Lifestyle and mental health disruptions during COVID-19.
02 Mar 2021-Proceedings of the National Academy of Sciences of the United States of America (Proceedings of the National Academy of Sciences)-Vol. 118, Iss: 9
TL;DR: It is suggested that disruption to physical activity is a leading risk factor for depression during the pandemic and restoration of those habits-either naturally or through policy intervention-has limited impact on restoring mental well-being.
Abstract: Using a longitudinal dataset linking biometric and survey data from several cohorts of young adults before and during the COVID-19 pandemic ([Formula: see text]), we document large disruptions to physical activity, sleep, time use, and mental health. At the onset of the pandemic, average steps decline from 10,000 to 4,600 steps per day, sleep increases by 25 to 30 min per night, time spent socializing declines by over half to less than 30 min, and screen time more than doubles to over 5 h per day. Over the course of the pandemic from March to July 2020 the proportion of participants at risk for clinical depression ranges from 46% to 61%, up to a 90% increase in depression rates compared to the same population just prior to the pandemic. Our analyses suggest that disruption to physical activity is a leading risk factor for depression during the pandemic. However, restoration of those habits through a short-term intervention does not meaningfully improve mental well-being.
Citations
More filters
TL;DR: A systematic review and meta-analysis of longitudinal cohort studies examined changes in mental health among the same group of participants before vs. during the COVID-19 pandemic in 2020 as discussed by the authors .
429 citations
Journal Article•
372 citations
TL;DR: This article examined factors associated with the adoption of self-protective health behaviors, such as social distancing and mask wearing, at the start of the Covid-19 pandemic in the USA.
Abstract: Given the role of human behavior in the spread of disease, it is vital to understand what drives people to engage in or refrain from health-related behaviors during a pandemic. This paper examines factors associated with the adoption of self-protective health behaviors, such as social distancing and mask wearing, at the start of the Covid-19 pandemic in the USA. These behaviors not only reduce an individual's own risk of infection but also limit the spread of disease to others. Despite these dual benefits, universal adoption of these behaviors is not assured. We focus on the role of socioeconomic differences in explaining behavior, relying on data collected in April 2020 during the early stages of the Covid-19 pandemic. The data include information on income, gender and race along with unique variables relevant to the current pandemic, such as work arrangements and housing quality. We find that higher income is associated with larger changes in self-protective behaviors. These gradients are partially explained by the fact that people with less income are more likely to report circumstances that make adopting self-protective behaviors more difficult, such as an inability to tele-work. Both in the USA and elsewhere, policies that assume universal compliance with self-protective measures-or that otherwise do not account for socioeconomic differences in the costs of doing so-are unlikely to be effective or sustainable.
209 citations
Cites background from "Lifestyle and mental health disrupt..."
...Moreover, studies specific to Covid-19 that have relied on self-reported information and data collected from devices such as cellphones have corroborated one another (Giuntella et al. (2020) and Huckins et al....
[...]
...Moreover, studies specific to Covid-19 that have relied on self-reported information and data collected from devices such as cellphones have corroborated one another (Giuntella et al. 2020; Huckins et al. 2020)....
[...]
...Moreover, studies specific to Covid-19 that have relied on self-reported information and data collected from devices such as cellphones have corroborated one another (Giuntella et al. (2020) and Huckins et al. (2020))....
[...]
TL;DR: In this paper , a systematic review and meta-analysis was conducted to investigate whether and to which extent physical activity changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account.
Abstract: With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094 participants (N between 10 and 60,560 subjects) from 14 countries worldwide with participants aged between four and 93 years were included. Thirty-two studies revealed a significant decline in PA, whereas only five studies found a significant increase in PA during the Covid-19 pandemic. Fourteen studies revealed mixed results. PA decreased in all age groups, independent of gender. Most self-reported and all device-based measurement methods showed a reduction in PA. However, effects were not found to be significant in all age groups. Nevertheless, the declining trend should be noted and governments should strive to enable PA within periods of pandemic restrictions, or promote alternatives such as digital training to avoid negative health consequences within the population.
90 citations
TL;DR: In this paper, the authors performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms during the COVID-19 pandemic.
Abstract: People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India. Between July 29, to September 12, 2020, we telephonically surveyed adults (n = 2335) with chronic conditions across four sites in India. Data on participants’ demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient’s experiences during the COVID-19 lockdowns and data analyzed using thematic analysis. One thousand seven hundred thirty-four individuals completed the survey (response rate = 74%). The mean (SD) age of respondents was 57.8 years (11.3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4.01,2.90–5.53), having diabetes (2.42, 1.81–3.25) and hypertension (1.70,1.27–2.27), and loss of income (2.30,1.62–3.26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3.67,2.52–5.35), and job loss (1.90,1.25–2.89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services. People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.
67 citations
References
More filters
TL;DR: The CES-D scale as discussed by the authors is a short self-report scale designed to measure depressive symptomatology in the general population, which has been used in household interview surveys and in psychiatric settings.
Abstract: The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
48,339 citations
TL;DR: A review of the psychological impact of quarantine using three electronic databases is presented in this article, where the authors report negative psychological effects including post-traumatic stress symptoms, confusion, and anger.
10,370 citations
Journal Article•
TL;DR: The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
Abstract: Background Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. Methods A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. Results A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. Conclusion The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
8,191 citations
"Lifestyle and mental health disrupt..." refers background or methods in this paper
...We measure anxiety using the GAD-7 scale ([Spitzer et al., 2006]), a 7 items scale designed to assess the presence and severity of generalized anxiety disorder....
[...]
...We assessed anxiety using the Generalized Anxiety Disorder scale (GAD-7, [Spitzer et al., 2006]), which assesses the frequency of anxiety related symptoms using a scale from 0 (Not at all) to 3 (Nearly every day)....
[...]
...Individuals with scores above 10 are considered to be at risk of generalized anxiety disorder [Spitzer et al., 2006], though recent studies have identified 8 as a reasonable cut-point for identifying anxiety disorder [Kroenke et al., 2007, Plummer et al., 2016]....
[...]
...Individuals with scores above 10 are considered to be at risk of generalized anxiety disorder [Spitzer et al., 2006], though recent studies have identified 8 as a reasonable cut-point for identifying anxiety disorder [Kroenke et al....
[...]
TL;DR: A number of case-finding instruments for detecting depression in primary care, ranging from 2 to 28 items, tend to be highly correlated, with little evidence that one measure is superior to any other.
Abstract: and treatable mental disorders presenting in general medical as well as specialty settings. There are a number of case-finding instruments for detecting depression in primary care, ranging from 2 to 28 items.1,2 Typically these can be scored as continuous measures of depression severity and also have established cutpoints above which the probability of major depression is substantially increased. Scores on these various measures tend to be highly correlated3, with little evidence that one measure is superior to any other.1,2,4
4,342 citations
TL;DR: The brief resilience scale (BRS) is a reliable means of assessing resilience as the ability to bounce back or recover from stress and may provide unique and important information about people coping with health-related stressors.
Abstract: Background: While resilience has been defined as resistance to illness, adaptation, and thriving, the ability to bounce back or recover from stress is closest to its original meaning. Previous resilience measures assess resources that may promote resilience rather than recovery, resistance, adaptation, or thriving. Purpose: To test a new brief resilience scale. Method: The brief resilience scale (BRS) was created to assess the ability to bounce back or recover from stress. Its psychometric characteristics were examined in four samples, including two student samples and samples with cardiac and chronic pain patients. Results: The BRS was reliable and measured as a unitary construct. It was predictably related to personal characteristics, social relations, coping, and health in all samples. It was negatively related to anxiety, depression, negative affect, and physical symptoms when other resilience measures and optimism, social support, and Type D personality (high negative affect and high social inhibition) were controlled. There were large differences in BRS scores between cardiac patients with and without Type D and women with and without fibromyalgia. Conclusion: The BRS is a reliable means of assessing resilience as the ability to bounce back or recover from stress and may provide unique and important information about people coping with health-related stressors.
3,285 citations
"Lifestyle and mental health disrupt..." refers methods in this paper
..., 2010] using 5 of the 6 items of the Brief Resilience Scale developed and validated by [Smith et al., 2008]....
[...]
...We measure resilience, defined as ”the ability to bounce back from stress” [Smith et al., 2010] using 5 of the 6 items of the Brief Resilience Scale developed and validated by [Smith et al., 2008]....
[...]
...We assess resilience – the ability to bounce back from stress and adversity – using the Brief Resilience Scale [Smith et al., 2008]....
[...]