Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study

Multimorbidity and Mental Health Trajectories Among Middle-Aged and Older U.S. Adults During the COVID-19 Pandemic: Longitudinal Findings From the COVID-19 Coping Study

Background and Objectives

This study aimed to examine the associations between multimorbidity at the COVID-19 pandemic onset and subsequent longitudinal trajectories of depressive symptoms, anxiety symptoms, and loneliness in middle-aged and older adults over a 12-month follow-up.

Research Design and Methods

Data were from monthly online questionnaires in the COVID-19 Coping Study of U.S. adults aged ≥55 from April/May 2020 through April/May 2021 (N = 4,024). Multimorbidity was defined as having ≥2 versus <2 chronic conditions at baseline. Mental health outcomes were assessed monthly as depressive symptoms (8-item Center for Epidemiologic Studies Depression scale), anxiety symptoms (5-item Beck Anxiety Inventory), and loneliness (3-item UCLA Loneliness Scale). We used multivariable-adjusted population- and attrition-weighted mixed-effects linear models to examine the longitudinal associations between multimorbidity and mental health symptoms.

Results

Multimorbidity at the pandemic onset was associated with elevated depressive (b = 0.37; 95% CI: 0.16-0.59) and anxiety (b = 0.39; 95% CI: 0.15-0.62) symptoms at baseline. Changes in symptoms for all three mental health outcomes were nonlinear over time, with worsening symptoms over the first 6 months of the pandemic (April/May to September/October 2020), followed by improvement in symptoms over the subsequent 6 months (September/October 2020 to April/May 2021). Middle-aged and older adults with multimorbidity experienced faster rates of change in anxiety symptoms and loneliness than those without multimorbidity, with persistently elevated mental health symptomatology throughout the follow-up.

Discussion and Implications

Results highlight the unique and persistent mental health risks experienced by middle-aged and older adults with multimorbidity during the COVID-19 pandemic. The observed improvements in symptoms underscore the mental resilience of these individuals, indicating their adaptation to the ongoing pandemic.

Using prosocial behavior to safeguard mental health and foster emotional well-being during the COVID-19 pandemic: A registered report of a randomized trial

Background

The COVID-19 pandemic, the accompanying lockdown measures, and their possible long-term effects have made mental health a pressing public health concern. Acts that focus on benefiting others—known as prosocial behaviors—offer one promising intervention that is both flexible and low cost. However, neither the range of emotional states prosocial acts impact nor the size of those effects is currently clear—both of which directly influence its attractiveness as a treatment option.

Objective

To assess the effect of prosocial activity on emotional well-being (happiness, belief that one’s life is valuable) and mental health (anxiety, depression).

Methods

1,234 respondents from the United States and Canada were recruited from Amazon’s Mechanical Turk and randomly assigned (by computer software) to perform prosocial (N = 411), self-focused (N = 423), or neutral (N = 400) behaviors three times a week for three weeks. A follow-up assessment was given two weeks after the intervention. Participants were blind to alternative conditions. Analyses were based on 1052 participants (Nprosocial = 347, Nself = 365, Nneutral = 340).

Findings

Those in the prosocial condition did not differ on any outcome from those in the self-focused or neutral acts conditions during the intervention or at follow-up, nor did prosocial effects differ for those who had been negatively affected socially or economically by the pandemic (all p’s > 0.05). Exploratory analyses that more tightly controlled for study compliance found that prosocial acts reduced anxiety relative to neutral acts control (β = -0.12 [95% CI: -0.22 to -0.02]) and increased the belief that one’s life is valuable (β = 0.11 [95% CI: 0.03 to 0.19]). These effects persisted throughout the intervention and at follow-up.

Conclusion

Prosocial acts may provide small, lasting benefits to emotional well-being and mental health. Future work should replicate these results using tighter, pre-registered controls on study compliance.

Exploring Barriers and Facilitators to Physical Activity during the COVID-19 Pandemic: A Qualitative Study

Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited; thus, this study aimed to understand barriers and facilitators to PA during the pandemic, focusing on groups more likely to have been affected by restrictions, and to map these onto the capability, opportunity, motivation model of behaviour (COM-B). One-to-one interviews were conducted with younger (aged 18–24) and older adults (aged 70+), those with long-term physical or mental health conditions, and parents of young children. Themes were identified using reflexive thematic analysis and were mapped onto COM-B domains. A total of 116 participants contributed (aged 18–93, 61% female, 71% White British). Key themes were the importance of the outdoor environment, impact of COVID-19 restrictions, fear of contracting COVID-19, and level of engagement with home exercise. Caring responsibilities and conflicting priorities were a barrier. PA as a method of socialising, establishing new routines, and the importance of PA for protecting mental health were motivators. Most themes mapped onto the physical opportunity (environmental factors) and reflective motivation (evaluations/plans) COM-B domains. Future interventions should target these domains during pandemics (e.g., adapting PA guidance depending on location and giving education on the health benefits of PA).

Pandemic and student mental health: mental health symptoms among university students and young adults after the first cycle of lockdown in the UK

BACKGROUND

Early COVID-19 research suggests a detrimental impact of the initial lockdown on young people's mental health.

AIMS

We investigated mental health among university students and young adults after the first UK lockdown and changes in symptoms over 6 months.

METHOD

In total, 895 university students and 547 young adults not in higher education completed an online survey at T1 (July-September 2020). A subset of 201 university students also completed a 6 month follow-up survey at T2 (January-March 2021). Anxiety, depression, insomnia, substance misuse and suicide risk were assessed.

RESULTS

At T1, approximately 40%, 25% and 33% of the participants reported moderate to severe anxiety and depression and substance misuse risk, clinically significant insomnia and suicidal risk. In participants reassessed at T2, reductions were observed in anxiety and depression but not in insomnia, substance misuse or suicidality. Student and non-student participants reported similar levels of mental health symptoms. Student status was not a significant marker of mental health symptoms, except for lower substance misuse risk.Cross-sectionally, greater symptoms across measures were consistently associated with younger age, pre-existing mental health conditions, being a carer, worse financial status, increased sleep irregularity and difficulty since lockdown. Longitudinally, T2 symptoms were consistently associated with worse financial status and increased difficulty sleeping at T1. However, these associations were attenuated when baseline mental health symptoms were adjusted for in the models.

CONCLUSIONS

Mental health symptoms were prevalent in a large proportion of young people after the first UK lockdown. Risk factors identified may help characterise high-risk groups for enhanced support and inform interventions.

Longitudinal changes in fear and anxiety among Chinese college students during the COVID-19 pandemic: a one-year follow-up study

There is growing evidence that levels of fear and anxiety have increased during the COVID-19 pandemic. However, given regular epidemic prevention and control measures, longitudinal changes and causal factors in the incidence of fear and anxiety need to be measured and explored. College students completed online surveys in two wave studies a year apart. The participants who completed both of the surveys numbered 22,578. The online surveys were completed at the pandemic's normalization/prevention stage (T1, from June 1 to 15, 2020) and during a phase of new local transmission of the disease in Guangdong Province (T2, from June 10 to 18, 2021). Multiple linear regressions were used to examine fear and anxiety predictors from demographic characteristics. Fear related to COVID-19 had significantly decreased at T2 (t = 66.64, p < 0.001), however, anxiety had significantly increased at T2 (t = -5.03, p < 0.001). In particular, not implementing preventive measures (e.g., handwashing) during the COVID-19 pandemic had the greatest impact in predicting the change in fear levels. By contrast, prior poor mental health status contributed the most in predicting the change in degree of anxiety. These results suggest different changes in anxiety levels (deterioration) and degree of fear (mitigation) occurred as the COVID-19 pandemic progressed. These findings have implications for planning mental health crisis provisions and have long-term impact beyond this pandemic.

Who is seeking help for psychological distress associated with the COVID-19 pandemic? Characterization of risk factors in 1269 participants accessing low-threshold psychological help

Background

The COVID-19 pandemic and accompanying restrictions are associated with substantial psychological distress. However, it is unclear how this increased strain translates into help-seeking behavior. Here, we aim to characterize those individuals who seek help for COVID-19 related psychological distress, and examine which factors are associated with their levels of distress in order to better characterize vulnerable groups.

Methods

We report data from 1269 help-seeking participants subscribing to a stepped-care program targeted at mental health problems due to the COVID-19 pandemic. Sample characteristics were compared to population data, and linear regression analyses were used to examine which risk factors and stressors were associated with current symptom levels.

Results

Seeking for help for COVID-19 related psychological distress was characterized by female gender, younger age, and better education compared to the general population. The majority reported mental health problems already before the pandemic. 74.5% of this help-seeking sample also exceeded clinical thresholds for depression, anxiety, or somatization. Higher individual symptom levels were associated with higher overall levels of pandemic stress, younger age, and pre-existing mental health problems, but were buffered by functional emotion regulation strategies.

Conclusions

Results suggest a considerable increase in demand for mental-healthcare in the pandemic aftermath. Comparisons with the general population indicate diverging patterns in help-seeking behavior: while some individuals seek help themselves, others should be addressed directly. Individuals that are young, have pre-existing mental health problems and experience a high level of pandemic stress are particularly at-risk for considerable symptom load. Mental-healthcare providers should use these results to prepare for the significant increase in demand during the broader aftermath of the COVID-19 pandemic as well as allocate limited resources more effectively.

Longitudinal changes in depression and anxiety during COVID-19 crisis in Uruguay

Longitudinal studies have reported decreased mental health symptoms throughout the COVID-19 crisis, while others have found improvements or no changes across time. However, most research was carried out in developed countries, with a high incidence of COVID-19 and, in several cases, mandatory lockdowns. Considering that Uruguay (a developing country) had a low COVID-19 incidence at the moment of this study and has implemented a mild lockdown, we aimed to evaluate the effect of time and mobility (using Google mobility data) on symptoms of anxiety and depression. A longitudinal panel study with six repeated measures was carried out to evaluate depressive (BDI-II) and anxiety (STAI-S) symptoms during the pandemic. A decline in symptoms of anxiety and depression was found across time. Interestingly, this effect was modulated by age; a greater difference in the symptomatology between age groups was found at the beginning of the measurements than at the end, with the youngest reporting the most severe symptoms. Finally, we found that depressive symptoms decreased as mobility increased. Overall, our findings indicate an improvement in mental health as quarantine passed and mobility increased but following a different pattern depending on age. Monitoring these trajectories is imperative moving forward, especially in vulnerable groups.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03460-w.

How long was it for you? Memories of the duration of the UK covid-19 lockdown

The covid-19 global pandemic has significantly impacted on the daily lives of people across the world. One consequence of this has been significant distortion to the speed at which time feels like it is passing during day-to-day life in comparison with prior to the pandemic. The current study sought to further understanding of the impact of the pandemic on temporal experience by exploring individual differences in the subjective length of the first 12 months of the pandemic in the UK. Using an online questionnaire, subjective judgments of the perceived length of the preceding 12 months were taken. In addition, measures of affect, task load and satisfaction with current levels of social interaction, physical activity, conformity with regulations, perceived covid risk and shielding status were taken. The results showed that only 9% of participants reported that the preceding 12 months felt like 12 months. The majority of participants (57%) reported that it felt like the pandemic had lasted for longer than 12 months, and this feeling was stronger for those who indicated greater levels of depression and anxiety, reduced physical activity, reduced satisfaction with social interaction and being advised to shield.

One-year into COVID-19 pandemic: Decision-making and mental-health outcomes and their risk factors

BACKGROUND

The COVID-19 pandemic represents an unprecedented worldwide crisis with serious socioeconomic, physical and mental health consequences. However, its long-lasting effects on both mental health and decision-making difficulties remain unexplored. This study aimed to determine the prevalence and severity of psychological disorders in Italy's populace one-year after the outbreak; further, we investigated potential risks impacting mental health and decision-making.

METHODS

In March 2021, 586 individuals (18-73 years) completed an online-survey plus a computerized delay discounting task for hypothetical money rewards.

RESULTS

Psychological symptoms prevalence exceeded the Italy's lockdown rates, with about one-third reporting moderate-to-extremely severe depression, another third anxiety, and the rest stress; mirrored by an increase of symptoms at clinically significant severity levels. One year into the pandemic, half of our sample presented at least one psychological problem, and one-third was at risk of developing a more clinically severe psychological outcome. Fear of job loss, loneliness and intolerance of uncertainty were among the major risk factors to mental health. Plus, social-relationships and financial uncertainty were key determinants of depression, while fear of COVID-19 infection predicted anxiety symptoms. For decision-making tendencies, elevated delay discounting rates, implying less future-oriented behaviors, were mostly predicted by increased job loss fear and older age (>35 years).

LIMITATIONS

This study provides cross-sectional evidence.

CONCLUSIONS

Depression, anxiety and stress levels were still alarming one-year into COVID-19. Individuals experiencing financial insecurity, loneliness and intolerance of uncertainty perhaps benefit most from early interventions. Governments need to implement timely recovery plans to reduce financial insecurity, given its significant mental health impact and decision-making outcomes.

The Association between Working Hours Flexibility and Well-Being Prior to and during COVID-19 in South Korea

Objective: This study examined the relationship between the flexibility of work schedule arrangements and well-being among full-time workers prior to and after the coronavirus disease (COVID-19) outbreak in South Korea. Methods: Data from the fifth 2017 and sixth 2020–2021 Korean Working Conditions Survey, including a final sample of 45,137 participants (22,460 males; 22,677 females), were used. Multiple logistic regression was performed to establish the association between schedule arrangement types and the 5-item World Health Organization Well-Being Index. Results: The study found an association between flexible schedule arrangements and good well-being in 2017: “little flexibility” (odds ratio (OR), 1.33; 95% confidence interval (CI), 1.27–1.48), “moderate flexibility” (OR, 1.48; 95% CI, 1.28–1.71), and “high flexibility” (OR, 1.35; 95% CI, 1.06–1.72). During COVID-19, only workers with “high flexibility” were likely to have good well-being (OR, 1.49; 95% CI, 1.18–1.88), while the association between well-being and “low flexibility” (OR, 1.06; 95% CI, 0.96–1.17) and “moderate flexibility” types (OR, 0.66; 95% CI 0.59–0.75) decreased. This study found that flexible working hours may contribute to better well-being among full-time workers. However, the impact of the COVID-19 pandemic on working conditions and employee well-being should be addressed while setting working hours.

How Did the Psychological Well-Being of Church of England Clergy and Laity Change From the First to the Third National COVID-19 Lockdowns?

The balanced affect model of psychological well-being conceptualises positive and negative affect as two separate continua and well-being as the function of these two entities. The COVID-19 pandemic lasted over two years in the United Kingdom and initially caused widespread declines in mental health and well-being. This paper tests whether such declines continued or stabilised as the pandemic lockdowns persisted. The psychological well-being of a religiously committed sample was assessed by perceived changes in affect balance (a function of negative and positive affect) using The Index of Affect Balance Change (TIBACh) from the first to the third COVID-19 lockdowns in the Church of England. The 2020 sample in the first lockdown comprised 792 stipendiary parochial clergy and 2,815 laity who were not in licensed ministry in the Church of England. A repeat survey in the third lockdown in England in 2021 collected responses from 401 equivalent clergy and 1027 equivalent laity. Both clergy and lay people showed increased proportions reporting lower positive affect and increased proportions reporting higher negative affect in the second survey, suggesting psychological well-being had continued to deteriorate as lockdowns persisted.

Two Years of COVID-19 in Austria-Exploratory Longitudinal Study of Mental Health Outcomes and Coping Behaviors in the General Population

Since the long-term mental health impact of COVID-19 is not yet fully understood, the present study explored changes in mental health outcomes and pandemic-related coping behaviors across four pandemic stages. The main objective was to gain insights into the dynamics of mental health and coping, considering different pandemic features at different assessment waves. The final sample consisted of N = 243 adults from the Austrian general population. Data were collected at four timepoints (between June 2020 and December 2021) via LimeSurvey, an open-source online survey tool. Symptoms of posttraumatic stress disorder (PTSD), adjustment disorder (AD), anxiety, and depression were assessed using validated instruments: Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), AD-New Module 8 (ADNM-8), and Patient Health Questionnaire (PHQ4). We also administered the Pandemic Coping Scale (PCS) to address pandemic-related coping behaviors. Cochran’s Q test and repeated measures ANOVAs were applied to assess changes over time. The results indicated that prevalence rates of AD (χ2(2) = 16.88, p = 0.001), depression (χ2(3) = 18.69, p < 0.001), and anxiety (χ2(3) = 19.10, p < 0.001) significantly changed across four assessment waves. Changes in mean scores of the assessed mental health outcomes were also observed. For pandemic-related coping, we found differences in the subscales: healthy lifestyle: F(3, 651) = 5.11, prevention adherence: F(2.73, 592.35) = 21.88, and joyful activities: F(3, 651) = 5.03. Taken together, our study showed a higher mental health burden in wintertime than in summertime, indicating an increased need for psychosocial support in times of stricter measures, higher incidences, and higher death rates. Furthermore, the observed decrease in adaptive coping behaviors suggests that easy-to-implement coping strategies should be actively promoted in order to maintain mental health during and in the aftermath of pandemics.

Psychological distress, loneliness, alcohol use and suicidality in New Zealanders with mental illness during a strict COVID-19 lockdown

INTRODUCTION

People with pre-existing mental health conditions may have been disproportionally impacted by the COVID-19 pandemic and associated public health restrictions. In this study, we compared psychological outcomes, experiences and sources of stress over the pandemic lockdown in New Zealanders with and without a previous diagnosis of mental illness.

METHODS

Two online surveys were conducted in New Zealand over the level 4 lockdown in April 2020 measuring psychological distress, anxiety, well-being, suicidality, alcohol use and subjective experiences. They included 3389 participants, of whom 18.4% reported having been previously diagnosed with a mental illness.

RESULTS

During the lockdown, people previously diagnosed with a mental illness had about twice the risk of reporting moderate-high levels of psychological distress (K10 ⩾ 12), at least moderate levels of anxiety (GAD-7 ⩾ 10) and poor well-being (WHO-5 ⩽ 12). They reported increased alcohol use and were about four times as likely to have experienced suicidal thoughts with 3% reporting having made a suicide attempt over the lockdown period. They reported less satisfaction with, and poorer relationships with people in their 'bubble', reduced social contacts and greater loneliness. They also reported higher levels of health and financial concerns.

CONCLUSION

During the COVID-19 lockdown in New Zealand, people with a previous diagnosis of a mental illness were at increased risk of detrimental psychological outcomes. This highlights the importance of recognising this and the challenges people face in pandemics.

Social Factors Predict Distress Development in Adults With Pre-existing Mental Disorders During the Coronavirus Disease 2019 Pandemic

Physical distancing measures during the coronavirus pandemic are associated with increased psychological distress, especially in people with mental disorders. We investigated which social risk and resilience factors influence distress over time in people with pre-existing mental disorders. We conducted a longitudinal online survey with weekly follow-ups between April and July 2020 (n = 196 individuals with, and n = 545 individuals without pre-existing mental disorders at baseline). Our results show that individuals with, but not those without pre-existing mental disorders displayed higher distress levels when social resources and empathic disconnection are low and perceived social isolation is high. The distress development differed between participants with and without pre-existing mental disorders depending on their level of social resources, empathic disconnection, and perceived social isolation. These findings offer specific information for targeted social interventions to prevent an increase in incidence of mental disorders during physical distancing measures.

Health-related and socio-economic burden of the COVID-19 pandemic in Vienna

Previous pandemics have rarely affected everyone equally and, so far, the COVID-19 pandemic is no exception. Emerging evidence has shown that incidence rate, hospitalisation rate, and mortality due to COVID-19 are higher among people in lower socio-economic position (SEP). In addition, first investigations indicate that not everyone is equally affected by this pandemic's collateral public health damage. Using a stratified random sample of 1,004 participants living in Vienna, a Central European city with approximately 1.9 million inhabitants, this study analysed the distribution of 10 adverse health-related and socio-economic outcomes attributable to the COVID-19 pandemic across socio-economic strata. To this end, we estimated differences in the incidence rate of these outcomes by SEP and each of its indicators using zero-inflated Poisson and logistic regression models, adjusted for age and gender. Data were collected during first lockdown measures between 27 April and 17 May 2020. Differences in the incidence rate between the two lowest and two highest SEP groups were clearly visible. Participants in the lowest SEP category had a 32.96% higher incidence rate (IRR = 1.333 [95% CI: 1.079-1.639]), and participants in the second lowest SEP category had a 44.69% higher incidence rate (IRR = 1.447 [95% CI: 1.190-1.760]) compared with participants in the highest SEP category. In sum, 6 out of 10 adverse COVID-19-related outcomes were, to a greater or lesser extent, disproportionately experienced by Viennese residents in lower SEP. Inequalities were most visible between income groups and for the outcomes job loss, worsening of the financial situation, and worse mental health. These results strengthen and extend the current evidence on the unequally distributed burden of the COVID-19 pandemic. In light of effect heterogeneity across SEP indicators, we encourage future investigators to pay increased attention to their operationalisation of SEP. Such awareness will help to correctly identify those in most urgent need of supportive polices.

The Role of Hope and Resilience in Protecting Against Suicidal thoughts and Behaviors During the COVID-19 Pandemic

OBJECTIVE

The COVID-19 pandemic has impacted the mental health and wellbeing of populations across the world. This study aimed to examine: (1) which specific aspects of the COVID-19 pandemic were associated with the presence of suicidal thoughts and behaviors, and (2) the extent to which participants' hopelessness and resilience moderated the relationship between COVID-19 related stress and suicidal thoughts and behaviors.

METHOD

We administered an online survey to 12,989 adult (16+) participants across Wales from the 9th June to the 13th July 2020. Participants completed a series of questionnaires measuring the stressors they had experienced during the COVID-19 pandemic, their levels of hopelessness over the past two weeks, their levels of resilience, and whether they had experienced suicidal thoughts or behaviors since the onset of the COVID-19 pandemic.

RESULTS

Our findings revealed that: (1) food insecurity, domestic abuse, relationship problems, redundancy, social isolation and financial problems were the COVID-19 related stressors most strongly associated with suicidal thoughts and behaviors, and (2) that both hopelessness and resilience moderated the relationship between COVID-19 stress and suicidal thoughts, such that the relationship between COVID-19 stress and the presence of suicidal thoughts was much stronger for individuals with high hopelessness and low resilience.

CONCLUSIONS

These results highlight the aspects of the COVID-19 pandemic that are closely related to suicidal thoughts and behaviors and demonstrate the important role that hope for the future and resilience play in protecting individuals against the negative effects of the COVID-19 pandemic.HighlightsStressors caused by the pandemic are linked to increased suicidal thoughts.Hope protects individuals against the negative impact of the COVID-19 pandemic.Resilience also protects people from the negative impact of the COVID-19 pandemic.

Capturing lifestyle changes and emotional experiences while having a compromised immune system during the COVID-19 pandemic: A photo-elicitation study

This study aimed to describe lifestyle and emotional changes individuals with compromised immune systems experienced during the early months of the coronavirus disease 2019 pandemic. A survey was distributed to online support organizations for those with chronic illness and a national research volunteer registry from April to June 2020. Participants were asked to document their experiences via three photo-elicitation prompts, followed by reflection and Likert scale questions. Forty-seven individuals responded with 282 photos submitted. Lifestyle changes noted include shifts in wellness strategies, health management, routine, stressors, and time perception. Participants described significant distress stemming from deteriorating mental health, safety fears, isolation, health management, and longing. Wellness strategies documented included finding comfort, connection, and escape, managing uncertainty, maintaining physical health, and building resilience. These findings can increase a sense of community for immunocompromised individuals who are struggling in isolation and enhance knowledge of their day-to-day health needs during times of increased stress and health risk.

The Effect of Perceived Social Support on Psychological Well-Being in COVID-19 Patients

Aim: This study aims to determine the effect of perceived social support experienced by COVID-19 patients on their psychological well-being. Methods: This study is a cross-sectional descriptive study. In the research, the data were collected through online platforms (such as Facebook and WhatsApp) via Google form between March-April 2021 to reduce the risk of transmission. Results: This cross-sectional study was performed on 403 COVID-19 patients. There were statistically significant positive correlations between the mean Psychological Well-Being Scale total score and the Multidimensional Scale of Perceived Social Support total score (r=0.772; p<0.001). Conclusion: It is extremely important to increase social support resources to maintain psychological well-being during and after quarantine practice in patients diagnosed with COVID-19. Keywords: COVID-19, patient, social, support, quarantine

Men and Women as Differential Social Barometers: Gender Effects of Perceived Friend Support on the Neuroticism-Loneliness-Well-Being Relationship in a Younger Adult Population

Loneliness and social isolation are well known to have detrimental effects on mental and physical health, and the perception of social support is frequently viewed as a protective factor. Yet, the beneficial effect varies when perceived support is considered with respect to gender and personality. We examined the mechanism of loneliness as a mediator of personality on health and moderation of this relationship by perceived social support and gender. Five hundred and thirty young adults (325 women) aged 18–32 years (Mage = 25.42, SD = 4.13) provided self-report assessments of personality, loneliness, perceived social support, general health and psychological impact of the COVID-19 pandemic on well-being. Using a series of regression-based mediation and moderated mediation models, we found higher scores on extraversion to be associated with lower loneliness and better general health and well-being; higher neuroticism with greater loneliness and poorer general health. Being male and perceiving greater friend support moderated the neuroticism–loneliness–well-being relationship. Men higher on neuroticism were less able to benefit from lower loneliness when the perception of support from friends was greater, yet were less sensitive to the negative impact on the well-being of perceiving low levels of friend support. Effects suggest important gender differences with the potential to inform health interventions.

The impact of consecutive COVID-19 lockdowns in England on mental wellbeing in people with inflammatory arthritis

Background

During the first UK COVID-19 lockdown, studies identified over half of inflammatory arthritis (IA) patients in the UK reported a worsening of emotional distress. Given the prolonged nature of the pandemic, and the strict ‘shielding’ restrictions imposed on ‘extremely clinically vulnerable’ populations, it is likely that the implementation of the second lockdown period in England, during November 2020, may also have had a negative impact on the mental health of IA patients. The aim of this study was to qualitatively explore the impact of consecutive lockdown periods on mental wellbeing in people with IA.

Methods

Nine IA patients took part in semi-structured telephone interviews at both baseline (June/July 2020) and follow-up (November 2020). The interview schedule, which was developed and piloted with a Patient Research Partner, explored patient experiences and mental health impacts of the COVID-19 lockdown periods. Interviews were analysed using inductive thematic analysis.

Results

Five males and four females, with rheumatoid arthritis, psoriatic arthritis, or spondylarthritis, aged between 24–79 years (mean = 49.9, SD = 20.9) were included in the sample. Four main themes impacting on mental wellbeing were identified from the data: (1) Pandemic fatigue versus pandemic acclimatisation, (2) Social interaction and isolation, (3) Clarity of information, (4) Seasonal changes.

Conclusion

The first two COVID-19 lockdown periods in England had an ongoing impact on the mental health of patients with IA. Healthcare professionals, in conjunction with government support, should ensure that adequate information and mental health resources are available to support IA patients during periods of ongoing restrictions, whilst also continuing to encourage behaviours which promote good mental health and wellbeing.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41927-022-00266-y.

The impact of COVID-19 pandemic on psychopathological symptoms in mothers and their school-age children before, during and after the COVID-19 pandemic peak

The COVID-19 pandemic had an impact on children's and caregivers' mental health. We investigated psychopathological symptoms in a group of non-at-risk and a group of at-risk mothers and their school-age children from the pre-pandemic period to the lockdown period and to the post-lockdown period. We used the SCL-90/R to assess mothers' psychological symptoms, the CBCL 1½-5, and the CBCL 6-18 for the perceived children's emotional-behavioral functioning. Analysis of variance was conducted to assess significant differences in the groups over the three assessment points. Linear regressions were run to investigate the effect of maternal psychological symptoms on their children's functioning. In the non-at-risk group, maternal psychopathological symptoms significantly varied during the pandemic. Children's Aggression scores decreased after the lockdown, while Depression scores significantly increased during lockdown and after. The mothers in the at- risk group presented overall decreasing scores over the three assessment points. Children's Aggression scores did not increase during lockdown. Depression scores did not show significant changes over the three assessment points. Overall, our results showed that mothers' psychopathological risk did not influence specific areas of children's emotional/behavioral functioning, but it had an effect on the general offspring psychological well-being.

Racial differences in the psychosocial response to the COVID-19 pandemic in veterans with psychosis or recent homelessness

The COVID-19 pandemic continues to disproportionately impact people of color and individuals experiencing psychosis and homelessness. However, it is unclear whether there are differences by race in psychosocial responses to the pandemic in vulnerable populations. The double jeopardy hypothesis posits that multiply marginalized individuals would experience worse psychosocial outcomes. The present study investigated the clinical and functional initial responses to the pandemic in both Black (n = 103) and White veterans (n = 98) with psychosis (PSY), recent homelessness (RHV), and in a control group (CTL) enrolled in Department of Veterans Affairs (VA) healthcare services. Clinical interviews were administered via phone at two time points: baseline (mid-May through mid-August 2020) and follow-up (mid-August through September 2020). The baseline interview also included retrospective measures of pre-COVID status from January 2020. There were no significant differences between Black and White veterans in depression, anxiety, or loneliness. However, Black veterans did endorse more fears of contamination, F(1, 196.29) = 9.48, p = .002. Across all groups, Black veterans had better family integration compared to White veterans, F(1, 199.98) = 7.62, p = .006. There were no significant differences by race in social integration, work/role productivity, or independent living. In sum, there were few significant differences between Black and White veterans in initial psychosocial response to the pandemic. The lack of racial disparities might reflect the presence of VA's wrap-around services. The findings also highlight the robust nature of social support in Black veterans, even in the context of a global pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

COVID-19 and Quitting Jobs

Despite substantial studies on COVID-19 and the problems employees face, the association between COVID-19 and resigning jobs has not caught the interest of researchers. Millions have already resigned from their employment, and more are expected to resign. This study aims to investigate the relationship between the demographics of employees, the course of COVID-19, perceived effect of COVID-19 on life (PEoC), fear, entrapment feeling, depression, and quitting the job during the COVID-19 pandemic. A cross-sectional study was designed, and a convenient sampling method was adopted. Data were collected via an online questionnaire and analyzed by using SPSS version 26. Correlation and regression analyses were performed to reveal the relationship. Coefficients and significance values were used to interpret the results. Independent samples t-test and one-way ANOVA are used to determine the difference across the groups. The correlation between depression and work location is statistically significant. The PEoC increases fear, internal and external entrapment, and depression. Despite the statistically significant correlations between quitting jobs and the education level, internal and external entrapment, PEoC, fear, and depression for employees who have COVID-19 history, quitting the job was found to be affected only by COVID-19 history, internal entrapment feeling, and education level. This study has shown that quitting the job is associated with PEoC, depression, and internal and external entrapments. The correlation between quitting jobs and other conditions differs depending on the COVID-19 history of the employee. Furthermore, quitting the job is being affected by the coronavirus history, the internal entrapment, and education level.

Merry Christmas and a “Healthy” New Year

Abstract. Background: In November 2020, many European governments imposed severe limitations on social contacts and festive gatherings to avoid a further outbreak of the COVID-19 pandemic. Aims: At the moment when it was still unclear whether Christmas gatherings would be allowed, the present vignette study was conducted to evaluate four hypothetical scenarios varying in restrictiveness (i.e., 1, 2, 4, or an unlimited number of visitors). Method: In total, 5,756 Belgian participants (65.7% female; Mage = 45.6, range: 18–89) evaluated each scenario in terms of the perceived strictness, probability of adherence, and expected psychological advantages (i.e., autonomy, relatedness, pleasure) and disadvantages (i.e., concerns). Results: Evidence for a curvilinear pattern was found, such that the expected psychological benefits increased with an increasing number of allowed visitors till 4, with this effect being reversed in case of an unlimited gathering. Yet, these main effects were qualified: Older adults, those living together, and those scoring high on risk perception and autonomous motivation to adhere to the corona measures expected the more restrictive scenarios to be equally beneficial compared to the more relaxed scenarios. Limitations: Limitations are self-selection of the sample, no counterbalancing of the scenario’s and the vignette-based methodology. Conclusion: The present findings suggest that people’s risk perception and autonomous motivation are key to secure and stimulate the acceptance of life-restricting measures.

The Psychological Consequences of the COVID-19 Pandemic in Adults Treated for Childhood Cancer

Background: Compared with the general population, childhood cancer survivors (CCS) could be at greater risk of psychological distress following the emergence of the COVID-19 pandemic. Purpose: This cross-sectional study assessed the psychological consequences of COVID-19 on the mental health of CCS. Design and participants: In December 2020, we interviewed through an online self-report questionnaire, 580 5-year CCS participating in the French Childhood Cancer Survivor Study (FCCSS) cohort. Methods: We first compared the mental health score of CCS with that observed in the French general population of the same age and gender. Subsequently, we studied predictors of the mental health score of CCS. Results: External comparisons revealed that the mental health score of CCS was similar to that of the general population. Among CCS, almost 42% stated that their psychological state had been worse during the lockdown. Predictors of poorer mental health included, among others, female gender, reporting a change in the occupational situation, having a relative who had been hospitalized or had died following COVID-19, and a greater perceived infection risk. Interpretation and Implications: Given the pre-existing vulnerability of some CCS to mental distress, the additional psychological consequences of COVID-19 in vulnerable survivors should receive attention from health care providers.

Global trends of suicidal thought, suicidal ideation, and self-harm during COVID-19 pandemic: a systematic review

Background

Suicide is one of the leading causes of death. The current systematic review is done to know the trend of suicidal thoughts, suicidal ideation, and self-harm during COVID-19 pandemic.

Main text

The search was done by using PubMed, ScienceDirect, and Google Scholar databases. With the help of Mendeley portal, articles were retrieved on the basis of inclusion criteria like to know the risk factors, vulnerable group, complete article PDFs, prevention strategies, aims, results, and limitations. The shortlisted data from search was tabulated, and the PRISMA chart was framed based on the inclusion and exclusion criteria.

Result

Sixteen studies that satisfied the inclusion criteria were organized and selected. The variables and global scenario were considered in databases. It has been noticed that trends of suicidal thoughts, suicidal ideation, and self-harm remains the same in some countries like Japan, whereas in some countries like Bangladesh and France, trends of suicides had increased during the pandemic period. The probable cause could be lockdown, social isolation, and stoppage of recreational activities.

Conclusions

The trends of suicidal ideation, suicidal thoughts, and self-harm are more in vulnerable categories like health care professionals, university students, elderly individuals, and psychiatrically ill patients. In health care professional, it is due to the increased risk of contagion and watching deaths closely. In university students, it is due to the lack of recreational activities and social isolation. Among elderly, it is due to thinking themselves as overburden. The increase in suicidality in psychiatric ill patient admitted during COVID-19 pandemic is due to unknown cause.

Influence factors analysis of COVID-19 Prevention behavior of chinese Citizens: a path analysis based on the hypothetical model

BACKGROUND

Under the outbreak of Coronavirus disease 2019 (COVID-19), a structural equation model was established to determine the causality of important factors that affect Chinese citizens' COVID-19 prevention behavior.

METHODS

The survey in Qingdao covered several communities in 10 districts and used the method of cluster random sampling. The research instrument used in this study is a self-compiled Chinese version of the questionnaire. Of the 1215 questionnaires, 1188 were included in our analysis. We use the rank sum test, which is a non-parametric test, to test the influence of citizens'basic sociodemographic variables on prevention behavior, and the rank correlation test to analyze the influencing factors of prevention behavior. IBM AMOS 24.0 was used for path analysis, including estimating regression coefficients and evaluating the statistical fits of the structural model, to further explore the causal relationships between variables.

RESULTS

The result showed that the score in the prevention behavior of all citizens is a median of 5 and a quartile spacing of 0.31. The final structural equation model showed that the external support for fighting the epidemic, the demand level of health information, the cognition of (COVID-19) and the negative emotions after the outbreak had direct effects on the COVID-19 prevention behavior, and that negative emotions and information needs served as mediating variables.

CONCLUSIONS

The study provided a basis for relevant departments to further adopt epidemic prevention and control strategies.

Perceived accessibility and mental health consequences of COVID-19 containment policies

BACKGROUND

Individuals have experienced various degrees of accessibility loss during the COVID-19 pandemic, which may consequently have influenced their mental health. Although efforts have been made to understand the mental health consequences of the pandemic and corresponding containment measures, the impacts of accessibility loss remain underexplored.

METHODS

Based on 186 family interviews, a 569-respondent panel survey was designed and distributed monthly from February to October 2020 in Kunming, China. A 3-wave cross-lagged panel model was developed to understand the causal relationship between mental health and perceived accessibility of daily necessities, key services, and social activities.

RESULTS

Goodness-of-fit indicators imply that the hypothesised model fits the observed data well: χ2/df = 2.221, AGFI = 0.910, NFI = 0.907, CFI = 0.933, RMSEA = 0.052. The results indicate that perceived accessibility of daily necessities and social activities had lagged effects on mental health status. The within-wave effects show that perceived accessibility of daily necessities (0.619, p < 0.01) and social activities (0.545, p < 0.01) significantly influenced respondents' mental health during the peak of the pandemic whilst perceived accessibility of social activities dominantly influenced their mental health after restrictions were lifted (0.779, p < 0.01). Perceived accessibility of public services such as healthcare did not significantly influence respondents' mental health in any wave. COVID-19 containment policies had different mental outcomes across population groups. Disadvantaged people experienced mental health issues due to accessibility loss for daily necessities and social activities until the lifting of compulsory QR-code-for-buses, whilst better-off populations had better mental health during the early phase of the outbreak and rapidly recovered their mental health after mobility restrictions eased.

CONCLUSION

Reduced perceived accessibility of daily necessities and social activities may be an underlying cause of mental health problems. Relative accessibility deprivation exacerbated mental health inequities during the COVID-19 pandemic.

Economic Recovery but Stagnating Mental Health During a Global Pandemic? Evidence from Ghana and South Africa

Ghana and South Africa proactively implemented lockdowns very early in the pandemic. We analyze a three-wave panel of households in Accra and Greater Johannesburg to study the mental and economic well-being of the urban poor between the COVID-19 lockdown and the "new normal" one year later. We find that even if economic well-being has mostly recovered, life satisfaction has only improved slightly and feelings of depression are again at lockdown levels one year into the pandemic. While economic factors are strongly correlated with mental health and explain the differences in mental health between South Africa and Ghana, increasing worries about the future and limited knowledge about the pandemic (both countries) as well as deteriorating physical health (South Africa) and trust in government (Ghana) explain why mental health has not recovered. Therefore, we need broad and country-specific policies, beyond financial support, to accelerate the post-pandemic recovery of the urban poor.

Profile of patients attending psychiatric emergency care during the coronavirus 2019 (COVID 19) pandemic: a comparative cross-sectional study between lockdown and post-lockdown periods in Lombardy, Italy

OBJECTIVE

To assess the long-term impact of early COVID-19 lockdown phase on emergency psychiatric consultations in two psychiatric emergency departments located in Italy.

METHODS

We conducted a cross-sectional study comparing the number and characteristics of emergency psychiatric consultations during post-lockdown with respect to the lockdown period. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis, information on multiple psychiatric consultations and hospitalisation were collected.

RESULTS

A rise of almost 60% in emergency psychiatric consultations during the post-lockdown compared to the lockdown period was observed. Emergency psychiatric consultations in the post-lockdown period were associated with lower rates of cannabis (aOR = 0.42, p = 0.011) and cocaine use (aOR = 0.39, p = 0.011). Despite a lower occurrence of two or more psychiatric consultations was observed during post-lockdown phase (aOR = 0.44, p = 0.008), subjects who had anxiety disorders (aOR = 3.91, p = 0.000) and substance intoxication or withdrawal (aOR = 6.89, p = 0.000) were more likely to present to emergency psychiatric consultations during post-lockdown period compared to the lockdown one.

CONCLUSIONS

Substance intoxication or withdrawal and anxiety disorders increased after the COVID-19 lockdown. The findings of this study suggest to address more economic and professional sources to the mental health areas potentially more affected by the different phases of a pandemic.KEYPOINTSCOVID-19 pandemic and lockdown measures increased mental health unmet needs.According to our findings, a rise in emergency psychiatric consultations during the post-lockdown compared to the lockdown period was observed.Patients with substance intoxication or withdrawal syndrome and anxiety disorders were significantly more likely to present to emergency psychiatric consultations during post-lockdown.Lockdown was associated with higher rates of both cannabis and cocaine use disorders as well as of multiple psychiatric consultations.Alternative strategies to improve mental health such as e-health technologies should be promoted.

Mental health and well-being during the second wave of COVID-19: longitudinal analyses of the UK COVID-19 Mental Health and Wellbeing study (UK COVID-MH)

BACKGROUND

Waves 1 to 3 (March 2020 to May 2020) of the UK COVID-19 Mental Health and Wellbeing study suggested an improvement in some indicators of mental health across the first 6 weeks of the UK lockdown; however, suicidal ideation increased.

AIMS

To report the prevalence of mental health and well-being of adults in the UK from March/April 2020 to February 2021.

METHOD

Quota sampling was employed at wave 1 (March/April 2020), and online surveys were conducted at seven time points. Primary analyses cover waves 4 (May/June 2020), 5 (July/August 2020), 6 (October 2020) and 7 (February 2021), including a period of increased restrictions in the UK. Mental health indicators were suicidal ideation, self-harm, suicide attempt, depression, anxiety, defeat, entrapment, loneliness and well-being.

RESULTS

A total of 2691 (87.5% of wave 1) individuals participated in at least one survey between waves 4 and 7. Depressive symptoms and loneliness increased from October 2020 to February 2021. Defeat and entrapment increased from July/August 2020 to October 2020, and remained elevated in February 2021. Well-being decreased from July/August 2020 to October 2020. Anxiety symptoms and suicidal ideation did not change. Young adults, women, those who were socially disadvantaged and those with a pre-existing mental health condition reported worse mental health.

CONCLUSIONS

The mental health and well-being of the UK population deteriorated from July/August 2020 to October 2020 and February 2021, which coincided with the second wave of COVID-19. Suicidal thoughts did not decrease significantly, suggesting a need for continued vigilance as we recover from the pandemic.

Health locus of control in a pandemic situation: cross-cultural differences between European and Asian respondents

Background

The present cross-cultural study examined the health locus of control construct during the COVID-19 pandemic. The scien-tific purpose of the study was to determine whether, during the pandemic situation, cultural and sex differences influence the health locus of control construct and change the internal health locus of control (IHLC), powerful others health locus of control (PHLC), and chance health locus of control (CHLC).

Participants and procedure

A total of 2617 recipients aged 18-70 years from Asia (China, India, and Indonesia), and Europe (Bulgaria, Germany, and Hungary) completed a questionnaire about their health. The participants completed an online version of the Multidimen-sional Health Locus of Control Scale – Form A.

Results

The survey shows that in a pandemic life-threatening situation, most individuals strive to rely on IHLC and/or PHLC, and fewer of them tend to rely on CHLC. However, there are differences (p < .001) between the two cultural samples: the rep-resentatives of Asian collectivistic culture are more dominated by PHLC, compared to the representatives of the European individualistic culture. When the comparison is between individuals from different cultures, sex differentiation affects the health locus of control, and as a result, significant differences in relation to IHLC, PHLC, and CHLC levels (р < .05) appear.

Conclusions

In conclusion, the study indicates that cultural differences influence both the IHLC and PHLC levels, and that Asian partici-pants are dominated by PHLC more than European respondents. Asian females are more likely to seek support from pow-erful others (PHLC) compared to European women, who perceive themselves as more independent. Asian male partici-pants are prepared to rely on powerful others (doctors or medical institutions), while European male respondents are prone to rely on themselves mainly (IHLC). The results show that sex differences do not significantly affect the health locus of control within the same cultural group.

Health locus of control in a pandemic situation: cross-cultural differences between European and Asian respondents

BACKGROUND

The present cross-cultural study examined the health locus of control construct during the COVID-19 pandemic. The scientific purpose of the study was to determine whether, during the pandemic situation, cultural and sex differences influence the health locus of control construct and change the internal health locus of control (IHLC), powerful others health locus of control (PHLC), and chance health locus of control (CHLC).

PARTICIPANTS AND PROCEDURE

A total of 2617 recipients aged 18-70 years from Asia (China, India, and Indonesia), and Europe (Bulgaria, Germany, and Hungary) completed a questionnaire about their health. The participants completed an online version of the Multidimensional Health Locus of Control Scale - Form A.

RESULTS

The survey shows that in a pandemic life-threatening situation, most individuals strive to rely on IHLC and/or PHLC, and fewer of them tend to rely on CHLC. However, there are differences (p < .001) between the two cultural samples: the representatives of Asian collectivistic culture are more dominated by PHLC, compared to the representatives of the European individualistic culture. When the comparison is between individuals from different cultures, sex differentiation affects the health locus of control, and as a result, significant differences in relation to IHLC, PHLC, and CHLC levels (p < .05) appear.

CONCLUSIONS

In conclusion, the study indicates that cultural differences influence both the IHLC and PHLC levels, and that Asian participants are dominated by PHLC more than European respondents. Asian females are more likely to seek support from powerful others (PHLC) compared to European women, who perceive themselves as more independent. Asian male participants are prepared to rely on powerful others (doctors or medical institutions), while European male respondents are prone to rely on themselves mainly (IHLC). The results show that sex differences do not significantly affect the health locus of control within the same cultural group.

Re-examining the relationship between interpersonal reactivity index sub-scales and mental well-being: Implications of the pandemic

The pandemic has severely impacted people's Mental Well-being (MWB) globally. Pre-pandemic studies have widely linked MWB with empathy. Against the backdrop of pandemic, we intend to re-examine this association between empathy, as widely measured by the Interpersonal Reactivity Index (IRI) sub-scales: perspective taking, empathic concerns, and personal distress with MWB. For this, a survey using a non-experimental research design was carried out during the 2020 lockdown. We used the Structural Equation Modeling approach to analyse the data. All the standardized scales have been tested for unidimensionality, reliability, and validity. We also resort to a self-administered questionnaire consisting of questions related to day-to-day activities to support the empirical findings. Results demonstrate a positive relationship between perspective taking and empathic concern with MWB and a negative relationship between personal distress and MWB. The response to the self-administered questionnaire corroborates with our model results and presents the scope of interpreting the findings. In continuation, limitations, contributions, and future scope conclude this essay.

Mental health problems among hotline callers during the early stage of COVID-19 pandemic

Background

The study aims to explore the mental health of the hotline callers during the COVID-19 pandemic in China.

Methods

Callers (N = 10,490) from the Beijing Psychological Support Hotline from January 21st to June 30th in 2019 and 2020 were enrolled and divided into two groups (during (2020) and before (2019) COVID-19 pandemic). The severity of depressive symptoms, psychological distress, hopefulness, and suicidal ideation (SI) was assessed. Demographic characteristics and major concerns were also collected. Mann-Whitney U and chi-square test were used to compare the differences in mental health conditions and major concerns between two years and between different age groups. The multivariable logistic regression was used to explore whether mental health conditions were associated with pandemic and demographic factors.

Results

Results from multivariable logistic regression analysis indicated that the change in suicidal ideation (OR = 1.52, 95% CI: 1.21-1.92) was significantly different across age groups. Callers during the pandemic reported a higher level of hopefulness (OR = 1.13, 95% CI [1.03-1.24]), a lower level of depressive symptoms (OR = 0.81, 95% CI [0.74-0.89]) and psychological distress (OR = 0.89, 95% CI [0.81-0.98]), and were less likely to report SI (OR = 0.69, 95% CI [0.61-0.77]) compared with callers before the pandemic.

Conclusions

Compared with callers before the pandemic, hotline callers during the early stage of COVID-19 pandemic did not present significant mental health problems. Younger callers during the pandemic were more vulnerable for the presence of suicidal ideation. Hotline-based crisis interventions might provide specific psychological support to cope with troubles during the pandemic.

COVID-19 Worries Predict Aging Preparation: Culture- and Domain-Specific Perspectives

OBJECTIVES

We investigated whether worrying about COVID-19 predict people's engagement in aging preparation. Furthermore, we expected that this association would have culture- (i.e., Hong Kong, Germany) and domain-specific (i.e., finances, housing, care needs, connectedness, end-of-life) tendencies, as the culture and domains that are most severely hit by the pandemic differ.

METHODS

A total of 360 and 1,294 adults (aged 18 to 98 years) living in Hong Kong and Germany, respectively, participated in a web-based study. We fitted our data to a multilevel model in order to take into account the interdependence of domains (i.e., Level 1) within the same individual (i.e., Level 2).

RESULTS

The results revealed that reporting higher COVID-19 worries was associated with pandemic-induced aging preparation, and this association was particularly apparent for Germans in comparison to those from Hong Kong. When domains were specified, this cultural difference appeared significantly stronger for the domains of care, connectedness, and end-of-life than finances and housing.

DISCUSSION

Findings imply that worrying about the COVID-19 pandemic predicts people to engage in aging preparation particularly in the culture and domains most affected by the pandemic. These results from those worried about the virus may be attributed to the increased self-relevance to the topic and hence motivation.

The effectiveness of remote therapy in two London IAPT services

The COVID-19 pandemic increased population levels of depression and anxiety, and infection control measures obliged services to provide psychological therapies remotely. Evidence for the routine provision of psychological therapy via telephone and video-conferencing is limited. This study compared therapy outcomes for 5360 clients in two London Improving Access to Psychological Therapy (IAPT) services before and after homeworking produced a compete shift to remotely delivered therapy. Despite the psychological impacts of pandemic restrictions, and the use of a novel therapy modality in video-conferencing, recovery rates and net score change improved in both services, significantly in one. There was no significant worsening of outcomes for any demographic group or presenting disorder. The findings suggest that for those able to access it, therapy provided by telephone and video is a clinically effective option for IAPT services.

Key learning aims

(1)

Mental health and social isolation under repeated mild lockdowns in Japan

The influence of repeated lockdowns on mental health and social isolation is unknown. We conducted a longitudinal study of the influence of repeated mild lockdowns during two emergency declarations in Japan, in May 2020 and February 2021. The analyses included 7893 people who participated in all online surveys. During repeated mild lockdowns, mental and physical symptoms decreased overall, while loneliness increased and social networks decreased. Subgroup analyses revealed that depression and suicidal ideation did not decrease only in the younger age group (aged 18-29 years) and that younger and middle-aged people (aged 18-49 years), women, people with a history of treatment for mental illness, and people who were socially disadvantaged in terms of income had higher levels of mental and physical symptoms at all survey times. Additionally, comprehensive extraction of the interaction structure between depression, demographic attributes, and psychosocial variables indicated that loneliness and social networks were most closely associated with depression. These results indicate that repeated lockdowns have cumulative negative effects on social isolation and loneliness and that susceptible populations, such as young people and those with high levels of loneliness, require special consideration during repeated lockdown situations.

Well-being app to support young people during the COVID-19 pandemic: randomised controlled trial

OBJECTIVES

To evaluate the efficacy and acceptability of 'Whitu: seven ways in seven days', a well-being application (app) for young people.

DESIGN

Prospective randomised controlled trial of Whitu against waitlist control, with 45 participants in each arm.

PARTICIPANTS

90 New Zealand young people aged 16-30 recruited via a social media advertising campaign.

SETTING

Participants' homes.

INTERVENTIONS

Developed during the COVID-19 pandemic, and refined from a prototype version that was evaluated during a smaller qualitative study, 'Whitu: seven ways in seven days' is a well-being app that, as its name suggests, contains seven modules to help young people (1) recognise and rate emotions, (2) learn relaxation and mindfulness, (3) practice self-compassion and (4) gratitude, (5) connect with others, (6) care for their physical health and (7) engage in goal-setting. It can be completed within a week or as desired.

MAIN OUTCOME MEASURES

Primary outcomes were changes in well-being on the WHO 5-item Well-Being Index and Short Warwick-Edinburgh Mental Well-Being Scale. Secondary outcomes were changes in depression on the Centre for Epidemiological Studies Depression Scale, anxiety on the Generalised Anxiety Disorder 7-item Scale, self-compassion on the Self Compassion Scale-Short Form, stress on the 10-item Perceived Stress Scale, sleep on the single-item Sleep Quality Scale and user engagement on the end-user version of the Mobile Application Rating Scale and via qualitative feedback during an online survey. Outcomes were evaluated at baseline, 4 weeks (primary study endpoint) and 3 months, and analysed using linear mixed models with group, time and a group-time interaction.

RESULTS

At 4 weeks, participants in the Whitu group experienced significantly higher emotional (Mean difference (md) 13.19 (3.96 to 22.42); p=0.005) and mental (md 2.44 (0.27 to 4.61); p=0.027) well-being, self-compassion (md 0.56 (0.28 to 0.83); p<0.001) and sleep (md 1.13 (0.24 to 2.02); p=0.018), and significantly lower stress (md -4.69 (-7.61 to -1.76); p=0.002) and depression (md -5.34 (-10.14 to -0.53); p=0.030), compared with the waitlist controls. Group differences remained statistically significant at 3 months for all outcomes. Symptoms of anxiety were also lower in the intervention group at 4 weeks (p=0.096), with statistically significant differences at 3 months (md -2.31 (-4.54 to -0.08); p=0.042). Usability of Whitu was high (subjective ratings of 4.45 (0.72) and 4.38 (0.79) out of 5 at 4 weeks and 3 months, respectively) and qualitative feedback indicated individual and cultural acceptability of the app.

CONCLUSIONS

Given the evolving psychological burden of the COVID-19 pandemic, Whitu could provide a clinically effective and scalable means of improving the well-being, mental health and resilience of young people. Replication of current findings with younger individuals and in other settings is planned.

TRIAL REGISTRATION NUMBER

Australian New Zealand Clinical Trials Registry (ACTRN12620000516987).

Romantic Relationships and Mental Health During the COVID-19 Pandemic in Austria: A Population-Based Cross-Sectional Survey

Background

Previous studies suggest that romantic relationships can be beneficial to mental health, but may also be a major stressor depending on specific relationship characteristics. Studies examining the role of romantic relationship in mental health are scarce. This study aimed to investigate differences in mental health with regards to relationship characteristics.

Methods

We assessed individuals’ mental health, i.e., suicidal ideation (via Beck Scale for Suicidal Ideation, BSS), depression (via Patient Health Questionnaire, PHQ-9), anxiety (Hospital Anxiety and Depression Scale, HADS), experience of psychological and physical violence, including changes in suicidal ideation and anxiety compared to before the pandemic, and relationship characteristics (i.e., relationship status, satisfaction, and commitment as well as family structure) with online questionnaires in a population-based cross-sectional study with 3,012 respondents in Austria during the COVID-19 pandemic.

Results

There were small to medium–sized group differences with regards to relationship status and satisfaction (η_p²: 0.011–0.056). Most mental health outcomes were less favorable in singles than in individuals in happy relationships, but scores for anxiety (p < 0.001), psychological (p < 0.001) and physical violence (p < 0.001), and the probability of experiencing an increase in anxiety compared to before the pandemic (p < 0.01) were lower in singles as compared to those with low relationship satisfaction. Furthermore, scores for suicidal ideation (p > 0.001) and psychological (p > 0.01) and physical violence (p > 0.01) were highest in individuals in relationships with low commitment and with a child living in the same household, but effect sizes were small (η_p²: 0.004–0.015).

Conclusion

During the COVID-19 pandemic, as compared to singles, mental health appeared worse in individuals with low relationship satisfaction and those in a relationship with low commitment and with a child in the household. Living in a happy relationship was associated with somewhat better mental health.

Mental disorders following COVID-19 and other epidemics: a systematic review and meta-analysis

COVID-19 has imposed a very substantial direct threat to the physical health of those infected, although the corollary impact on mental health may be even more burdensome. Here we focus on assessing the mental health impact of COVID-19 and of other epidemics in the community. We searched five electronic databases until December 9, 2020, for all peer-reviewed original studies reporting any prevalence or correlates of mental disorders in the general population following novel epidemics in English, Chinese or Portuguese. We synthesised prevalence estimates from probability samples during COVID-19 and past epidemics. The meta-analytical effect size was the prevalence of relevant outcomes, estimated via random-effects model. I² statistics, Doi plots and the LFK index were used to examine heterogeneity and publication bias. This study is pre-registered with PROSPERO, CRD42020179105. We identified 255 eligible studies from 50 countries on: COVID-19 (n = 247 studies), severe acute respiratory syndrome (SARS; n = 5), Ebola virus disease (n = 2), and 1918 influenza (n = 1). During COVID-19, we estimated the point prevalence for probable anxiety (20.7%, 95% CI 12.9-29.7), probable depression (18.1%, 13.0-23.9), and psychological distress (13.0%, 0-34.1). Correlates for poorer mental health include female sex, lower income, pre-existing medical conditions, perceived risk of infection, exhibiting COVID-19-like symptoms, social media use, financial stress, and loneliness. Public trust in authorities, availability of accurate information, adoption of preventive measures and social support were associated with less morbidity. The mental health consequences of COVID-19 and other epidemics could be comparable to major disasters and armed conflicts. The considerable heterogeneity in our analysis indicates that more random samples are needed. Health-care professionals should be vigilant of the psychological toll of epidemics, including among those who have not been infected.

The Emotions, Coping, and Psychological Well-Being in Time of COVID-19: Case of Master's Students

Background: Master’s students have been affected by COVID-19 and the changing study conditions due to the lockdown. The aim was to uncover changes in emotions, coping strategies, and psychological well-being during a pandemic. Methods: Ryff scale, multidimensional emotion questionnaire, and Brief COPE scale. Participants: sample of 118 master’s students after the first wave and 128 master’s students after the second wave. Results: After the second wave of COVID-19, the happy, enthusiastic, and inspired scores of the emotion construct components increased statistically significantly (p < 0.05), but the scores of the components sad, afraid, angry, ashamed, and anxious decreased significantly (p < 0.05). After the first wave, students commonly used planning, positive reframing, self-blame, humor, and acceptance coping strategies, which are classified as problem-focused and emotion-focused coping strategies. The psychological well-being of master’s students after the second wave was statistically (p < 0.05) better than that after the first wave in many indicators. Environment mastery skills did not change significantly. Significant associations were revealed between the same components of psychological well-being, emotion, and coping strategies. Conclusions: This study showed that the master’s students improved their adaptive abilities probably in the environment of long-term exposure to coronavirus disease, as most psychological well-being indicators improved significantly after the second wave.

Prevalence and associated factors of suicidal ideation among college students during the COVID-19 pandemic in China: a 3-wave repeated survey

OBJECTIVE

The coronavirus disease 2019 (COVID-19) pandemic, a major public health crisis, harms individuals' mental health. This 3-wave repeated survey aimed to examine the prevalence and correlates of suicidal ideation at different stages of the COVID-19 pandemic in a large sample of college students in China.

METHODS

Using a repeated cross-sectional survey design, we conducted 3 online surveys of college students during the COVID-19 pandemic at 22 universities in Guandong, China. The 3 surveys were conducted during the outbreak period (T1: 3 February to 10 February 2020, N = 164,101), remission period (T2: 24 March to 3 April 2020, N = 148,384), and normalized prevention and control period (T3: 1 June to 15 June 2020, N = 159,187). Suicidal ideation was measured by the ninth item of the Patient Health Questionnaire-9. A range of suicide-related factors was assessed, including sociodemographic characteristics, depression, anxiety, insomnia, pre-existing mental health problems, and COVID-19-related factors.

RESULTS

The prevalence of suicidal ideation was 8.5%, 11.0% and 12.6% at T1, T2, and T3, respectively. Male sex (aOR: 1.35-1.44, Ps < 0.001), poor self-perceived mental health (aOR: 2.25-2.81, Ps < 0.001), mental diseases (aOR: 1.52-2.09, P < 0.001), prior psychological counseling (aOR: 1.23-1.37, Ps < 0.01), negative perception of the risk of the COVID-19 epidemic (aOR: 1.14-1.36, Ps < 0.001), depressive symptoms (aOR: 2.51-303, Ps < 0.001) and anxiety symptoms (aOR: 1.62-101.11, Ps < 0.001) were associated with an increased risk of suicidal ideation.

CONCLUSION

Suicidal ideation appeared to increase during the COVID-19 pandemic remission period among college students in China. Multiple factors, especially mental health problems, are associated with suicidal ideation. Psychosocial interventions should be implemented during and after the COVID-19 pandemic to reduce suicide risk among college students.

Patterns and predictors of alcohol use during the early stages of the COVID-19 pandemic in Australia: Longitudinal cohort study

Background

The COVID‐19 pandemic has resulted in disruptions across many life domains. The distress associated with the pandemic itself, and with public health efforts to manage the outbreak, could result in increased alcohol use. This study aimed to quantify changes in alcohol use during the early stages of the pandemic and factors associated with different patterns of use.

Methods

Data were obtained from a longitudinal survey of a representative Australian adult sample (N = 1296, 50% female, M_age = 46.0) conducted from March to June 2020, during the first wave of the COVID‐19 outbreak in Australia. Change in alcohol consumption was examined using Alcohol Use Disorders Identification Test‐Consumption (AUDIT‐C) scores from waves one, three, five, and seven of the study, each 4 weeks apart. Factors associated with alcohol consumption were examined, including depression (PHQ‐9) and anxiety (GAD‐7) symptoms, health risk tolerance, stress and coping, work and social impairment (WSAS), COVID impacts, and sociodemographic variables. We tested changes in alcohol use across the full sample using a mixed effects repeated measure ANOVA model and a multinomial logistic regression to identify factors assessed at wave 1 that were independently associated with alcohol use.

Results

There was no significant change in AUDIT‐C scores across the study. For most participants, alcohol use did not increase during the early phase of the COVID‐19 pandemic in Australia. COVID‐19 exposure, higher perceived coping, depression symptoms, and male gender were associated with greater odds of increasing or elevated levels of alcohol use. Social changes, which included working from home, had mixed effects on alcohol consumption.

Conclusions

Although no evidence was found for increased alcohol use overall during the early months of the pandemic, several factors were associated with alcohol consumption at risky levels. Greater understanding of motivations for drinking across public and private contexts, along with targeted support for high‐risk groups, could assist in reducing harm associated with alcohol consumption.

How has physical distancing impacted on health and well-being during the COVID-19 pandemic? A Scottish longitudinal qualitative study

OBJECTIVES

This study provides an in-depth understanding of the impact of physical distancing restrictions and other quarantining measures during the first 6 months of the COVID-19 pandemic on physical and mental health and well-being.

DESIGN

Longitudinal qualitative research using semistructured interviews at two time points (21 May to 10 June 2020 when the first restrictions were eased, and 2 to 26 August 2020 when many restrictions had been eased, but physical distancing measures remained) and framework analysis.

SETTING

Interviews by telephone or video call in Scotland.

PARTICIPANTS

Thirty participants: 16 women, 93% reporting white ethnicity, 18+ years, 47% from deprived areas, 47% reported mental and/or physical health conditions.

RESULTS

Four main themes described the impact of physical distancing restrictions on (1) health behaviours; (2) healthcare access; (3) physical health; and (4) mental health. Changes in impact over the two time points were compared. For example, health behaviours in May/June, such as reduced physical activity and increased calorie intake, appeared to improve by August. From May/June to August, an increasing number of participants expressed dissatisfaction with healthcare they received. Participants with existing physical health conditions reported continued negative impact of restrictions on their physical health. All participants reported some negative mental health impact, mostly anxiety. An increasing number reported mental health improvements in August, with those with mental health conditions or under 30 years reporting improvement most frequently.

CONCLUSIONS

In line with previous research, our participants felt able to return to prepandemic health habits. Our findings corroborate evidence of reduced preventive healthcare use and help-seeking behaviours. People with existing health conditions appear to be most vulnerable to negative mental and physical health impacts of physical distancing. These negative impacts and periods of unhealthy behaviours have potential long-term consequences, especially among already underserved groups. We recommend public health and policy strategies to mitigate long-term impacts of physical distancing.

Characterizing Unusual Spatial Clusters of Male Mental Health Emergencies Occurring During the First National COVID-19 "Lockdown" in the East Midlands Region, UK: A Geospatial Analysis of Ambulance 999 Data

The widespread psychological effects of contagion mitigation measures associated with the novel coronavirus disease 2019 (COVID-19) are well known. Phases of "lockdown" have increased levels of anxiety and depression globally. Most research uses methods such as self-reporting that highlight the greater impact of the pandemic on the mental health of females. Emergency medical data from ambulance services may be a better reflection of male mental health. We use ambulance data to identify unusual clusters of high rates of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national "lockdown" and to explore factors that may explain clusters. Analysis of more than 5,000 cases of male mental health emergencies revealed 19 unusual spatial clusters. Binary logistic regression analysis (χ2 = 787.22, df = 20, p ≤ .001) identified 16 factors that explained clusters, including proximity to "healthy" features of the physical landscape, urban and rural dynamics, and socioeconomic condition. Our findings suggest that the factors underlying vulnerability of males to severe mental health conditions during "lockdown" vary within and between rural and urban spaces, and that the wider "hinterland" surrounding clusters influences the social and physical access of males to services that facilitate mental health support. Limitations on social engagement to mitigate effects of the pandemic are likely to continue. Our approach could inform delivery of emergency services and the development of community-level services to support vulnerable males during periods of social isolation.