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Association between depression, anxiety, stress and perceived quality of life in a Malaysian B40 urban community during the COVID-19 lockdown: A cross-sectional study

Background: In Malaysia, B40 communities are those with a median monthly household earning of under RM 3166. With the prolonged COVID-19 pandemic and the resulting lockdown, the livelihoods of those in these areas has been severely impacted. This has increased their vulnerability to psychological afflictions and has led to a poorer perception of their quality of life (QoL) in comparison to the rest of the population. We investigated the association between perceived levels of depression, anxiety and stress and their impact on quality of life (QoL) among B40 residents in a low-cost urban housing area in Kuala Lumpur, Malaysia. Methods: A cross-sectional study was conducted between July 2020 and February 2021 in the Seri Pantai housing settlement. The validated Malay versions of the depression, anxiety, and stress scale-21 (DASS-21) and the World Health Organization Quality of Life, brief (WHOQOL-BREF) were distributed to the participants using Google forms. The statistical significance of the association between subscales of depression, anxiety, stress and QoL domains were assessed using the Pearson’s correlation test. Results: Of the 180 participants, the majority were Malays (87.2%) and females (82.2%).  The average scores were the highest for stress (5.66 ± 4.59) and the score in the environment domain of QoL (59.27 ± 17.23) was the lowest. A statistically significant negative correlation was found between the subscales of DASS-21 and the four domains of the QoL, with the social relationships and psychological domains showing a highly significant association (p < 0.001). The strongest correlation was observed between the psychological domain and depression (r= -.520) followed by psychological domain and stress (r= -.496). Conclusion: The strongest correlation was observed between psychological domain and depression. This suggests a need to address potential devastating mental health consequences of the COVID-19 pandemic and its effect on the QoL of residents in B40 communities.                                        