en ● Psychosocial Health مقاله اصيل پژوهشي Orginal Article <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Tahoma;"><span style="line-height:2;"><b><span lang="EN-CA">Background</span>: </b><span lang="EN-CA">The COVID-19 pandemic disrupted daily life and posed mental health challenges. Evidence on changes in self-perceived mental health (SPMH) remains limited. This study examined psychosocial and pandemic-related predictors of declines in SPMH.</span><span dir="RTL" lang="AR-SA"><span style="font-family:&quot;Times New Roman&quot;,serif"></span></span><br> <b><span lang="EN-CA">Methods:</span></b> A <span lang="EN-CA">cross-sectional online survey was conducted among 648 Iranian adults during August-September 2022. Multivariate logistic regression identified factors associated with worsened SPMH from pre- to during-pandemic periods.</span><br> <b><span lang="EN-CA">Results:</span></b><span lang="EN-CA"> Participants were mostly female (60.3%), urban (96.9%), and aged 35&ndash;54 years (mean = 45.8), with 67.0% holding postsecondary education. Overall, 45.1% reported a decline in mental health. In multivariate analysis, frequent loneliness showed the strongest association (OR = 3.34; 95% CI: 1.87&ndash;5.96), followed by moderate/severe stress (OR = 2.49; 95% CI: 1.66&ndash;3.74). Economic strain from income loss increased risk (OR = 1.64; 95% CI: 1.10&ndash;2.45). Behavioral changes, including altered sleep (OR = 1.95; 95% CI: 1.23&ndash;3.10) and increased TV viewing (OR = 1.63; 95% CI: 1.08&ndash;2.46), were also associated with poorer SPMH. COVID-19 exposure factors (infection, bereavement, vaccination) were significant in initial models but lost significance after psychosocial variables were added, suggesting mediation by loneliness and stress.</span><br> <b><span lang="EN-CA">Conclusion:</span></b><span lang="EN-CA"> Loneliness, stress, financial strain, and lifestyle disruptions were strongly associated with poorer SPMH among urban Iranian adults during the COVID-19 pandemic. Attenuation of exposure effects after psychosocial adjustment suggests indirect pathways, warranting mediation testing in longitudinal research and representative sampling. These associations may guide strategies to reduce loneliness and stress, address economic strain, and promote healthy routines. Interpretations should remain cautious given the cross-sectional design and sampling bias.</span></span></span></span></div> COVID-19, Mental Health, Loneliness, Stress, Behavioral Disruptions, Pandemic, Iran 5 5 http://jrh.gmu.ac.ir/browse.php?a_code=A-10-2816-1&slc_lang=en&sid=1 Amir Erfani amire@nipissingu.ca 1 100319475328460045794 Yes Department of Sociology, Faculty of Arts and Science, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario, Canada. Arghavan Hajsheykholeslami Hajsheykholeslami.a@iums.ac.ir 2 100319475328460045795 No Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Marzieh Nojomi mnojomi@iums.ac.ir 3 100319475328460045796 No Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences. Tehran, Iran.