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A pilot study of the depression, anxiety and stress in Greek military personnel during the first year of the COVID-19 pandemic
  1. Athanasios S Kotoulas1,2,
  2. D Karamanavis3,
  3. G Ι Lambrou4 and
  4. P Karanikas5
  1. 1 Research & Informatics Department, IT Center, Hellenic Tactical Air Force, Larissa, Greece
  2. 2 Bioinformatics Laboratory, Department of Food Science and Human Nutrition, University of Thessaly, Karditsa, Greece
  3. 3 Medical Department, Hellenic Tactical Air Force, Larissa, Greece
  4. 4 First Department of Pediatrics, Choremeio Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece
  5. 5 Medical Department, 110CW/Hellenic Tactical Air Force, Larissa, Greece
  1. Correspondence to Maj Athanasios S Kotoulas, Research Head Operator, Research & Informatics Department, Hellenic Tactical Air Force, IT Center, Larissa, Greece; athkot{at}


Introduction The ongoing SARS-CoV-2 pandemic is a global health crisis which poses many psychological research challenges. The objective of this study was to evaluate the responsiveness and validity of depression, anxiety and stress in a representative cohort of Hellenic military personnel using the short version of the Greek military version of the Depression–Anxiety–Stress Scales-21 (DASS-21) questionnaire.

Methods A total of 158 participants were voluntarily surveyed using an electronically developed structured questionnaire. The anonymous e-questionnaire included a social demographic section and the DASS-21 scale section. It was distributed in September 2020 to the military personnel of the Hellenic Tactical Air Force Units using an intranet network during government restrictive measures due to the COVID-19 crisis.

Results Our DASS-21 survey indicated a positive outcome at the psychometric level of our military sample population. Age, sex and systemic medications were statistically correlated with anxiety. Inter-correlations between the DASS-21 statements showed that individuals with low-level depression also experienced some degree of stress. Factor analysis indicated the reliability and validity of the questionnaire.

Conclusions The low levels of depression and stress among our military sample population demonstrate the importance of periodic monitoring of the psychometric items of the DASS-21 subscales to design and implement psychological prevention strategies, especially during the ongoing and future healthcare crises.

  • psychiatry
  • depression & mood disorders
  • anxiety disorders
  • COVID-19

Data availability statement

Data are available upon reasonable request. All data relevant to the study are available upon reasonable request directly by the corresponding author.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

Data are available upon reasonable request. All data relevant to the study are available upon reasonable request directly by the corresponding author.

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  • Contributors ASK, DK and PK conceived the idea and developed the theory. ASK and DK designed the framework. ASK developed the e-questionnaire, gathered and processed the appropriate data. DK supervised the implementation stage. GL verified the statistics results. ASK and GL wrote the manuscript. All authors discussed the results. ASK and DK co-directed the project.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.