Who were the lonely people? A snapshot from a Spanish population-based cohort from before and during the COVID-19 pandemic (preprint)

Purpose This study aims to assess the changes in loneliness during the first wave of the COVID-19 pandemic and to explore the factors that are associated with these changes. Methods We interviewed 1102 participants from a longitudinal adult population from the provinces of Madrid and Barcelona (Spain) belonging to the Edad con Salud project. Two interviews were carried out: before, and during the lockdown. Loneliness was measured with the UCLA loneliness scale, and covariates related to sociodemographic, psychosocial, and health and wellbeing domains were measured. Results Descriptive and multivariate analyses revealed a trend of increased loneliness among younger individuals, those experiencing economic decline, and participants depressed during the lockdown. In contrast, a decreasing trend in loneliness was observed among participants who were older, only had primary education, had limited virtual contact, previously had depression, or had medium/high neuroticism. A regression model showed that the relevant factors associated with the changes in loneliness during the lockdown were: changes in social relationships (β= 1.05, p-value < 0.001), depression during the lockdown (β = 1.12, p-value < 0.001), and neuroticism (β = -0.3, p-value < 0.001). Conclusion Identifying individuals at risk of increased loneliness during such crises is crucial for prevention and intervention. This study provides insights into relevant contributing factors, informing future public mental health responses.

Coping with COVID: Risk and Resilience Factors for Mental Health in a German Representative Panel Study (preprint)

Background: The COVID-19 pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare. Methods: In a stratified random sample of the German household population (n=6,684), we conducted survey-weighted multiple linear regressions to determine the association of various psychological risk and protective factors with changes in psychological distress (PD; measured via PHQ-4) from pre-pandemic (average of 2016 and 2019) to peri-pandemic (both 2020 and 2021) time points. Control analyses on PD change between two pre-pandemic time points (2016 and 2019) were conducted. Regularized regressions were computed to inform on which factors were statistically most influential in the multicollinear setting. Results: PHQ-4 in 2020 (M=2.45) and 2021 (M=2.21) was elevated compared to 2019 (M=1.79). Several risk factors (catastrophizing, neuroticism, asking for instrumental support) and protective factors (perceived stress recovery, positive reappraisal, optimism) were identified for the peri-pandemic outcomes. Control analyses revealed that in pre-pandemic times, neuroticism and optimism were predominantly related to PD changes. Regularized regression mostly confirmed the results and highlighted perceived stress recovery as most consistent influential protective factor across peri-pandemic outcomes. Conclusions: We identified several psychological risk and protective factors related to PD outcomes during the COVID-19 pandemic. Comparison to pre-pandemic data stress the relevance of longitudinal assessments to potentially reconcile contradictory findings. Implications and suggestions for targeted prevention and intervention programs during highly stressful times such as pandemics are discussed.

Sustained negative mental health outcomes among healthcare workers over the first year of the COVID-19 pandemic: a prospective cohort study (preprint)

Objective: To characterize the evolution of healthcare workers' mental health status over the 1-year period following the initial COVID-19 pandemic outbreak and to examine baseline characteristics associated with resolution or persistence of mental health problems over time. Methods: We conducted an 8-month follow-up cohort study. Eligible participants were healthcare workers working in Spain. Baseline data were collected during the initial pandemic outbreak. Survey-based self-reported measures included COVID-19-related exposures, sociodemographic characteristics, and three mental health outcomes (psychological distress, depression symptoms, and posttraumatic stress disorder symptoms). We examined three longitudinal trajectories in mental health outcomes between baseline and follow-up assessments (namely asymptomatic/stable, recovering, and persistently symptomatic/worsening). Results: We recruited 1,807 participants. Between baseline and follow-up assessments, the proportion of respondents screening positive for psychological distress and probable depression decreased, respectively, from 74% to 56% and from 28% to 21%. Two-thirds remained asymptomatic/stable in terms of depression symptoms and 56% remained symptomatic or worsened over time in terms of psychological distress. Conclusions: Poor mental health outcomes among healthcare workers persisted over time. Occupational programs and mental health strategies should be put in place.