Two studies published yesterday in The Lancet Public Health detail how COVID-19 restrictions moderately affected adults' mental health in 15 nations, with one finding that the type of lockdowns were linked to the level of distress and opinion of the government, and the other suggesting that mental health declined slightly but significantly under lockdown—especially among women.

COVID-zero countries had greater freedoms

An international team led by a Simon Fraser University researcher in Canada assessed the stringency of daily public health policies using the Oxford COVID-19 Government Response Tracker and psychological distress and life evaluations using the Imperial College London-YouGov COVID 19 Behaviour Tracker Global Survey.

Respondents from 15 countries were tracked from Apr 27, 2020, to Jun 28, 2021, when most participants weren't fully vaccinated. They completed the four-item Patient Health Questionnaire (PHQ-4) and the single-question Cantril Ladder every 2 weeks.

Included countries were Australia, Canada, Denmark, Finland, France, Germany, Italy, Japan, the Netherlands, Norway, Singapore, South Korea, Spain, Sweden, and the United Kingdom. The researchers also studied a subset of the Nordic countries, with Sweden following a mitigation strategy, and Denmark, Finland, and Norway adopting an elimination approach. Australia, Japan, Singapore, and South Korea pursued a COVID-elimination strategy, while the remainder took a mitigation approach.

Participants gave 432,642 valid responses, with 14,918 responses every 2 weeks, on average, on following physical distancing guidelines and their views of the government's pandemic response.

"Because early and targeted action resulted in lower levels of virus circulation, average policy stringency was lower in countries that pursued elimination strategies than countries that pursued mitigation strategies," in both the 15-country and Nordic samples, the researchers wrote.

After controlling for variables, stricter policies were tied to higher average psychological distress scores and lower life evaluations, as was pandemic intensity, defined by the number of deaths per 100,000 residents. But the effects were small, and the negative association between policy stringency and mental health was ameliorated by following physical distancing guidelines and positive views of the government's pandemic response.

In a Lancet news release, lead author Lara Aknin, PhD, of Simon Fraser University, noted that governmental responses to the pandemic have been widely debated. "At first sight, it may seem that eliminator countries implemented much harsher strategies than other countries because of their widely reported international travel bans," she said.

"But, in reality, people within these borders enjoyed more freedom and less restrictive domestic containment measures overall than citizens in mitigator countries."

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