Going through the lockdown: a longitudinal study on the psychological consequences of the coronavirus pandemic
Coronavirus 2019 pandemic lockdown in Italy lasted for 2 months, 1 week and 2 days. During this long period, one of the longest in Europe, the restrictions produced effects on people’s psychological well-being, with consequences that also continued after lockdown. The purpose of the study is to investigate these effects and how they changed in the general population over a period of time. We are also interested in exploring people’s post-lockdown anxiety and concerns. We conducted an online survey using snowball sampling techniques. The longitudinal study consisted of four administrations covering a period of 10 weeks between April (baseline) and June (last follow-up). Levels of anxiety and depression were assessed by GAD-7 and PHQ-9, coping strategies were assessed by Brief Resilient Coping Scale (BRCS) and social support was assessed by MSPSS. Post-lockdown anxiety was explored by developing a set of ad-hoc questions. PCA was used to determine the principal categories of post-lockdown anxiety/concern resulting from the ad-hoc questions. Longitudinal data, given their nested structure, were analyzed through mixed modeling. Of the 411 responders at baseline, 169 had at least 3 out of 4 data points; the analysis was therefore conducted on this sample. Levels of depression and anxiety were found to be significantly higher in the study sample in comparison with normative samples for each of the fourtime points; levels of coping showed that scores from the study sample were significantly lower than normative data at all-time points. Levels of perceived social support were significantly lower than normative data at the baseline and the first follow-up. The results of the study suggest that the lockdown experience had enduring consequences on the mental health of individuals. Prevention and support interventions to limit the psychological distress caused by COVID-19 should be taken into consideration in countries experiencing a second wave of the pandemic.
Alves, G. S., Casali, M. E., Veras, A. B., Carrilho, C. G., Bruno Costa, E., Rodrigues, V. M., & Dourado M. C. N. (2020). A systematic review of home-setting psychoeducation interventions for behavioral changes in dementia: some lessons for the COVID-19 pandemic and post-pandemic assistance. Frontiers in Psychiatry, 11, 577871. DOI: https://doi.org/10.3389/fpsyt.2020.577871
Barzilay, R., Moore, T. M., Greenberg, D. M., DiDomenico, G. E., Brown, L. A., White, L. K., Gur, R. C., & Gur, R.E. (2020). Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers. Translational Psychiatry, 10(1), 291. DOI: https://doi.org/10.1038/s41398-020-00982-4
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227), 912-920. DOI: https://doi.org/10.1016/S0140-6736(20)30460-8
Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287, 112934. DOI: https://doi.org/10.1016/j.psychres.2020.112934
Cava, M. A., Fay, K. E., Beanlands, H. J., McCay, E. A., & Wignall, R. (2005). The Experience of Quarantine for Individuals Affected by SARS in Toronto. Public Health Nursing, 22(5), 398-406. DOI: https://doi.org/10.1111/j.0737-1209.2005.220504.x
Chew, Q., Wei, K., Vasoo, S., Chua, H., & Sim, K. (2020). Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: Practical considerations for the COVID-19 pandemic. Singapore Medical Journal, 61(7), 350-356. DOI: https://doi.org/10.11622/smedj.2020046
Chiang, H.-H., Chen, M.-B., & Sue, I.-L. (2007). Self-state of nurses in caring for sars survivors. Nursing Ethics, 14(1), 18-26. DOI: https://doi.org/10.1177/0969733007071353
Cimerman, S., Chebabo, A., Cunha, C. A. da, & Rodríguez-Morales, A. J. (2020). Deep impact of COVID-19 in the healthcare of Latin America: The case of Brazil. The Brazilian Journal of Infectious Diseases, 24(2), 93-95. DOI: https://doi.org/10.1016/j.bjid.2020.04.005
Dong, L., & Bouey, J. (2020). Public Mental Health Crisis during COVID-19 Pandemic, China. Emerging infectious diseases, 26(7), 1616-1618. DOI: https://doi.org/10.3201/eid2607.200407
El-Zoghby, S. M., Soltan, E. M., & Salama, H. M. (2020). Impact of the COVID-19 Pandemic on Mental Health and Social Support among Adult Egyptians. Journal of Community Health, 45(4), 689-695. DOI: https://doi.org/10.1007/s10900-020-00853-5
Fullana, M. A., Hidalgo-Mazzei, D., Vieta, E., & Radua, J. (2020). Coping behaviors associated with decreased anxiety and depressive symptoms during the COVID-19 pandemic and lockdown. Journal of Affective Disorders, 275, 80-81. DOI: https://doi.org/10.1016/j.jad.2020.06.027
Gualano, M. R., Lo Moro, G., Voglino, G., Bert, F., & Siliquini, R. (2020). Effects of COVID-19 Lockdown on Mental Health and Sleep Disturbances in Italy. International Journal of Environmental Research and Public Health, 17(13), DOI: https://doi.org/10.3390/ijerph17134779
Gurvich, C., Thomas, N., Thomas, E. H., Hudaib, A.-R., Sood, L., Fabiatos, K., Sutton, K., Isaacs, A., Arunogiri, S., Sharp, G., & Kulkarni, J. (2020). Coping styles and mental health in response to societal changes during the COVID-19 pandemic. International Journal of Social Psychiatry. DOI: https://doi.org/10.1177/0020764020961790
Hofmann, S. G., Litz, B. T., & Weathers, F. W. (2003). Social anxiety, depression, and PTSD in Vietnam veterans. Journal of Anxiety Disorders, 17(5), 573-582. DOI: https://doi.org/10.1016/S0887-6185(02)00227-X
Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., & Styra, R. (2004). SARS control and psychological effects of quarantine, Toronto, Canada. Emerging Infectious Diseases, 10(7), 1206–1212. DOI: https://doi.org/10.3201/eid1007.030703
Howard, M. C. (2016). A review of exploratory factor analysis decisions and overview of current practices: What we are doing and how can we improve? International Journal of Human-Computer Interaction, 32(1), 51-62. DOI: https://doi.org/10.1080/10447318.2015.1087664
Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007). Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146(5), 317. DOI: https://doi.org/10.7326/0003-4819-146-5-200703060-00004
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. DOI: https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Kumar, A., & Nayar, K. R. (2020). COVID 19 and its mental health consequences. Journal of Mental Health, 1-2. DOI: https://doi.org/10.1080/09638237.2020.1757052
Liu, C. H., Zhang, E., Wong, G. T. F., Hyun, S., & Hahm, H. C. (2020). Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health. Psychiatry Research, 290, 113172.
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population: Medical Care, 46(3), 266-274. DOI: https://doi.org/10.1097/MLR.0b013e318160d093
Maunder, R., Lancee, W., Balderson, K., Bennett, J., Borgundvaag, B., Evans, S., Fernandes, C., Goldbloom, D., Gupta, M., Hunter, J., McGillis Hall, L., Nagle, L., Pain, C., Peczeniuk, S., Raymond, G., Read, N., Rourke, S., Steinberg, R., Stewart, T., Wasylenki, D. (2006). Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging Infectious Diseases, 12(12), 1924-1932. DOI: https://doi.org/10.3201/eid1212.060584
Ozamiz-Etxebarria, N., Dosil-Santamaria, M., Picaza-Gorrochategui, M., & Idoiaga-Mondragon, N. (2020). Niveles de estrés, ansiedad y depresión en la primera fase del brote del COVID-19 en una muestra recogida en el norte de España. Cadernos de Saúde Pública, 36(4), e00054020. DOI: https://doi.org/10.1590/0102-311x00054020
Palgi, Y., Shrira, A., Ring, L., Bodner, E., Avidor, S., Bergman, Y., Cohen-Fridel, S., Keisari, S., & Hoffman, Y. (2020).
The loneliness pandemic: Loneliness and other concomitants of depression, anxiety and their comorbidity during
the COVID-19 outbreak. Journal of Affective Disorders, 275, 109-111.
Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 88, 901-907. DOI: https://doi.org/10.1016/j.bbi.2020.05.026
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. General Psychiatry, 33(2), e100213. DOI: https://doi.org/10.1136/gpsych-2020-100213
Que, J., Shi, L., Deng, J., Liu, J., Zhang, L., Wu, S., Gong, Y., Huang, W., Yuan, K., Yan, W., Sun, Y., Ran, M., Bao, Y., & Lu, L. (2020). Psychological impact of the COVID-19 pandemic on healthcare workers: A cross-sectional study in China. General Psychiatry, 33(3), e100259. DOI: https://doi.org/10.1136/gpsych-2020-100259
Ran, L., Wang, W., Ai, M., Kong, Y., Chen, J., & Kuang, L. (2020). Psychological resilience, depression, anxiety, and somatization symptoms in response to COVID-19: A study of the general population in China at the peak of its epidemic. Social Science & Medicine, 262, 113261. DOI: https://doi.org/10.1016/j.socscimed.2020.113261
Rossi, R., Socci, V., Talevi, D., Mensi, S., Niolu, C., Pacitti, F., Di Marco, A., Rossi, A., Siracusano, A., & Di Lorenzo, G (2020). COVID-19 Pandemic and Lockdown Measures Impact on Mental Health Among the General Population in Italy. Frontiers in Psychiatry, 11, 790. DOI: https://doi.org/10.3389/fpsyt.2020.00790
Serafini, G., Parmigiani, B., Amerio, A., Aguglia, A., Sher, L., & Amore, M. (2020). The psychological impact of COVID-19 on the mental health in the general population. QJM: An International Journal of Medicine, 113(8), 531-537. DOI: https://doi.org/10.1093/qjmed/hcaa201
Sigdel, A., Bista, A., Bhattarai, N., Poon, B. C., Giri, G., Marqusee, H., & Thapa, subash. (2020). Depression, Anxiety and Depression-anxiety comorbidity amid COVID-19 Pandemic: An online survey conducted during lockdown in Nepal [Preprint]. Public and Global Health.
Sinclair, V. G., & Wallston, K. A. (2004). The Development and Psychometric Evaluation of the Brief Resilient Coping Scale. Assessment, 11(1), 94-101. DOI: https://doi.org/10.1177/1073191103258144
Smith, L., Jacob, L., Yakkundi, A., McDermott, D., Armstrong, N. C., Barnett, Y., … Tully, M. A. (2020). Correlates of symptoms of anxiety and depression and mental wellbeing associated with COVID-19: A cross-sectional study of UK-based respondents. Psychiatry Research, 291, 113138. DOI: https://doi.org/10.1016/j.psychres.2020.113138
Solomou, I., & Constantinidou, F. (2020). Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter. International Journal of Environmental Research and Public Health, 17(14), 4924. DOI: https://doi.org/10.3390/ijerph17144924
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166(10), 1092. DOI: https://doi.org/10.1001/archinte.166.10.1092
Spitzer, R. L. (1999). Validation and utility of a self-report version of PRIME-MDThe PHQ primary care study. JAMA, 282(18), 1737. DOI: https://doi.org/10.1001/jama.282.18.1737
Vinothkumar, M., Arathi, A., Joseph, M., Nayana, P., Jishma, Ej., & Sahana, U. (2016). Coping, perceived stress, and job satisfaction among medical interns: The mediating effect of mindfulness. Industrial Psychiatry Journal, 25(2), 195. DOI: https://doi.org/10.4103/ipj.ipj_98_14
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020a). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the General Population in China. International Journal of Environmental Research and Public Health, 17(5), 1729. DOI: https://doi.org/10.3390/ijerph17051729
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., Choo, F. N., Tran, B., Ho, R., Sharma, V. K., & Ho, C. (2020b). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity, 87, 40-48. DOI: https://doi.org/10.1016/j.bbi.2020.04.028
Wang, J., Wang, J.-X., & Yang, G.-S. (2020). The psychological Impact of COVID-19 on Chinese Individuals. Yonsei Medical Journal, 61(5), 438. DOI: https://doi.org/10.3349/ymj.2020.61.5.438
Wang, C., & Zhao, H. (2020). The impact of COVID-19 on anxiety in Chinese University students. Frontiers in Psychology, 11, 1168.
Wu, P., Fang, Y., Guan, Z., Fan, B., Kong, J., Yao, Z., Liu, X., Fuller, C. J., Susser, E., Lu, J., & Hoven, C. W. (2009). The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. The Canadian Journal of Psychiatry, 54(5), 302-311. DOI: https://doi.org/10.1177/070674370905400504
Zgueb Y, Bourgou S, Neffeti A, Amamou B, Masmoudi J, Chebbi H, Somrani N, Bouasker A. (2020). Psychological crisis intervention response to the COVID 19 pandemic: A Tunisian centralised Protocol. Psychiatry Research, 289, 113042. DOI: https://doi.org/10.1016/j.psychres.2020.113042
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30-41. DOI: https://doi.org/10.1207/s15327752jpa5201_2
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