The psychological impact of COVID-19 and restrictive measures in the world

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Highlights

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Awareness and coping strategies positively correlated with risk of mental disorders.
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COVID-19 increases risk of severe level of stress, depression, anxiety and PTSD.
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Highest risk categories are females and people with lower education and income.
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Higher psychological disturbs linked to incessant exposure to COVID-19 news reports.
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Lower risk categories are moderate social network users, between one and two h/day.

Abstract

Background

In a short time, the COVID-19 pandemic turned into a global emergency. The fear of becoming infected and the lockdown measures have drastically changed people's daily routine. The aim of this study is to establish the psychological impact that the COVID-19 pandemic is entailing, particularly with regards to levels of stress, anxiety and depression, and to the risks of developing Post-Traumatic Stress Disorder (PTSD).

Methods

The study, carried out with a sample of 1612 subjects distributed in seven countries (Australia, China, Ecuador, Iran, Italy, Norway and the United States), allowed us to collect information about the psychological impact of COVID-19.

Results

The findings of this study show that the levels of stress, depression and anxiety, as well as the risks of PTSD, are higher than average in over half of the considered sample. The severity of these disorders significantly depends on gender, type of outdoor activities, characteristics of their homes, eventual presence of infected acquaintances, time dedicated to looking for related information (in the news and social networks), type of source information and, in part, to the level of education and income.

Conclusions

We conclude that COVID-19 has a very strong psychological impact on the global population. This appears to be linked to the coping strategies adopted, level of mindful awareness, socio-demographic variables, people's habits and the way individuals use means of communication and information.

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Most cited references 96

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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li … (2020)

Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

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The PHQ-9: validity of a brief depression severity measure.

K Kroenke, R L Spitzer, J. Williams (2001)

While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.

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The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)

Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

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Author and article information

Journal

Journal ID (nlm-ta): J Affect Disord

Journal ID (iso-abbrev): J Affect Disord

Title: Journal of Affective Disorders

Publisher: The Authors. Published by Elsevier B.V.

ISSN (Print): 0165-0327

ISSN (Electronic): 1573-2517

Publication date PMC-release: 15 January 2021

Publication date (Print): 15 March 2021

Publication date (Electronic): 15 January 2021

Volume: 283

Pages: 36-51

Affiliations

[a ]Italian Society of Cognitive Behavioural Therapy (CBT-Italy), Florence, Italy

[b ]Agrarian University of Ecuador, Department of Agricultural Economic, Guayaquil, Ecuador

[c ]Norwegian University of Science and Technology, Department of Civil and Environmental Engineering, Trøndelag, Norway

[d ]Chang'an University, School of Highway, Shaanxi, China

[e ]University of Technology Sydney, School of Civil and Environmental Engineering, New South Wales, Australia

[f ]State Key Laboratory of Silicate Materials for Architectures, Wuhan University of Technology, Hubei, China

[g ]Bam University of Medical Sciences, School of Medicine, Kerman, Iran

[h ]University of Illinois at Urbana – Champaign, Department of Civil and Environmental Engineering, Illinois, United States

[i ]Norwegian National Railway Administration, Bane NOR, Vestfold and Telemark, Norway

[j ]University of Modena and Reggio Emilia, DIEF, Department of Engineering “Enzo Ferrari”, Modena, Italy

[k ]Northern Arizona University, Department of Civil Engineering, Construction Management, and Environmental Engineering, Flagstaff, Arizona, United States

[l ]Centro Armonico Terapeutico (CAT), Campogalliano, Italy

Author notes

[* ]Corresponding author.

Article

Publisher Item ID: S0165-0327(21)00033-1

DOI: 10.1016/j.jad.2021.01.020

PMC ID: 7833558

PubMed ID: 33516085

SO-VID: 73564ba7-82d3-48f0-8ed5-720ccc37c91b

License:

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

History

Date received : 17 September 2020

Date revision received : 4 January 2021

Date accepted : 7 January 2021

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The psychological impact of COVID-19 and restrictive measures in the world

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Highlights

Abstract

Background

Methods

Results

Conclusions

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 96

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

The PHQ-9: validity of a brief depression severity measure.

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

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Article

History

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Comments

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Similar content 236

Cited by 62

Most referenced authors 5,460