Rates of post-traumatic stress disorder, depression, and anxiety were high in a recent study on the mental health impact of COVID-19. Loneliness predicted all three of these outcomes, while social support and sense of belonging served as protective factors. The study, published in Brain, Behavior, and Immunity, was the first to examine the mental health effects of COVID-19 in the Spanish population.
Several studies have uncovered significant psychological burden in the general population when it comes to the COVID-19 pandemic. Little research has focused on European countries, despite the fact that these communities remain some of the hardest hit. Researchers set out to examine Spain, a country that, at the time of study, had 72,248 cases of COVID-19 and the second-highest number of related deaths.
The study was conducted between March 21 to 28, 2020, during the second week of a declared state of emergency in Spain. A total of 3,480 residents of Spain between the ages of 18-80 completed an online survey that measured symptoms of PTSD, depression, and anxiety. Three-quarters of the sample were women and most (57%) were between the ages of 18-39. Assessments of loneliness, spirituality, intersectional discrimination, perceived social support, self-compassion, and sense of belonging were additionally collected.
Findings from the Patient Health Questionnaire-2 scale revealed that around 19% of the sample met qualifications for a depressive disorder. The Generalized Anxiety Disorder-2 scale showed that 22% met the threshold for anxiety. Furthermore, on the civilian version of the Post-traumatic Stress Disorder Checklist-Reduced version, 16% of respondents displayed scores corresponding to “moderate to extreme post-traumatic symptoms.”
Results revealed certain factors affecting the likelihood of experiencing adverse mental health outcomes. First, women showed significantly more symptoms of anxiety, depression, and PTSD than men. The study authors acknowledge that rates of anxiety and PTSD are typically higher in women under normal circumstances. They also reason that “women generally tend to assume a caregiving role, having to balance it with work and, usually household tasks” making them “at risk and more vulnerable in this situation of overload.”
Next, younger subjects showed more symptoms of anxiety, depression, and PTSD than older subjects. Researchers suggest that this finding might reflect the younger group’s lower level of maturity and lack of resources to deal with the unprecedented situation.
Interestingly, participants who reported receiving too much information related to the virus showed increased anxiety, while those reporting “sufficient” information had fewer anxiety symptoms. The authors express that “information can be a double-edged sword if received in excess.”
Finally, loneliness was associated with heightened psychological impact, while social support, sense of belonging, and self-compassion were all protective factors. Regression models revealed that loneliness was the strongest predictor for anxiety, depression, and PTSD. Conversely, the strongest protective factor was spiritual well-being.
The authors address the limitation that their sample may not be representative of the Spanish population. Furthermore, the elderly and men were two underrepresented groups. Since their study took place just two weeks into the quarantine, the researchers suggest future prospective studies look at the impact of the COVID-19 outbreak over a longer period of time.
The study, “Mental Health Consequences during the Initial Stage of the 2020 Coronavirus Pandemic (COVID-19) in Spain”, was authored by Clara González-Sanguino, Berta Ausín, Miguel ÁngelCastellanos, Jesús Saiz, Aída López-Gómez, Carolina Ugidos, and Manuel Muñoz.
