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COVID-19 and depressive symptoms in students before and during lockdown

30 Apr 2020-medRxiv (Cold Spring Harbor Laboratory Press)-

TL;DR: There is evidence that students, a high-risk category for mental disorders, report on average worse depressive symptoms than 6 months before isolation, which should alert clinician of a possible aggravation as well as new-onsets of depressive symptoms in students.

AbstractThe lockdown due to coronavirus pandemic may exacerbate depressive symptoms, experts argue. Here we report that students, a high-risk category for mental disorders, report on average worse depressive symptoms than six months before isolation. The prospective data reported herein should alert clinician of a possible aggravation as well as new-onsets of depressive symptoms in students.

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COVID-19 and depressive symptoms in students before and during lockdown
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Nicola Meda
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; Susanna Pardini
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, MSc; Irene Slongo
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, BSc; Luca Bodini
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, MSc; Paolo Rigobello
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;
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Francesco Visioli
1,4*
, PhD; Caterina Novara
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, PhD
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Department of Molecular Medicine, University of Padova, Padova, Italy
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Department of General Psychology, University of Padova, Padova, Italy
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Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
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IMDEA-Food, CEI UAM + CSIC, Madrid, Spain
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*
Corresponding author: Francesco Visioli, PhD, Department of Molecular Medicine, University of
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Padova, Viale G. Colombo 3, 35131 Padova, Italy (francesco.visioli@unipd.it)
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. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprintthis version posted April 30, 2020. ; https://doi.org/10.1101/2020.04.27.20081695doi: medRxiv preprint
NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.

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ABSTRACT
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The lockdown due to coronavirus pandemic may exacerbate depressive symptoms, experts argue.
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Here we report that students, a high-risk category for mental disorders, report on average worse
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depressive symptoms than six months before isolation. The prospective data reported herein should
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alert clinician of a possible aggravation as well as new-onsets of depressive symptoms in students.
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The current coronavirus pandemic has been affecting Europe since late February 2020, forcing
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governments to put citizens in lockdown. Among growing concerns of the effects of isolation on
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mental health
1,2
, only retrospective data are available to assess if actual changes occur
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. Here we
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provide prospective evidence of a change in depressive symptomatology of Italian students during
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COVID-19-related lockdown.
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The study was approved by the University of Padova Ethical Committee of Psychology and
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participants provided informed consent. Between October 3
rd
and October 23
rd
2019, we introduced
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the study to approximately 1000 University of Padova students, 153 of which matched target
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population characteristics (Italian native speaker students, age 18-30) and completed a demographic
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questionnaire and the Italian version of Beck Depression Inventory-2
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(BDI-2, a validated self-
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report questionnaire for depressive symptoms evaluation, the score of which correlates with severity
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of depressive symptomatology) online
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, both in October and in April (between 3
rd
-23
rd
) 2020. We
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implemented generalised linear mixed models to evince if BDI-2 score changed during isolation
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with respect to the scores reported 6 months before. To assess a percentage change in BDI-2 score,
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we defined %ΔBDI-2 as the difference between BDI-2 score during lockdown and before
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lockdown, the whole divided by BDI-2 score before lockdown + 1 and analysed %ΔBDI-2 with
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linear mixed-effects models. To assess clinically relevant changes in depressive symptoms, we
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employed multinomial regression models. Sample characteristics and models employed are reported
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in Tables A and B, respectively. Anonymised dataset, further details on data analysis, and script are
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provided as Supplementary Material.
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. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprintthis version posted April 30, 2020. ; https://doi.org/10.1101/2020.04.27.20081695doi: medRxiv preprint

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BDI-2 total score is slightly higher during lockdown than before (Figure, A and Table). We
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recorded that the median percentage increase is higher in males (+36%; IQR = -12 – 91%) than in
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females (+16%; -26 – 89%) and is independent from a history of mental disorder (Figure, B),
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although students with such history report higher before and during lockdown BDI-2 scores than
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students without any established diagnosis of psychopathology (Figure, C and Table). This increase
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is not significantly linked to sex, familiarity for a mental disorder, worry for one’s economic
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situation, or residence. Statistically, it is significantly linked to BDI-2 score before lockdown
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(Figure, D) and age, evidencing that younger participants with lower BDI-2 score before lockdown
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report higher percentage increases in BDI-2 score during lockdown. To assess if such increase
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could be clinically relevant, we divided participants into three clinically useful categories according
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to BDI-2 scores before lockdown (below 90
th
percentile, above 95
th
percentile, and between these
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two ranges
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) and tested how many participants switched from one category to another, or remained
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in the same one during lockdown. We fit the observed data to a multinomial regression model and
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found that a median increase of 22% in BDI-2 score (IQR= -21 – 90%) would not clinically affect
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79,2% of our target population (IQR = 74,7 – 81,4%); 8,2% (6,9 – 9,8%) would progress to a more
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serious clinical category (either from < 90
th
to 90
th
-95
th
range or from this latter to > 95
th
); and 6,2%
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(5,3 – 7,2%) would directly progress from < 90
th
percentile category to the most severe clinical
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category (Figure, E and F). Less than 5% of participants would improve.
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As Italy was entirely put in lockdown, it is impossible to assess isolation-independent
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changes in BDI-2 score. Students could be diversely affected by lockdowns: isolation may be
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responsible of a median increase of 22% in BDI-2 score, which would be clinically relevant for up
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to 15% of our target population. Our data should alert clinicians of possible aggravation of
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depressive symptoms in students, independently from a history of mental disorder.
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. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprintthis version posted April 30, 2020. ; https://doi.org/10.1101/2020.04.27.20081695doi: medRxiv preprint

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Author contributions: All authors designed the study protocol, interpreted data and critically
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revised the manuscript; N.M. acquired data and analysed it and drafted the manuscript; P.R., F.V.
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C.N., S.P. provided technical, material or administrative support to the study; F.V., C.N., S.P.
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provided their supervision and expertise.
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Competing interests: the authors declare no competing interests
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Funding/Support: this study received no financial support
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Additional Information: Dataset and R Script for analysis are provided as Supplementary Material
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. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprintthis version posted April 30, 2020. ; https://doi.org/10.1101/2020.04.27.20081695doi: medRxiv preprint

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. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprintthis version posted April 30, 2020. ; https://doi.org/10.1101/2020.04.27.20081695doi: medRxiv preprint

Citations
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TL;DR: The psychological impact of COVID-19 lockdowns is small in magnitude and highly heterogeneous, suggesting that lockdowns do not have uniformly detrimental effects on mental health and that most people are psychologically resilient to their effects.
Abstract: Lockdowns to control the spread of the coronavirus disease 2019 (COVID-19) have had profound effects on everyday life worldwide, but their effect on mental health remains unclear because available meta-analyses and reviews rely mostly on cross-sectional studies. We conducted a rapid review and meta-analysis of longitudinal studies and natural experiments investigating the relationship between COVID-19 lockdowns and mental health. A total of 25 studies involving 72 004 participants and 58 effect sizes were analyzed. Using a random effects model, we found that lockdowns had small effects on mental health symptoms, g = 0.17, s.e. = 0.05, 95% CI (0.06-0.24), p = 0.001, but the effects on positive psychological functioning, g = -0.12, s.e. = 0.11, 95% CI (-0.33 to 0.09), p = 0.27, were not significant. Multivariate analysis of effect sizes revealed significant and relatively small effect sizes for anxiety and depression, while those for social support, loneliness, general distress, negative affect, and suicide risk were not significant. The results indicated substantial heterogeneity among studies, but meta-regression analyses found no significant moderation effects for mean age, gender, continent, COVID-19 death rate, days of lockdown, publication status or study design. The psychological impact of COVID-19 lockdowns is small in magnitude and highly heterogeneous, suggesting that lockdowns do not have uniformly detrimental effects on mental health and that most people are psychologically resilient to their effects.

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Abstract: The COVID-19 pandemic has had huge effects on the daily lives of most individuals in the first half of 2020. Widespread lockdown and preventative measures have isolated individuals, affected the world economy, and limited access to physical and mental healthcare. While these measures may be necessary to minimize the spread of the virus, the negative physical, psychological, and social effects are evident. In response, technology has been adapted to try and mitigate these effects, offering individuals digital alternatives to many of the day-to-day activities which can no longer be completed normally. However, the elderly population, which has been worst affected by both the virus, and the lockdown measures, has seen the least benefits from these digital solutions. The age based digital divide describes a longstanding inequality in the access to, and skills to make use of, new technology. While this problem is not new, during the COVID-19 pandemic it has created a large portion of the population suffering from the negative effects of the crisis, and unable to make use of many of the digital measures put in place to help. This paper aims to explore the increased negative effects the digital divide is having in the elderly population during the COVID-19 pandemic. It also aims to highlight the need for increased attention and resources to go toward improving digital literacy in the elderly, and the need to put in place measures to offer immediate solutions during the COVID-19 crisis, and solutions to close the digital divide for good in the long-term.

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Abstract: The official announcement of COVID-19 as a global pandemic on 11 March 2020 by WHO, the world economy has abruptly declined, billions of people are in lockdown, maintaining self-isolation. In this survey, 150 respondents were selected randomly and this survey intends to highlight the impact of lockdown in agriculture Students on their education along with their response towards pros and cons. This survey shows that maximum respondent, around 52% of them found lockdown beneficial in the sense that it has helped to neutralize the gravity of viral infection and 48% of them doesn’t found it beneficial as their educational schedule has been halted. The practical education of a student is disturbed due to lockdown and now they are utilizing this period involving in online courses, training, and webinars. Many of them couldn’t have access to the internet to catch the session, thus the government should initiate policy in education through a long term perspective so that no pandemic could interfere with the educational institution in digital world.

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Cites background from "COVID-19 and depressive symptoms in..."

  • ...They are mentally disturbed (Meda et al., 2020) due to lockdown which seems to be unhealthy regarding physical health but staying at home is necessary to prevent spread of disease....

    [...]


10 Dec 2020
Abstract: Objective: to analyze the mental health of physical education students before and during lockdown Method: a descriptive study was cconducted The Mental Health Scale was employed to assess mental health of physical education students An online survey was fulfilled by 103 students of the Institute of Physical Education and Sport, University of Ouargla, in Algeria Results: the results showed that there were statistically significant differences in mental health among physical education students before and during lockdown There were no statistically significant differences in mental health among students before and during the lockdown period, depending on the academic level variable, and there were statistically significant differences in mental health among students before and during the lockdown period, depending on the city variable Conclusion: establishing online mental health platforms and programs is necessary keywords: COVID-19, lockdown, mental health, physical education students

References
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TL;DR: Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data Capture tools to support clinical and translational research.
Abstract: Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.

20,023 citations


Journal ArticleDOI
Abstract: 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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It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.