Abstract
The COVID-19 pandemic and government imposed social restrictions like lockdown exposed most individuals to an unprecedented stress, increasing mental health disorders worldwide.We explored subjective cognitive functioning and mental health changes and their possible interplay related to COVID-19-lockdown. We also investigated potential risk factors to identify more vulnerable groups. Across Italy, 1215 respondents completed our Qualtrics-based online-survey during the end of a seven to 10-week imposed lockdown and home confinement (from April 29 to May 17, 2020). We found subjective cognitive functioning and mental health severely changed in association with the lockdown. Under government regulations, cognitive complaints were mostly perceived in routine tasks involving attention, temporal orientation and executive functions—with no changes in language abilities. A paradoxical effect was observed for memory, with reduced forgetfulness compared to pre-lockdown. We found higher severity and prevalence of depression, anxiety disorders, abnormal sleep, appetite changes, reduced libido and health anxiety: with mild-to-severe depression and anxiety prevalence climbing to 32 and 36 percent, respectively, under restrictions. Being female, under 45 years, working from home or being underemployed were all identified as relevant risk factors for worsening cognition and mental health. Frequent consumers of COVID-19 mass media information or residents in highly infected communities reported higher depression and anxiety symptoms, particularly hypochondria in the latter. If similar restrictions are reimposed, governments must carefully consider these more vulnerable groups in their decisions, whilst developing effective global and long-term responses to the cognitive and mental health challenges of this type of pandemic; as well as implementing appropriate psychological interventions with specific guidelines: particularly regarding exposure to COVID-19 mass-media reports.
Highlights
Since the novel coronavirus’s outbreak in December 2019, known as COVID-19, curfews and mass quarantines were adopted worldwide to reduce the pandemic’s impact on healthcare
Looking at mental health changes, we found a significant increase of Hospital Anxiety and Depression Scale (HADS)-D and HADS-A scores suggesting an overall increase in depressive and anxiety disorders related to lockdown
Our findings corroborate this evidence showing a worsening on mental health disorders, and for the first time our study demonstrates that COVID-19-lockdown has a substantial impact on self-reported cognitive functioning
Summary
Since the novel coronavirus’s outbreak in December 2019, known as COVID-19, curfews and mass quarantines were adopted worldwide to reduce the pandemic’s impact on healthcare. Psychological and social consequences associated with this stressfully unique situation were expected to be pervasive–affecting mental health, potentially yielding negative long-term effects [1]. Evidence from historical quarantines report massive impacts on mental-health; albeit, those studies were mostly focused on medical staff and virus-affected patients quarantined less than two weeks [2]. Exposure to COVID-19 confinements seems to be an unprecedented condition, incomparable to previous outbreaks, for its global magnitude. These longer-term home confinements still allowed online schooling, some work and socializing—yet, led to depression, anxiety and frustrations due to home-confinement, isolation, disrupted travel, massmedia overload and panic buying [3,4,5]
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