The influence of repeated mild lockdown on mental and physical health during the COVID-19 pandemic: a large-scale longitudinal study in Japan (preprint)

The mental and physical effects of repeated lockdowns are 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 7,893 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) and that younger and middle-aged people (aged 18-49), 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 interpersonal interaction and loneliness and that susceptible populations, such as young people and those with high levels of loneliness, require special consideration during repetitive lockdown situations.

The psychological impact of 'mild lockdown' in Japan during the COVID-19 pandemic: a nationwide survey under a declared state of emergency (preprint)

This study examined the psychological distress caused by non-coercive lockdown (mild lockdown) in Japan. An online survey was conducted with 11,333 people (52.4% women; mean age = 46.3 {+/-} 14.6 years, range = 18-89 years) during the mild lockdown in the seven prefectures most affected by COVID-19 infection. Over one-third (36.6%) of participants experienced mild-to-moderate psychological distress (Kessler Psychological Distress Scale [K6] score 5-12), while 11.5% reported serious psychological distress (K6 score [≥] 13). The estimated prevalence of depression (Patient Health Questionnaire-9 score [≥] 10) was 17.9%. Regarding the distribution of K6 scores, the proportion of individuals displaying psychological distress in this study was significantly higher compared to previous national survey data from 2010, 2013, 2016 and 2019. Healthcare workers, those with a history of treatment for mental illness, and younger participants (aged 18-19 or 20-39 years) were particularly vulnerable. Psychological distress severity was influenced by specific interactional structures of risk factors: high loneliness, poor interpersonal relationships, COVID-19-related sleeplessness and anxiety, deterioration of household economy, and work and academic difficulties. Flexible approaches that are optimised for the difficulties specific to each individual through cross-disciplinary public-private initiatives are important to combat lockdown-induced mental health problems.