Abstract

BackgroundThe COVID-19 pandemic has led to a wide range of stressors related to depressive symptoms. Prevention measures like physical distancing have burdened the general population, especially in highly urbanized areas. However, little is known about the associations between pandemic-related stressors, coping strategies, and depressive symptoms in highly urbanized vs. less urbanized environments.MethodsParticipants were recruited in a cross-sectional online survey in Germany. Propensity score matching yielded a matched sample of city (n = 453) and town (n = 453) inhabitants. Depressive symptoms, COVID-19-related stressors, and coping strategies were compared between cities and towns. Multiple regression analysis was performed to determine associations between pandemic-related stressors and depressive symptoms for the two groups separately.ResultsCity inhabitants showed significantly higher depression scores than town inhabitants (t = 2.11, df = 897.95, p = 0.035). Seven coping strategies were more often used by the city sample. Depressive symptoms were associated with “restricted physical social contact” and “difficult housing conditions” (adjusted R2= 0.19, F[9,443] = 12.52, p < 0.001) in city inhabitants, and with “fear of infection” and “difficult housing conditions” (adjusted R2= 0.20, F[9,443] = 13.50, p < 0.001) in town inhabitants.LimitationsThe data were collected at the end of the first wave and represent a snapshot without causal inferences. Pandemic-related stressors were measured with a newly developed scale.ConclusionDepressive symptoms, perceived stressors, and approach/avoidance coping strategies differed between city vs. town inhabitants. These differences should be considered in policy-making and mental health care.

Highlights

  • The coronavirus disease 2019 (COVID-19) pandemic has affected the lives of hundreds of millions of people worldwide, changing their ways of living, working, and interacting with others

  • Depressive symptoms, perceived stressors, and approach/avoidance coping strategies differed between city vs. town inhabitants

  • As a result of the variety of stressors caused by the pandemic and by preventive measures to contain the spread of infection, people have been confronted with a wide range of known risk factors for mental health problems, amplifying major mental health problems, and depressive symptoms, worldwide [4,5,6,7]

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Summary

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has affected the lives of hundreds of millions of people worldwide, changing their ways of living, working, and interacting with others. During the first wave of COVID-19 in Germany (02/2020 to 05/2020), these measures included contact restrictions (e.g., restricted personal contact), work-related restrictions (e.g., closure of shops and restaurants, working from home), restrictions in daily activity (e.g., reduced leisure activities), closure of educational institutions (e.g., schools, universities, and kindergartens), and border closures [2]. These preventive measures have resulted in massive disruptions in economic systems and in people’s personal lives, leading, among other problems, to job loss or reduced income [3]. Little is known about the associations between pandemic-related stressors, coping strategies, and depressive symptoms in highly urbanized vs. less urbanized environments

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