Mental Health among Adults during the COVID-19 Pandemic Lockdown: A Cross-Sectional Multi-Country Comparison

Abstract

Despite the global impact of COVID-19, studies comparing the effects of COVID-19 on population mental health across countries are sparse. This study aimed to compare anxiety and depression symptoms during the COVID-19 lockdown among adults from 11 countries and to examine their associations with country-level COVID-19 factors and personal COVID-19 exposure. A cross-sectional survey was conducted among adults (≥18 years) in 11 countries (Brazil, Bulgaria, China, India, Ireland, North Macedonia, Malaysia, Singapore, Spain, Turkey, United States). Mental health (anxiety, depression, resilient coping, hope) and other study data were collected between June–August 2020. Of the 13,263 participants, 62.8% were female and 51.7% were 18–34 years old. Participants living in Brazil had the highest anxiety and depression symptoms while participants living in Singapore had the lowest. Greater personal COVID-19 exposure was associated with increased anxiety and depression symptoms, but country-level COVID-19 factors were not. Higher levels of hope were associated with reduced anxiety and depression; higher levels of resilient coping were associated with reduced anxiety but not depression. Substantial variations exist in anxiety and depression symptoms across countries during the COVID-19 lockdown, with personal COVID-19 exposure being a significant risk factor. Strategies that mitigate COVID-19 exposure and enhance hope and resilience may reduce anxiety and depression during global emergencies.

Physical Activity among Adults Residing in 11 Countries during the COVID-19 Pandemic Lockdown

“…To ensure the study procedures were implemented consistently across the 11 countries, we used the same valid and reliable instruments in all participating countries and limited the data collection period to 30 days for each country from start to end date of active study enrollment, and between 1 June to 31 August 2020. More details about the study design and procedures are described elsewhere [ 27 ]. The study first received ethical approval from the Institutional Review Board at Nationwide Children’s Hospital (in the US, ID = STUDY00001110).…”

“…The seven countries that used non-English versions of the survey had the final survey translated and back translated by independent bilingual professionals to ensure accuracy before use. In total, we used surveys in eight languages: Bulgarian, Simplified Chinese, English, Macedonian, Malay, Brazilian Portuguese, Spanish, and Turkish [ 27 ].…”

“…The survey took about 15 min to complete. Following completion of data collection, each team downloaded their country’s survey data and securely sent data to the US team for management and analysis [ 27 ]. We received 15,529 surveys from the 11 countries.…”

“…Country-level COVID-19 risk was measured using two variables based on publicly available data published by Our World in Data [ 34 ]. The first variable, increase in confirmed cases per million people, was calculated for each participating country as the average change in the cumulative number of confirmed COVID-19 cases per million people in a country between the date the participating country reached its 100th case and August 31, 2020 (the last day of our study data collection) [ 27 ]. The second variable, governmental policy responses to COVID-19, was determined for each country using the average daily Government Stringency Index (GSI) score between the date the participating country reached its 100th case and 31 August 2020 [ 27 ].…”

Factors Associated with Financial Security, Food Security and Quality of Daily Lives of Residents in Nigeria during the First Wave of the COVID-19 Pandemic

“…Food insecurity was worse in the most fragile regions of the world [1]. There were also substantial variations in anxiety and depression symptoms across countries during the COVID-19 lockdown [2,3]. In many countries around the world, many organisations and businesses had to shut down to maximise public safety resulting in significant loss of revenue.…”