A recent study suggests that a subset of Australian citizens have experienced adverse changes in health-related behaviors since the onset of the pandemic and are at risk for heightened depression, anxiety, and stress. The findings were published in the International Journal of Environmental Research and Public Health.
“Australia, like other countries, has been significantly impacted by COVID-19. The abrupt and necessary changes to way we undertake usual daily activities was recognised early on as likely resulting in significant psychological distress,” said study author Rob Stanton (@RobStanton2), a senior lecturer at Central Queensland University.
“As a group of health behaviour and mental health researchers we were very interested to understand how any change in health-related behaviour might be associated with depression, anxiety, or stress, in Australian adults.”
The combination of lockdown regulations with increased stress may have prompted citizens to exchange positive health behaviors for other, more harmful ones. In the first Australian study of its kind, Stanton and his team explored how changes in health-related behaviors would impact the mental health of citizens during the pandemic.
A total of 1,491 Australian adults took part in an online survey between April 9 and April 19, 2020. At this time, significant social distancing was underway in Australia — public gatherings were banned, meetings with more than one person from another household were off-limits, and most schools were shut down. Participants were asked to indicate, along a scale, how their physical activity, sleeping habits, smoking habits, and alcohol intake had changed since the onset of the pandemic. Participants additionally completed the Depression, Anxiety, and Stress Scale as a measure of psychological distress.
Nearly half (49%) of respondents indicated that their physical activity had dropped since the start of the pandemic. An additional 41% said their sleep quality had worsened and over a quarter (27%) reported an increase in alcohol consumption. “Worryingly,” the authors say, “this report suggests that almost 30% of adults are drinking more to cope with psychological distress.”
While only 7% of the overall sample had increased their smoking habits, of those who were smokers, half of them had increased their smoking behavior. This statistic is important, researchers say, because smokers are not only more likely to catch a respiratory illness, but smoking behavior has been linked to a poorer prognosis after contracting COVID-19.
Most importantly, adverse changes in each of these health behaviors were linked to poorer mental health. Subjects who experienced adverse changes in physical exercise, sleep, alcohol, or smoking habits had an increased likelihood of heightened depression, anxiety, and stress symptoms.
“The key take home messages from our analysis so far is that despite community observations that more people are regularly out walking or undertaking other exercise, our data suggests around half of survey respondents are doing less activity than pre-COVID,” Stanton told PsyPost.
“Other health behaviours also showed negative changes; for example, around 40% reported worse sleep, and more than ¼ were drinking more than pre-COVID. Notably, when we combined the positive and negative changes in health behaviours, the greater the negative change, that is, the poorer overall health behaviour became, the greater the levels of depression, anxiety, and stress people experience. Hence, adopting strategies to maintain healthy behaviours , or at least not adopting negative behaviours such as smoking or drinking more, might be a way of reducing psychological distress during the pandemic.”
The authors acknowledge that their study relied on self-report data and that reports may have been biased.
“Since this study was cross sectional, causation cannot be determined. We are intending to collect follow up data at selected timepoints to see how these health behaviours and any associations with psychological distress change over time. Our sample were on average, older than other studies examining health behaviours so generalising our findings to all age groups is not feasible,” Stanton explained.
“Finally, all data were self-reported and so can be subject to recall bias. We need to look more closely at how our findings can be translated to public health policy so the best messages can be delivered to the Australian public to preserve community health.”
Still, the findings suggest that the impact of lockdown regulations should be monitored on a continual basis. Additionally, public health campaigns should actively encourage citizens to maintain positive health behaviors during the pandemic in order to reduce psychological distress.
The study, “Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults”, was authored by Robert Stanton, Quyen G. To, Saman Khalesi, Susan L. Williams, Stephanie J. Alley, Tanya L. Thwaite, Andrew S. Fenning, and Corneel Vandelanotte.