Abstract

BackgroundExisting estimates of the impact of the COVID-19 burden on mental wellbeing come from countries with high mortality rates. This study therefore aimed to investigate the impact of the first COVID-19 lockdown (March–April 2020) on risk for stress/depression and functional impairment in a representative sample of adult individuals in Denmark, which had lower infection rates, and whether the impact of lockdown was heterogeneous across living situation.MethodsUsing a representative, randomly drawn sample from the complete Danish adult population interviewed in March 2 to April 13, 2020 (n = 2836) and again in July 2020 (n = 1526, 54% retention rate), we study how the imposed lockdown announced March 11 following the onset of the first Danish wave of COVID-19 infections affected mental wellbeing. We use the World Health Organization Five Well-being Index (WHO-5) and the Work and Social Adjustment Scale (WSAS) to capture risk for stress/depression (WHO-5 < 50) and functional impairment (WSAS > 10). Using covariate adjusted ordinary least squares linear probability models and exploiting variation in the timing of responses occurring just before and just after the introduction of lockdown, we compare respondents before lockdown to respondents that answered during lockdown, as well as to answers in re-interviews in July.ResultsIn our fully controlled models, we find reduced depressive symptoms among adults immediately after the shutdown, concentrated in adults with children living at home (−.089, p < .01 (from pre lockdown baseline .273)). Measures of functional impairment also declined immediately after the March shutdown among adults with children living at home (−.066, p < .05 (from pre lockdown baseline .150)). Impairment intensified for the entire sample between March and July (+.199, p < .001 (from pre lockdown baseline .248)), but depressive symptoms remained at lower rate in July (−.033, p < .05 (from pre lockdown baseline .332).ConclusionsFindings in Denmark indicate that living with children at home may have, in the short term, buffered the potential mental health sequelae of the COVID-19 shutdown.

Highlights

  • As of mid-October 2020, more than 90 countries across the world had imposed some form of lockdown in the wake of the COVID-19 pandemic [1]

  • Andersen et al BMC Public Health (2021) 21:984 several groups, such as singles, females, and people who lost their jobs because of lockdowns [9,10,11]. This literature has raised the concern of a “second pandemic” of morbidity due to mental health problems following COVID-19 [12], and calls have been made for prioritizing high-quality research on the mental health effects of the pandemic [13]

  • Unlike for previously studied countries, the Danish lockdown was imposed uniformly and rapidly following the first infections and came into effect before the first Danish registered COVID-19 fatality. We address these limitations and extend prior work by examining mental wellbeing in Denmark, a country that imposed a lockdown in March 2020 but reports a substantially lower COVID-19 burden as of November 30, 2020 (i.e., 14.3 deaths per 100,000 population) than does France, the US, or the UK (i.e., 78 to 87 deaths per 100, 000 population) [18]

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Summary

Introduction

As of mid-October 2020, more than 90 countries across the world had imposed some form of lockdown in the wake of the COVID-19 pandemic [1]. Lockdowns range in scope and duration, but all imply a degree of social isolation as well as disruption from routine social, Andersen et al BMC Public Health (2021) 21:984 several groups, such as singles, females, and people who lost their jobs because of lockdowns [9,10,11]. Taken together, this literature has raised the concern of a “second pandemic” of morbidity due to mental health problems following COVID-19 [12], and calls have been made for prioritizing high-quality research on the mental health effects of the pandemic [13]. We defined the beginning of the lockdown measures as March 11, 2020

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