Lockdown, quarantine measures, and social distancing: Associations with depression, anxiety and distress at the beginning of the COVID-19 pandemic among adults from Germany

"Abstract

... In this study, we investigated the role of sociodemographic and COVID-19 related factors for immediate mental health consequences in a nationwide community sample of adults from Germany (N = 4335). Specifically, we examined the effects of different forms and levels of restriction resulting from public health measures (e.g. quarantine, stay-at-home order) on anxiety and depression symptomatology, health anxiety, loneliness, the occurrence of fearful spells, psychosocial distress and life-satisfaction. We found that higher restrictions due to lockdown measures, a greater reduction of social contacts and greater perceived changes in life were associated with higher mental health impairments. Importantly, a subjectively assumed but not an officially announced stay-at-home order was associated with poorer mental health...

2.1. Participants

Between 17th April and 15th May 2020, a cross-sectional study was conducted among 4335 adults (75.8% women and 24.2% men) from all federal states of Germany... Participants were recruited via convenience sampling methods (social media, personal contacts, e-mails, etc.) and completed an online survey (soscisurvey.de)...

3.1. Clinical characteristics

In the present study, 31.1% of the sample exceeded the cutoff score for a potential depression diagnosis (PHQ-9 ≥ 10), 21.2% exceeded the cutoff score for a potential anxiety disorder diagnosis (GAD-7 ≥ 10), 29.4% exceeded the cutoff score for health anxiety (WI-7 ≥ 3), 55.2% reported to be lonely (Loneliness ≥ 6), 41.4% of the sample reported mild psychosocial distress (PHQ stress module scores ranging between 5 and 9), while 26.5% reported moderate to severe psychosocial distress (PHQ stress module ≥ 10). 13.1% of the sample reported having experienced a fearful spell during the last 4 weeks. The mean score of life-satisfaction was 6.42 (SD = 2.31)...

4. Discussion

In the present study, we found that a higher level of restrictions due to lockdown measures was associated with more loneliness, higher psychosocial distress and lower life-satisfaction but was not related to anxiety and depressive symptomatology or fearful spells. Although the level of restriction due to lockdown measures was not associated with an immediate increase in psychopathological symptoms, more loneliness and higher psychosocial distress might be relevant factors that facilitate or moderate potential negative consequences for mental health. Especially loneliness has been associated with an increased risk for several mental disorders and somatic diseases in general (Beutel et al., 2017; Holt-Lunstad et al., 2015; Valtorta et al., 2018; Luhmann and Hawkley, 2016) and during the current pandemic (Palgi et al., 2020; González-Sanguino et al., 2020; Luchetti et al., 2020)."