1. Methodology

2.1 Study population and sample

The target population selected for the feedback consisted of people living in Karachi, the biggest city of Pakistan, an industrial hub, and a port city comprising over 15 million population. The demographics included age, gender, profession, students, working, non-working, retired, etc. The city was under complete lockdown since the 1^st week of April. The study conducted in the third week from April 16-23, 2020 for assessment of the mental health of the population in the context of lockdown and confinement due to COVID-19 in Pakistan. Because of the large population, the stigma attached to mental health, and ethical considerations the questionnaire was kept anonymous and the non-probability convenience sampling technique was used.

2.2 Rating instruments

The Research instruments PHQ-9 was used for the assessment of the mental health of the population (Hartung et al., 2017; Hinz et al., 2006) under three week’s lockdown during COVID-19. Patient Health Questionnaire (PHQ-9) is a nine-item depression severity measuring instrument with a total score of 20. Depression Severity Scores represent: 0-5 = Mild, 6-10 = Moderate 11-15 = Moderately Severe 16-20 = Severe Depression (Kroenke et al., 2010).

2.3 Data analysis

PHQ-9 and GAD-7 forms designed on Google form and survey was conducted online sharing the link via Emails, Whatsapp, Facebook, and LinkedIn using 120 research volunteers. The respondent cooperation and readiness were high as it was anonymous, easy to complete within 3 minutes, and submission over a single click through their cell phone. The survey started on 16^th April and was completed within seven days by April 21. The 6876 respondents completed the questionnaire included in the final analysis. The statistical analytical tool SPSS was implied for descriptive analyses. Initially, descriptive analysis was conducted to describe the demographic characteristics of people of Karachi under lockdown for the last three weeks (April 16 to April 23). Secondly, the prevalence of severity of depression symptoms was measured on a rating scale of minimal, mild, moderate, and severe stratified by gender, age, and occupation.

2.4 Ethical considerations

The ethical committee of qualified psychiatrists and psychologists of BasicNeeds Pakistan endorsed the study. The respondents were not required to provide any personal information and identity to keep the survey anonymous; consequently, they participated in the study.

2.5 Demographic information

The demographic elements consisted of age (18-65 in five categories), gender (Male & Female), professionals, students, and entrepreneurs (self-employed and owners of the SMEs). The study was confined to the urban population who faced strict lockdown restrictions and complete closure.