The prevalence, incidence, and risk factors of mental health problems and mental health service use before and 9 months after the COVID-19 outbreak among the general Dutch population. A 3-wave prospective study.

OBJECTIVES: Gain insight into the effects of the COVID-19 pandemic on the prevalence, incidence, and risk factors of mental health problems among the Dutch general population and different age groups in November-December 2020, compared with the prevalence, incidence, and risk factors in the same period in 2018 and 2019. More specifically, the prevalence, incidence, and risk factors of anxiety and depression symptoms, sleep problems, fatigue, impaired functioning due to health problems, and use of medicines for sleep problems, medicines for anxiety and depression, and mental health service. METHODS: We extracted data from the Longitudinal Internet studies for the Social Sciences (LISS) panel that is based on a probability sample of the Dutch population of 16 years and older by Statistics Netherlands. We focused on three waves of the longitudinal Health module in November-December 2018 (T1), November-December 2019 (T2), and November-December 2020 (T3), and selected respondents who were 18 years and older at T1. In total, 4,064 respondents participated in all three surveys. Data were weighted using 16 demographics profiles of the Dutch adult population. The course of mental health problems was examined using generalized estimating equations (GEE) for longitudinal ordinal data and differences in incidence with logistic regression analyses. In both types of analyses, we controlled for sex, age, marital status, employment status, education level, and physical disease. RESULTS: Among the total study sample, no significant increase in the prevalence of anxiety and depression symptoms, sleep problems, fatigue, impaired functioning due to health problems, use of medicines for sleep problems, of medicines for anxiety and depression, and of mental health service in November-December 2020 was observed, compared with the prevalence in November-December 2018 and 2019 (T3 did not differ from T1 and T2). Among the four different age categories (18-34, 35-49, 50-64, and 65 years old and older respondents), 50-64 years respondents had a significantly lower prevalence of anxiety and depression symptoms at T3 than at T1 and T2, while the prevalence at T1 and T2 did not differ. A similar pattern among 65+ respondents was found for mental health service use. We found no indications that the incidence of examined health problems at T2 (no problems at T1, problems at T2) and T3 (no problems at T2, problems at T3) differed. Risk factors for mental health problems at T2 were mostly similar to risk factors at T3; sex and age were less/not a risk factor for sleep problems at T3 compared with at T2. CONCLUSIONS: The prevalence, incidence, and risk factors of the examined mental health problems examined nine months after the COVID-19 outbreak appear to be very stable across the end of 2018, 2019, and 2020 among the Dutch adult population and different age categories, suggesting that the Dutch adult population in general is rather resilient given all disruptions due to this pandemic.

Does pre-event lack of emotional support increase the risk of post-event PTSD, anxiety, depression symptoms and lack of support? A comparative population-based study among victims of threat and violence.

Our knowledge about the effects of perceived emotional support on PTSD, anxiety and depressive symptoms after serious threat and violence is primarily based on post-event studies. Very little is known about the extent to which (1) victims lacking pre-event emotional support are more at risk of post-event symptoms and lack of post-event support than victims with pre-event emotional support, and (2) victims with pre-event emotional support and victims lacking emotional support are more at risk of post-event anxiety and depressive symptoms than nonvictims with similar pre-event support levels. For this purpose, we conducted a 2-wave prospective study (VICTIMS) using the Dutch population-based longitudinal LISS panel. Multivariate logistic regression analyses were conducted, controlling for pre-event demographics, symptoms, and physical, work-related and financial problems. As hypothesized, victims (Nvictims total = 187) lacking pre-event support more often had high post-event PTSD, anxiety and depressive symptoms than victims with pre-event support. No significant differences were found between victims and nonvictims with pre-event emotional support (Nnonvictims total = 2,828, not exposed to any event). Since victims and nonvictims with pre-event support did not differ in post-event symptoms and support, the findings offer strong evidence for the buffering hypothesis of emotional support.

Pre-outbreak determinants of perceived risks of corona infection and preventive measures taken. A prospective population-based study.

OBJECTIVES: Assess how people perceive the risks of coronavirus infection, whether people take preventive measures, and which pre-outbreak factors contribute to the perceived risks and measures taken, such as pre-outbreak respiratory problems, heart problems, diabetes, anxiety and depression symptoms, loneliness, age, gender, marital and employment status and education level. METHODS: Data were collected in the longitudinal LISS panel, based on a random sample of the Dutch population. The coronavirus survey started on March 2, and the data collection ended on March 17 2020. Data were linked with surveys on health and social integration conducted at the end of 2019 (Nstudy sample = 3,540). RESULTS: About 15% perceived the risk of infection as high, and 11% the risk becoming ill when infected. Multivariable logistic regression analyses showed the following. Older age-groups perceived the risk for coronavirus infection as lower (all adjusted Odd Ratio's [aOR] ≤ .070). In total, 43.8% had taken preventive measures, especially females (aOR = 1.46, 95% CI = 1.26-1.70). Those with lower education levels less often used preventive measures (aOR = 0.55, 95% CI = 0.45-0.67). Those with pre-outbreak respiratory problems (aOR = 2.75, 95% CI = 2.11-3.57), heart problems (aOR = 1.97, 95% CI = 1.34-2.92) and diabetes (aOR = 3.12, 95% CI = 2.02-4.82) perceived the risk becoming ill when infected as higher than others. However, respondents with pre-outbreak respiratory problems and diabetes did not more often take preventive measures. CONCLUSIONS: Vulnerable patients more often recognize that they are at risk becoming ill when infected by the coronavirus, but many do not take preventive measures. Interventions to stimulate the use of preventive measures should pay additional attention to physically vulnerable patients, males and those with lower education levels.

Assessing the equivalence of Web-based and paper-and-pencil questionnaires using differential item and test functioning (DIF and DTF) analysis: a case of the Four-Dimensional Symptom Questionnaire (4DSQ).

PURPOSE: Many paper-and-pencil (P&P) questionnaires have been migrated to electronic platforms. Differential item and test functioning (DIF and DTF) analysis constitutes a superior research design to assess measurement equivalence across modes of administration. The purpose of this study was to demonstrate an item response theory (IRT)-based DIF and DTF analysis to assess the measurement equivalence of a Web-based version and the original P&P format of the Four-Dimensional Symptom Questionnaire (4DSQ), measuring distress, depression, anxiety, and somatization. METHODS: The P&P group (n = 2031) and the Web group (n = 958) consisted of primary care psychology clients. Unidimensionality and local independence of the 4DSQ scales were examined using IRT and Yen's Q3. Bifactor modeling was used to assess the scales' essential unidimensionality. Measurement equivalence was assessed using IRT-based DIF analysis using a 3-stage approach: linking on the latent mean and variance, selection of anchor items, and DIF testing using the Wald test. DTF was evaluated by comparing expected scale scores as a function of the latent trait. RESULTS: The 4DSQ scales proved to be essentially unidimensional in both modalities. Five items, belonging to the distress and somatization scales, displayed small amounts of DIF. DTF analysis revealed that the impact of DIF on the scale level was negligible. CONCLUSIONS: IRT-based DIF and DTF analysis is demonstrated as a way to assess the equivalence of Web-based and P&P questionnaire modalities. Data obtained with the Web-based 4DSQ are equivalent to data obtained with the P&P version.

Vacationers Happier, but Most not Happier After a Holiday.

The aim of this study was to obtain a greater insight into the association between vacations and happiness. We examined whether vacationers differ in happiness, compared to those not going on holiday, and if a holiday trip boosts post-trip happiness. These questions were addressed in a pre-test/post-test design study among 1,530 Dutch individuals. 974 vacationers answered questions about their happiness before and after a holiday trip. Vacationers reported a higher degree of pre-trip happiness, compared to non-vacationers, possibly because they are anticipating their holiday. Only a very relaxed holiday trip boosts vacationers' happiness further after return. Generally, there is no difference between vacationers' and non-vacationers' post-trip happiness. The findings are explained in the light of set-point theory, need theory and comparison theory.