How the pandemic is affecting us
Summary
The first studies exploring the psychological effects of the pandemic are now available, but their conclusions should be interpreted with caution due to methodological limitations. Several studies are currently underway that aim to overcome these and other limitations, such as the two presented in this article.
The pandemic, lockdown measures, and their many consequences can easily trigger anxiety and depression. To address these symptoms, health organizations offered some recommendations, such as avoiding repeated news reports about the pandemic (CDC 2020). However, these recommendations were based on previous studies of different experiences with the current coronavirus crisis. To understand the psychological effects of the pandemic and how we can mitigate them, we need new studies specifically designed for this purpose.
Currently, some of these new studies have already been published. For example, during the April lockdown, we conducted an online survey of five thousand people to assess the level of anxiety and depression, as well as the frequency with which participants engaged in various behaviors such as following a routine or maintaining a balanced diet (Fullana, Hidalgo-Mazzei et al. 2020).
Two-thirds reported symptoms of anxiety or depression, demonstrating the devastating impact of the COVID-19 pandemic on mental health. Fortunately, we also observed that a few simple behaviors appeared to protect against these symptoms, which could serve as recommendations to help people cope with this crisis. For example, maintaining a healthy diet and avoiding excessive COVID-19 news were associated with lower levels of both anxiety and depression. Sticking to a routine and taking time for hobbies were also associated with lower levels of depression.
How to manage stress during the COVID-19 pandemic?
Another survey in China found that the use of coping behaviors was associated with fewer mental health problems (Guo, Feng et al. 2020), and yet another survey in Poland found that anxiety may mediate the relationship between the threat of COVID-19 and coping behaviors (Cypryanska and Nezlek 2020).
However, the conclusions of these studies and our own should be interpreted with caution due to some methodological limitations. For example, they only correlate the frequency of certain behaviors with levels of anxiety and depression, so we can't say "which came first, the chicken or the egg." It could be that when someone reads a lot of news about COVID-19, the news makes them nervous, and we might then find that people who read a lot of news about COVID-19 exhibit more anxiety. But it could be the other way around. It could be that when someone is nervous thinking about COVID-19, they decide to read more news to try to calm themselves, and we might then find that people with more anxiety read a lot of news about COVID-19.
Currently, several studies are underway that aim to overcome this and other limitations. I will present two. The first is an international study to understand how the pandemic is affecting our physical and mental health. The second is a study that conducts periodic assessments of the same individuals to determine which behavioral changes are subsequently accompanied by changes in anxiety or depression (and not which changes in symptoms are subsequently accompanied by behavioral changes). Both studies target the general population—that is, all of us. And I believe both studies will be important: the first because of its size, and the second because of its careful follow-up.
The study "COH-FIT: How the Pandemic Affects Our Physical and Mental Health" is a large online survey to identify risk and protective factors for physical and mental health during the pandemic. It is a major international collaboration, with over two hundred researchers and one hundred and fifteen thousand participants from one hundred and fifty different countries, a number that continues to rise daily. The general survey is for adults, but adapted versions for children and adolescents are also available, always with the appropriate consent.
The ultimate goal of the study is to design effective prevention programs. The study also aims to examine the moderating effect of demographic, occupational, and behavioral variables, as well as various environmental and contextual factors, and the effect of different levels of social distancing measures. Two further surveys will be conducted at 6 and 12 months after the pandemic ends.
To evaluate the impact of COVID-19 in order to act on public health strategies
This study is coordinated by Charité Universitätsmedizin Berlin and the University of Padua, and in Spain the main participants are the Gregorio Marañón University General Hospital, the Hospital Clínic of Barcelona / IDIBAPS, the University of Navarra and Sant Joan de Déu.
The study "Coping with the Pandemic: What Works Best to Reduce Anxiety and Depression" also uses online surveys, but in this case, they are shorter and conducted every two weeks for a year. The information provided by these surveys will allow us to determine whether behavioral changes occur first, followed by changes in anxiety or depression symptoms, or whether, conversely, changes in anxiety or depression symptoms occur first, followed by behavioral changes. This distinction is crucial for understanding whether behavioral changes are the cause or the consequence of an increase or decrease in anxiety or depression.
This study is coordinated by the Hospital Clínic of Barcelona / IDIBAPS, and also involves FIDMAG Hermanas Hospitalarias, the Hospital del Mar / IMIM, the Gregorio Marañón Health Research Institute, the University of Valencia and the University Clinic of Navarra.
I encourage everyone to participate in these studies. And I especially invite older people. In both studies, we are finding it difficult to get responses from older adults, who represent a population we would like to help.
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