalence and associated factors for elevated fear and depressive symptoms among the private service holders in Bangladesh during the Covid-19 pandemic: A cross-sectional study. Health Sci Rep. 2022;5(5):e795. Published 2022 Aug 23. doi:10.1002/hsr2.795

- Daria S, Islam MR. Increased suicidal behaviors among students during COVID-19 lockdowns: A concern of student's mental health in Bangladesh. J Affect Disord Rep. 2022;8:100320. doi:10.1016/j.jadr.2022.100320

- Repon MAU, Pakhe SA, Quaiyum S, Das R, Daria S, Islam MR. Effect of COVID-19 pandemic on mental health among Bangladeshi healthcare professionals: A cross-sectional study. Sci Prog. 2021;104(2):368504211026409. doi:10.1177/00368504211026409

-Islam MR, Quaiyum S, Pakhe SA, Repon MAU, Bhuiyan MA. Dataset concerning the mental health of healthcare professionals during COVID-19 pandemic in Bangladesh. Data Brief. 2021;39:107506. doi:10.1016/j.dib.2021.107506

4. The epidemiological data presented in this paper are also very old, they should be updated to let the readers know about the up-to-date information.

5. Getting 851 responses by inviting 1000 potential respondents are extremely rate in the context of biasness free online survey. As the global response rate is approximately 25% for all online survey. How the authors eliminate bianess of their study. How they selected participants and what was the assumtions befre data collection, these explanation and information should be given in the method section.

6. Why the autors took 70% female participants??? Was it randon effect, pls give explanation and potetianl consequences on the results.

Reviewer #2: I appreciate the opportunity to review the manuscript entitled "Prevalence and determinants of anxiety and stress in the general population during COVID-19 pandemic”. The study aimed to determine the prevalence of anxiety and stress among the general population during the outbreak of COVID-19 and assess their associated factors. This study is relevant and provides a significant contribution to the knowledge about the psychological impact of the 1st wave of COVID. However, there are some issues that must be addressed prior to publication. I have included my comments and recommendations below:

Introduction

P. 3, ln 61: The authors state: “limited research has addressed the direct effect of COVID-19 on mental health” – nowadays, there are a lot of research on this matter, so this information must be updated. The authors should refer to existing information, as well as the profile of people with more risk factors in terms of their mental health, in order to see if, in the area in question, the profile is similar or different. I think the relevance will be more in this sense, because there are already many studies.

Method

Study Participants

Additional information is needed about the key informants and the participants criteria that based the initial selection od the 1000 people.

If the questionnaire was sent through social media, is it possible that people without that kind of access were excluded, biasing the sample? As can be seen in the description of the participants, it is mostly young people who responded, which makes sense considering the way the questionnaire was disseminated. The older people are a minority of the sample, which should be mentioned in the limitations of the study.

Measures

Reliability information must be presented, for both scales.

Results

If the authors use scales like the Perceived Stress Scale and the Anxiety Scale, it makes no sense to present the statistics for each item, only the overall stress score.

The statistical information presented, such as t-test results, should be presented in greater detail, not only the p-values

Discussion

In the discussion there is no point in re-presenting statistical values.

How can the authors guarantee that the values found are due to the pandemic impact and do not reflect pre-pandemic values?

This should also be mentioned in the limitations, since this is a cross-sectional study

Reviewer #3: This is a well-written manuscript that highlights a topical issue of interest to global health. However, the paper can be improved by considering the under-listed comments.

1. Line 90: What is the total size of the population? How did you arrive at the sample size used?

2. Line 91: The inclusion and exclusion criteria should be clearly stated.

3. Lines: 92 to 96: The statements there should be moved to a section on sampling.

4. Line 96 to 98: From the sentence beginning “The online …. Should be moved to a section on data collection.

5. The authors used an online questionnaire to gather the data. What shows that the intended respondents answered the questionnaire? The limitations of the study should be stated including the weaknesses of using the approach to data collection employed.

6. The discussion section is highly descriptive. The authors can improve upon it by providing explanations as to why they reported a particular result and also explain why a particular study support or does not support their study.

7. The paper requires minor editing.

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Reviewer #1: Yes: Md. Rabiul Islam

Reviewer #2: Yes: Rute Brites

Reviewer #3: No

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Attachments

Attachment

Submitted filename: Plos One Review.docx

Prevalence and determinants of anxiety and stress in the general population during COVID-19 pandemic in Iraq: A cross-sectional study

PONE-D-22-24670R1

Dear Dr. Shabila,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Suhad Daher-Nashif, MSc., PhD

Academic Editor

PLOS ONE

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: (No Response)

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: (No Response)

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for addressing my previous comments and suggestions. I think the manuscript has significantly improved from this revison.

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Md. Rabiul Islam

Reviewer #2: Yes: Rute Brites

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