Abstract
The psychological impacts of the lockdown due to the Covid-19 pandemic are widely documented. In India, a family-centric society with a high population density and extreme social stratification, the impact of the lockdown might vary across diverse social groups. However, the patterning in the psychological impact of the lockdown among LGBT adults and persons known to be at higher risk of the complications of Covid-19 (such as persons with comorbidities or a history of mental illness) is not known in the Indian context. We used mixed methods (online survey, n = 282 and in-depth interviews, n = 14) to investigate whether the psychological influence of the lockdown was different across these groups of Indian adults. We fitted linear and logistic regression models adjusted for sociodemographic covariates. Thematic analysis helped us identify emergent themes in our qualitative narratives. Anxiety was found to be higher among LGBT adults (β = 2.44, CI: 0.58, 4.31), the high-risk group (persons with comorbidities) (β = 2.20, CI:0.36, 4.05), and those with a history of depression/loneliness (β = 3.89, CI:2.34, 5.44). Persons belonging to the LGBT group reported a greater usage of pornography than the heterosexuals (β = 2.72, CI: 0.09, 5.36) during the lockdown. Qualitative findings suggested that LGBT adults likely used pornography and masturbation to cope with the lockdown, given the limited physical access to sexual partners in a society that stigmatizes homosexuality. Moreover, both qualitative and quantitative study findings suggested that greater frequency of calling family members during lockdown could strengthen social relationships and increase social empathy. The study thereby urgently calls for the attention of policymakers to take sensitive and inclusive health-related decisions for the marginalized and the vulnerable, both during and after the crisis.
Highlights
The coronavirus disease (Covid-19), caused by the novel coronavirus SARS-CoV-2, first emerged in Wuhan, China during late 2019 and was labeled a public health emergency by the World Health Organization [1]
Using quantitative data from 282 Indian adults and qualitative narratives of 14 adults, our mixed methods study found that even though the Covid-19 crisis indiscriminately affected everyone, its psychological effects were disproportionate among diverse social groups in India
Our quantitative and qualitative findings both suggest that LGBT adults, compared to the heterosexuals, are at a higher risk of developing anxiety, depressive symptoms, and using pornography during the lockdown
Summary
The coronavirus disease (Covid-19), caused by the novel coronavirus SARS-CoV-2, first emerged in Wuhan, China during late 2019 and was labeled a public health emergency by the World Health Organization [1]. The lockdown restricted citizens’ physical mobility, advocated social distancing norms, and limited a majority of public services while allowing the essential ones. These measures of sheltering-in-place, equivalent to an extended quarantine, likely created a stressful environment for the citizens, given the sudden disruption in their daily routines [5], [6]. These disruptions could contribute towards adverse psychological outcomes such as post-traumatic stress symptoms [7] and aggressive behaviors [8]. Individuals who are living alone or away from family (or loved ones), those suffering from economic losses, or having a history of negative psychological states, could be at a higher risk of depression, loneliness, and anxiety disorders during the lockdown
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