Dynamics of psychological responses to COVID-19 in India: A longitudinal study

Abstract

The novel COVID-19 pandemic has created chaos around the globe. To curb its spread, the Government of India announced a nationwide lockdown on March 24th, 2020 for 21 days, which was extended further for a longer time. This long period of lockdown disrupted the routine of all citizens, affecting their psychological well-being. While recent studies showed the psychological burden of Indians during the pandemic, no study has assessed whether the psychological toll changed over time due to repeated extensions of the lockdown. We followed up 159 Indian adults during the first two months of the lockdown to assess any change in their anxiety, stress, and depressive symptoms. Multilevel linear regression models of repeated observations nested within individuals adjusted for sociodemographic covariates showed that anxiety (β = 0.81, 95% CI: 0.03, 1.60), stress (β = 0.51, CI: 0.32, 0.70), and depressive symptoms (β = 0.37, CI: 0.13, 0.60) increased over time during the lockdown. This increase was higher among women than men independent of covariates. Individual resilience was negatively associated with adverse psychological outcomes. Our findings suggested that while the lockdown may help in effectively addressing this pandemic, the state and society at large need to be sensitive to the mental health impacts of a long-drawnout lockdown. Such effects likely have long-term sequelae. The disproportionate impact on women needs immediate attention. Moreover, it behooves society to address the root causes driving the unequal distribution of psychological distress during such crises.

Prevalence of psychological disorders in the COVID-19 epidemic in China: A real world cross-sectional study

“…In our study, half of all respondents experienced symptoms of anxiety, with a relatively higher incidence among female respondents, which is consistent with previous results showing that women are in general more vulnerable to anxiety disorders than are men ( Gao et al , 2020 , Guo et al , 2016 ). A previous study has also reported a greater increase of anxiety, stress and depression among women during the lockdown in India, as well showing that women reported a higher risk of stress and anxiety despite their social support and psychological resilience ( Gopal et al , 2020 ). There are three potential reasons for this phenomenon.…”

“…First, women could be confronted with an increase in their household responsibilities, leaving less time to care for themselves. Studies in North America showing that male academics have a higher publication rate than female academics gives indirect support for this conjecture ( Gopal et al , 2020 , Viglione, 2020 ). Second, the social restrictions led to a decrease in physical activity, especially among the female group.…”

“…The third potential reason for the gender difference could be the emergence of latent domestic hostility during the lockdown. Women across the world during the pandemic have been under a heightened risk for domestic violence, including emotional, physical, and sexual abuse ( Chandan et al , 2020 , Gopal et al , 2020 , Mahase, 2020 ). Although there is no direct evidence of increased domestic violence in China during the lockdown, any such incidents would undoubtedly place great stress on the victimized women's mental health.…”

Psychological Health amidst COVID-19: A Review of existing literature in the Indian Context

“…Empirical studies reporting on mental health dysfunction in general and specific population - Seven studies observed the occurrence of mental health dysfunction in the general Indian population, 13 , 14 , 15 , 16 , 17 , 18 , 19 two addressed mental health issues in professionals working in healthcare, 1 , 20 and one dealt with those suspected to be infected with COVID-19 and kept in quarantine. 21 The findings of these studies are summarized in Table 1 .…”

“…Literature addressing impact of pandemic on Vulnerable sections of the population especially migrant workers and women- Ten publications 9 , 10 , 11 , 19 , 22 , 23 , 24 , 25 , 26 , 27 have identified vulnerable populations based on the pre-existing social condition and the interventions needed to protect them. The scope of present paper for vulnerable group is only for migrant workers and women.…”