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Timeline for restrictions in Lower Saxony and Bavaria. Closure of most schools = Some classes with special priorities could still attend school (e.g., graduating classes); Stay at home order = People are not allowed to leave the house except for work, shopping essentials or walking/jogging alone. At the beginning of June 2020, in Bavaria social contacts were still restricted by order (less than 2 contacts allowed), whereas in Lower Saxony there was only a recommendation.
Source publication
After the first COVID-19 case was diagnosed in Germany, various measures limiting contact between people were introduced across the country. The implementation of these measures varied between jurisdictions and potentially had a negative impact on the psychological well-being of many people. However, the prevalence, severity, and type of symptoms o...
Citations
... On 22nd March 2020, Germany imposed a partial lockdown and extensive protective measures against the spread of COVID-19 [14]. A rise in stress-induced psychopathology was expected due to the widespread societal changes as a result of the severe lockdown measures [15]. In Germany, public health authorities had been generating a continuous flow of data on the prevalence of mental health disorders prior to the COVID-19 pandemic [16][17][18][19]. ...
Background
The current paper analyzed the effect of the pandemic-induced lockdown on maternal mental health during the first 12 postpartum weeks in Germany.
Methods
In this cohort study, we compared the participants’ anamnestic backgrounds and the results of psychological tests, measuring stress levels, depressive symptoms and attachment. The 327 participants were divided into two groups with one representing the “pre-COVID” sample and the other the “lockdown” sample. We performed multiple comparisons, investigating the distribution of diagnoses and the correlating risk profiles between the two cohorts.
Results
Our analysis showed a significant difference between the two cohorts, with a 13.2% increase in the prevalence of adjustment disorders (AD), but not postpartum depression (PPD), in the first 12 weeks postpartum. However, during the pandemic, women with AD had fewer risk factors compared to their pre-pandemic counterparts. In the “lockdown” cohort, a tendency toward higher stress and lower mother-child attachment was observed in AD.
Conclusions
In sum, we observed some negative impact of the pandemic on maternal mental health. The lockdown might have contributed to an increase in the number of cases involving AD in the postpartum period. The prevalence of PPD (ca. 6–10%), on the other hand, was not affected by the lockdown. Thus, the effect of COVID-19 on maternal mental health might not, after all, have been as severe as assumed at the beginning of the pandemic.
... The long periods of quarantine lead to a significant financial and psychological burden, such as increased levels of anger, confusion and stress, as well as extensive behavioral changes worldwide [9][10][11][12][13][14][15][16]. In Portugal, empirical evidence showed that a large amount of the population experienced phobias, fear and anxiety linked to COVID-19, influenced by the perceived risk of contracting COVID-19. ...
Confinement measures at the beginning of the COVID-19 pandemic imposed major changes on the global population. The aim of this study was to explore the level to which the public adhered to protective guidelines by adopting the most appropriate behaviors at that time (such as hand washing with soap and using sanitizer gel) and to identify the determinants of these behaviors. A purposive sample of 1013 individuals was invited and voluntarily participated in the online survey. The questionnaire collected information on demographic data, hand washing, risk perception, anxiety (through the S = Anxiety scale of STAI) and risky-choice framing. Results showed increased levels of anxiety, a moderate perception of the risk of catching coronavirus and increased adoption of protective behaviors, such as handwashing and cleaning surfaces with disinfectant/antiseptic products. Multiple ordinal logistic regression models showed that being female, more educated and cleaning home with disinfectant / antiseptic products predicted handwashing with soap. Additionally, having an increased perception of getting the coronavirus, being older and cleaning the home with disinfectant / antiseptic products predicted handwashing with antiseptics. Public health interventions should take into consideration the unified cleaning pattern and the combined effect of sociodemographic variables and risk perception on the adoption of protective behaviour in the context of a health crisis which is out of people's control.
... Despite this limitation, the UPRIGHT intervention gained health and saved costs [45]. The stress and measures to restrict social mobility associated with the COVID-19 pandemic hampered proper assessment of the effectiveness of the UPRIGHT intervention to strengthen resilience in the study (2020-2021) [46,47]. Specifically, the repeated measures approach used to estimate the effectiveness was implemented in the context of adolescents experiencing added difficulties in their social lives and greater anxiety and stress. ...
Background:
As mental health in adulthood is related to mental status during adolescence, school-based interventions have been proposed to improve resilience. The objective of this study was to build a simulation model representing the natural history of mental disorders in childhood, adolescence and youth to estimate the cost-effectiveness of the UPRIGHT school-based intervention in promoting resilience and mental health in adolescence.
Methods:
We built a discrete event simulation model fed with real-world data (cumulative incidence disaggregated into eight clusters) from the Basque Health Service database (609,381 individuals) to calculate utilities (quality-adjusted life years [QALYs]) and costs for the general population in two scenarios (base case and intervention). The model translated changes in the wellbeing of adolescents into different risks of mental illnesses for a time horizon of 30 years.
Results:
The number of cases of anxiety was estimated to fall by 5,125 or 9,592 and those of depression by 1,269 and 2,165 if the effect of the intervention lasted 2 or 5 years respectively. From a healthcare system perspective, the intervention was cost-effective for all cases considered with incremental cost-utility ratios always lower than €10,000/QALY and dominant for some subgroups. The intervention was always dominant when including indirect and non-medical costs (societal perspective).
Conclusions:
Although the primary analysis of the trial did not did not detect significant differences, the UPRIGHT intervention promoting positive mental health was dominant in the economic evaluation from the societal perspective. Promoting resilience was more cost-effective in the most deprived group. Despite a lack of information about the spillover effect in some sectors, the economic evaluation framework developed principally for pharmacoeconomics can be applied to interventions to promote resilience in adolescents. As prevention of mental health disorders is even more necessary in the post-coronavirus disease-19 era, such evaluation is essential to assess whether investment in mental health promotion would be good value for money by avoiding costs for healthcare providers and other stakeholders.
... Different studies, which have been performed worldwide during the COVID-19 pandemic showed an increased risk for mental disorders [1]. In the general population of different countries, relatively high rates of anxiety, depression, post-traumatic stress disorders, and psychological distress were found during the COVID-19 pandemic [2][3][4]. ...
Purpose
There are different studies worldwide, which have shown a higher risk of mental disorders due to the COVID-19 pandemic. One aim of this study was to identify influencing factors of the psychological burden related to the COVID-19 pandemic and the impact on the development of postpartum depression. Further, the role of individual stress and coping strategies was analyzed in this context.
Materials and methods
Between March and October 2020, 131 women in obstetric care at the LMU Clinic Munich completed a questionnaire at consecutive stages during their perinatal period. The times set for the questionnaire were before birth, 1 month, 2 months, and 6 months after birth. The questionnaire was designed to evaluate the psychological burden related to the COVID-19 pandemic. For this a modified version of the Stress and coping inventory (SCI) and the Edinburgh Postnatal Depression Scale (EPDS) was used.
Results
We could show that the psychological burden related to the COVID-19 pandemic influenced the EPDS score 1, 2 and 6 months after birth. In addition, the prenatal stress and individual coping strategies affected the EPDS and the burden related to the COVID-19 pandemic before and after birth significantly.
Conclusion
An association of the psychological burden related to the COVID-19 pandemic with the risk of developing postpartum depressive symptoms could be shown in this study. In this context, the separation of the partner and the family was recognized as an important factor. Furthermore, the SCI was identified as an effective screening instrument for identifying mothers with an increased risk of postpartum depression. Hereby allowing primary prevention by early intervention or secondary prevention by early diagnosis.
... The previous literature stresses that lockdown measures negatively affected the psychological well-being of individuals in many countries (see [3] for an overview). Correspondingly, in our empirical strategy, we assume that this lockdown affected the lives of large (if not all) parts of Germany's society (see [31,47,48] for empirical support). Nevertheless, we cannot observe who complied with the rules of the lockdown or who did not. ...
Even though the COVID-19 pandemic had consequences for the whole society, like during most crises, some population groups tended to be disproportionally affected. We rely on the most recent data from the IAB-BAMF-SOEP Survey of Refugees to explore the resilience or vulnerability of refugees in the face of the pandemic. As the 2020 wave of the survey was in the field when the second nationwide lockdown started in December, we are able to apply a regression discontinuity design to analyze how refugees in Germany are coping with these measures. Our results reveal a negative effect of the lockdown on refugees’ life satisfaction. Male refugees and those with a weaker support system face stronger negative outcomes than their counterparts. Since mental health is an important prerequisite for all forms of integration, understanding the related psychological needs in times of crisis can be highly important for policymakers and other stakeholders.
... However, there is some debate about whether this trend is attributable to overall prevalence or to other factors, such as coding practice or patients' help-seeking behavior [63,64]. Furthermore, the COVID-19 pandemic may have contributed to a generally higher mental health burden nowadays [65][66][67]. Given that our data collection took place in June to July 2021, with very low regional incidences [68] and few restrictions, we consider the impacts of COVID-19 on our results rather limited. ...
Unwelcome environmental changes can lead to psychological distress, known as “solastalgia”. In Germany, the open-pit mining of brown coal results in environmental changes as well as in the resettlement of adjacent villages. In this study, we investigated the risk of open-pit mining for solastalgia and psychological disorders (e.g., depression, generalized anxiety and somatization) in local communities. The current residents and resettlers from two German open-pit mines were surveyed concerning environmental stressors, place attachment, impacts and mental health status. In total, 620 people responded, including 181 resettlers, 114 people from villages threatened by resettlement and 325 people from non-threatened villages near an open-pit mine. All groups self-reported high levels of psychological distress, approximately ranging between 2–7.5 times above the population average. Respondents from resettlement-threatened villages showed the worst mental health status, with 52.7% indicating at least moderate somatization levels (score sum > 9), compared to 28% among resettlers. We observed a mean PHQ depression score of 7.9 (SD 5.9) for people from resettlement-threatened villages, 7.4 (SD 6.0) for people from not-threatened villages, compared to 5.0 (SD 6.5) for already resettled people (p < 0.001). In conclusion, the degradation and loss of the home environment caused by open-pit mining was associated with an increased prevalence of depressive, anxious and somatoform symptoms in local communities. This reveals a need for further in-depth research, targeted psychosocial support and improved policy frameworks, in favor of residents’ and resettlers’ mental health.
This study explored impacts of the COVID-19 pandemic on creativity and productivity and how personality variables moderated these impacts. Two online self-report surveys were conducted. 863 (spring 2020) and 421 (spring 2021) participants were asked how the corona crisis affected their creativity and productivity. In addition, personality variables, namely the Big Five (openness, conscientiousness, extraversion, agreeableness, neuroticism), as well as interpersonal trust, need for cognition, risk-taking, and life satisfaction, were assessed. As a result of the crisis, the group of participants appeared more creative in 2020, while no significant group effect of the pandemic was found for productivity. In 2021, however, the crisis had a negative impact on creativity and productivity. In 2020, predictors for an improved creativity were openness, conscientiousness, neuroticism, and life satisfaction; predictors for improved productivity were conscientiousness, negative interpersonal trust, and life satisfaction. In 2021, only life satisfaction predicted improved creativity, while improved productivity was predicted by conscientiousness, negative neuroticism, and life satisfaction. At its beginning, the COVID-19 pandemic had, on average, a positive effect on creativity and a neutral one on productivity. Later, the impact turned negative on both creativity and productivity. Here, lower life satisfaction was particularly relevant.
Background:
Chronic stress is highly prevalent in the German population. It has known adverse effects on mental health, such as burnout and depression. Known long-term effects of chronic stress are cardiovascular disease, diabetes, and cancer.
Objective:
This study aims to derive an interpretable multiclass machine learning model for predicting chronic stress levels and factors protecting against chronic stress based on representative nationwide data from the German Health Interview and Examination Survey for Adults, which is part of the national health monitoring program.
Methods:
A data set from the German Health Interview and Examination Survey for Adults study including demographic, clinical, and laboratory data from 5801 participants was analyzed. A multiclass eXtreme Gradient Boosting (XGBoost) model was constructed to classify participants into 3 categories including low, middle, and high chronic stress levels. The model’s performance was evaluated using the area under the receiver operating characteristic curve, precision, recall, specificity, and the F1-score. Additionally, SHapley Additive exPlanations was used to interpret the prediction XGBoost model and to identify factors protecting against chronic stress.
Results:
The multiclass XGBoost model exhibited the macroaverage scores, with an area under the receiver operating characteristic curve of 81%, precision of 63%, recall of 52%, specificity of 78%, and F1-score of 54%. The most important features for low-level chronic stress were male gender, very good general health, high satisfaction with living space, and strong social support.
Conclusions:
This study presents a multiclass interpretable prediction model for chronic stress in adults in Germany. The explainable artificial intelligence technique SHapley Additive exPlanations identified relevant protective factors for chronic stress, which need to be considered when developing interventions to reduce chronic stress.
Objectives
We aimed to (1) describe the course of the emotional burden (i.e., depression, anxiety, and stress) in a general population sample during the coronavirus pandemic in 2020 and 2021 and (2) explore the association between emotional burden and a serologically proven infection with SARS-CoV-2.
Study design
This longitudinal study involved a sample of community-dwelling persons aged ≥14 years from the general population of South Tyrol (Province of Bolzano-Bozen, Northern Italy). Data were collected at two stages over a 1-year period in 2020 and 2021.
Methods
Persons were invited to participate in a survey on socio-demographic, health-related and psychosocial variables (e.g., age, chronic diseases, Depression Anxiety Stress Scale, DASS-21), as well as in the serological testing for of SARS-CoV-2-specific immunoglobulins.
Results
In 2020, 855 (23.8%) out of 3,600 persons participated; in 2021, 305 (35.7%) out of 855 were tested again. We observed a statistically significant decrease in mean DASS-21 scores for depression, stress, and total scores between 2020 and 2021, yet not for anxiety. Persons with a confirmed SARS-CoV-2-infection between the first and second data collection exhibited increased emotional burden compared to those without SARS-CoV-2-infection. The odds of participants with a self-reported diagnosis of mental disorder for future infection with SARS-CoV-2 was almost four times higher than that of participants without mental disorders (OR:3.75; 95%CI:1.79-7.83).
Conclusion
Our findings support to the hypothesis of a psycho-neuroendocrine-immune interplay in COVID-19. Further research is necessary to explore the mechanisms underlying the interplay between mental health and SARS-CoV-2 infections.
Purpose
The COVID-19 pandemic has been a leading cause of stress and feelings of loss of control, both of which have been related to eating disorder (ED) pathology onset and deterioration. We aim to estimate the magnitude of changes in the prevalence rates of, and indicators for, ED psychopathology in the face of the COVID-19 pandemic.
Method
Pre-registered systematic review with frequentist and Bayesian meta-analyses. Searches for eligible studies were performed in PubMed, Web of Science and pre-print servers until January 15 2023.
Results
Our searches yielded 46 eligible studies reporting on a total of 4,688,559 subjects. These data provide strong evidence indicating increased rates of diagnosed and self-reported ED’s and a concordant increased need for care in the face of the pandemic. ED symptom severity scores in patients were not elevated during the pandemic, except for those related to anorexia nervosa. On average, people in the general population report relatively high levels of emotional and binge eating during the pandemic, although the evidential strength for these associations is only anecdotal to moderate. Moderators of between-study heterogeneity were not detected.
Conclusions
Altogether, our results suggest that the COVID-19 pandemic is associated with a wide spread negative effect on ED pathology in patient samples and the general population. The development of online prevention and intervention programs for EDs during stressful times like a pandemic is encouraged. A limitation is that the results reported here may be prone to biases, amongst others, self-report bias.
Level of evidence: Level I, systematic review and meta-analysis.
Preregistration: Prospero [https://www.crd.york.ac.uk/prospero] ID: CRD42022316105.
