Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan.

OBJECTIVES: We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic. DESIGN: Cross-sectional online survey. SETTING: Community cohort study in Japan. PARTICIPANTS: The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20-59 years. MAIN OUTCOME MEASURES: The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis. STATISTICAL METHODS: Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected. RESULTS: Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation. CONCLUSION: Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.

Proposed Cut-Off Score for the Japanese Version of the Fear of Coronavirus Disease 2019 Scale (FCV-19S): Evidence from a Large-Scale National Survey in Japan.

The Fear of coronavirus disease 2019 (COVID-19) Scale (FCV-19S) is a seven-item self-administered psychological scale for measuring the fear of this disease. The scale has been widely adapted and validated worldwide. This study aimed to propose a cut-off score for the validated Japanese version of the FCV-19S. We conducted a nationwide online survey and included 26,286 respondents in the analysis. Respondents answered questions on their sociodemographic characteristics, and using the FCV-19S and six-item Kessler Psychological Distress Scale, we measured psychological distress and assessed whether the fear of COVID-19 interfered with their daily lives. A total score of ≥21 points was considered adequate to identify those with psychological distress or difficulties in daily living because of the fear of COVID-19. This cut-off score will contribute to mental health assessment during the COVID-19 pandemic.

Confirming validity of The Fear of COVID-19 Scale in Japanese with a nationwide large-scale sample.

Assessing fear and anxiety regarding COVID-19 viral infection is essential for investigating mental health during this epidemic. We have developed and validated a Japanese-language version of The Fear of COVID-19 Scale (FCV-19S) based on a large, nationwide residential sample (n = 6,750) recruited through news and social media responding to an online version of the questionnaire. Data was collected from August 4-25, 2020. Results correlated with K6, GAD-7 and IES-R psychological scales, and T-tests and analysis of variance identified associated factors. All indices indicated the two-factor model emotional fear reactions and symptomatic expressions of fear a better fit for our data than a single-factor model in Confirmatory Factor Analysis (χ2 = 164.16, p<0.001, CFI 0.991, TLI = 0.985, RMSEA = 0.043). Socio-demographic factors identified as disaster vulnerabilities such as female sex, sexual minority, elderly, unemployment, and present psychiatric history associated with higher scores. However, respondent or family member experience of infection risk, or work/school interference from confinement, had greatest impact. Results suggest necessity of mental health support during this pandemic similar to other disasters.