1.Risk factors for common mental disorders in hospitalized patients during the covid-19 pandemic
Enkhtuvshin R ; Yerkyebulan M ; Munkh-Uchral D ; Enkhnaran T ; Mongoljin A ; Munkh E ; Uranchimeg M ; Maidar E ; Amarsaikhan A ; Amirlan B ; Otgonbayar R ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):32-38
Background:
The COVID-19 pandemic has profoundly impacted mental health, particularly exacerbating conditions
such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD), and emotional disorders among hospitalized
patients. This study examined the prevalence of COVID-19-related mental health issues and risk factors in hospitalized
patients affiliated with MNUMS, compared to a control group.
Aim:
To assess the prevalence of mental health disorders such as depression, anxiety, insomnia, and post-traumatic stress
disorder (PTSD), and to identify their associated risk factors.
Materials and Methods:
The study was conducted at hospitals under MNUMS, including the Mongolian-Japanese Hospital,
Central Hospital, and the National Center for Maternal and Child Health. A total of 552 participants (399 case
group, 153 control group) who were hospitalized were included. Depression (PHQ-9≥10), anxiety (GAD-7≥10), insomnia
(ISI≥15), and PTSD (PCL-5≥33) were assessed using standardized scales. Analysis was performed using chi-square tests
and binary logistic regression (crude odds ratio [cOR]/adjusted odds ratio [aOR], 95% confidence interval [CI]), adjusted
for group, age, and sex.
Results:
In the case group, depression (23.1% vs. 13.7%, p=0.015, cOR=1.884 [1.124-3.156]), anxiety (16.8% vs. 11.1%,
p=0.096), and any mental disorder (18.0% vs. 13.7%, p=0.225) were higher, while insomnia was lower (19.5% vs. 30.1%,
p=0.008). PTSD was low overall (1.8% vs. 0.7%, p=0.333). Risk factors included female sex (p<0.001, cOR=0.362 for
depression in males), younger age (p=0.004), unemployment (p=0.017), and prior trauma (p<0.001). COVID-19 symptoms
(difficulty breathing) increased the risk of depression (p<0.001, cOR=2.828 [1.708-4.682]).
Conclusion
Hospitalization for COVID-19 increases the risk of depression and anxiety, modulated by demographic,
clinical, and socioeconomic factors. Targeted interventions for vulnerable groups are essential.
2.Changes in mental health following COVID-19 infection: results of a prospective cohort study in mongolia
Enkhtuvshin R ; Mongoljin A ; Munkh.E ; Uranchimeg M ; Yerkyebulan A ; Munkh-Uchral D ; Enkhnaran T ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):39-44
Background:
COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the
WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first
case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus
affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways
(e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global
studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al.,
BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected
individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National
Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but
long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and
PTSD among COVID-19 patients over 12 months, compared to a control group.
Aim:
To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic
stress disorder (PTSD) among individuals who have had COVID-19
Materials and Methods:
In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited
from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021
and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12
months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases
were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and
multivariable logistic regression (p < 0.05).
Results:
Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12
months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p =
0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19
group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios
confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and
individuals aged 40–59 years were at elevated risk.
Conclusions
1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times
higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control
group.
2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected
after 12 months; this resolution is posited to be associated with the adaptive capacity of the population.
3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.
3.A study on socio-economic condition of health care workers
Nadmidtseren G ; Zoljargalan G ; Yerkebulan M ; Jargalsaikhan T ; Avirmed D ; Unurtsetseg Ch ; Munkh-Uchral D ; Munkhnasan Ts ; Erkhes E ; Baigal D ; Sugarmaa M
Mongolian Medical Sciences 2023;205(4):16-27
Background:
It is stated in the Government Programme of 2016-2020 that public servants, including health care workers, shall be given a gradually increased salary based on their skill, dexterity, workload, and productivity, and such increase started from 2018 as planned. In the health sector of our country, regarding demand and regulation of the programme, the change shall be made that the system for median salary of physicians and overall staff employed at hospitals gets even constructive, and the required human resource for the sector shall be prepared. Thus, inferring from these claims, median salary, real wage, and socioeconomic condition are in critical need for further evaluation.
Objective:
To examine the current socio-economic condition of health care workers, and to study the influencing
factors at play.
Methods:
In this study, we used quantitative and qualitative methods. In the survey, we involved 655 health
care workers from 6 family health centers, 2 district hospitals, 3 health centers (district-based) in
Songinokhairkhan, Sukhbaatar, and Baganuur districts; and Provincial hospital, regional diagnosis and
health center, 16 soum health centers from Khovd, Uvs, Arkhangai, Bulgan, Khentii, Dornod, Umnugovi, and Dornogovi provinces, along with 3 National specialized health centers and 1 National central hospital. As for data gathering for the qualitative analysis, 30 focus group interviews and 47 key informant interviews were conducted for the purpose of examining socioeconomic condition, real wage sufficiency of health care workers.
Results:
Average household income of study participants was 1,880,269 tugrik, the real wage was 1,073,065
tugrik, and the overall household is seen to be composed of 2 different sources on average, namely,
self-wage and the income coming from family members or supplement of Child Money Programme. It
has come to notice that 19.5% of the participants have lower than average living standard, 89.2% have
2 different loans (mortgage, auto loan or mobile application based loans). Material deprivation index is
seen to be 2.73, hence deemed as insufficient. In order to increase the real wage of those workers, it
shall be taken into consideration that the basic salary is low, and some financial supplements need to
be given. Furthermore, the performance based funding system of health sector is seen to be in need of
improvement.
Conclusion
Real wage of the health care workers is, thus, insufficient. The fact that one in every five workers in this sector have lower than average living standard, and the material deprivation index is 2.73 implying that the financial lives of health care workers are immensely fragile.
4.Opportunities to access equal health care services for people who are heavily disabled
Munkh-Uchral D ; Chuluundolgor B ; Chimedsuren O ; Erdenesambuu TS ; Munkhbaatar S
Mongolian Medical Sciences 2011;158(4):36-40
Background. There are at least 650 million people and one out or every 10 people worldwide has a disability. In Mongolia, around 128.000 people with disabilities and 12.000 are wheelchair users. Disabilities affect people in different ways. Causing trouble to their economy, their social life, mental and daily self care.The people with disabilities in Mongolia have much difficulties for their daily activities, have limited possibilities to be included in a health and social services equally and the status to become isolated from the society of them and their families are the invariable problem for them.Goal. To study and evaluate the daily embarrassments and problems of the disabled people and the standard medical environment for them.Results. The 55.8% were male and 4.2% were female of the participants in the survey 88.4% of them answered that they can use their wheelchairs in even land and square only. The 76.4% of the participants do not use public transportation and there is no road for the wheelchair users, no ramp is planned for the citizens with wheelchairs in service centers and organizations and so these are the facing problems for the disabled citizens in Mongolia.It demonstrates that the standard for the disabled citizens is not considered in the medical environmental standards seemingly from no ramp is planned for the citizens with wheelchairs in 92% of the hospitals, no elevator for the citizens with wheelchairs in 91% of the hospitals, 88% of the hospitals have not equipped their toilets with the equipments for the disabled citizens, and 91 % of the hospitals have not planned a room for the disabled citizens for the hospitals included in the surveys.Conclusions:1. Wheelchair users mostly dependent for daily and creative activities. Also they have limited social opportunities because there is no appropriate environment.2. Hospitals involved in the research showed that disabled people have limited health services, hospital environmental standard is not appropriate for them and 1,2 and 3 level of hospitals must setup infrastructure for the disabled people.
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