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Differential effects of COVID-19 and containment measures on mental health: Evidence from ITA.LI—Italian Lives, the Italian household panel

ABSTRACT: This study used a subsample of a household panel study in Italy to track changes in mental health before the onset of COVID-19 and into the first lockdown period, from late April to early September 2020. The results of the random-effects regression analyses fitted on a sample of respondents aged 16 years and older (N = 897) proved that there was a substantial and statistically significant short-term deterioration in mental health (from 78,5 to 67,9; β = -10.5, p < .001; Cohen’s d -.445), as measured by a composite index derived from the mental component of the 12-item Short-Form Health Survey (SF-12). The findings also showed heterogeneity in the COVID-related effects. On the one hand, evidence has emerged that the pandemic acted as a great leveller of pre-existing differences in mental health across people of different ages: the decrease was most pronounced among those aged 16–34 (from 84,2 to 66,5; β = -17.7, p < .001; Cohen’s d -.744); however, the magnitude of change reduced as age increased and turned to be non-significant among individuals aged 70 and over. On the other hand, the COVID-19 emergency widened the mental health gender gap and created new inequalities, based on the age of the youngest child being taken care of within the household.

SUBMITTER: Lucchini M

PROVIDER: S-EPMC8594801 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThis study investigated changes in the prevalence of insomnia in Italy during COVID-19, starting from the first lockdown period (8 March 2020). We hypothesized that lockdown precipitated increased prevalence of insomnia symptoms relative to the pre-pandemic period; b) the gradual relaxation of containment measures - post-lockdown period (Phase 2 and Phase 3) - reduced insomnia severity, leading to a relative recovery of pre-pandemic levels; and c) we tested age-related heterogeneity in sleep responses, with an expected higher increase in insomnia in younger and middle-age groups.MethodsAnalyses drew on a subsample (N = 883) of respondents to ITA.LI - Italian Lives, a recently established panel study on a probability sample of individuals aged 16 + living in Italy. To estimate patterns of change in insomnia, we first fitted a random-effects ordered logistic model on the whole sample. We then added an interaction term between policy phases and the respondent age to test whether the relationship between insomnia and policy phases differed across age groups. Analyses accounted for survey non-response weights.ResultsThe fraction of respondents reporting moderate ("somewhat" + 0.159, S.E. 0.017) or severe ("very much" + 0.142, S.E. 0.030) sleep disturbances significantly increased during Phase 1. The prevalence of insomnia followed an inverted U-shaped curve across policy phases, with further increases from baseline levels ("somewhat" + 0.168, S.E. 0.015; "very much" + 0.187, S.E. 0.030) during Phase 2, followed by a relative reduction in Phase 3, although it remained significantly higher than in the pre-pandemic period ("somewhat", + 0.084, S.E. 0.016; "very much", + 0.045, S.E. 0.010). There were significant age-related differences in insomnia patterns, as the discrete change from pre-pandemic levels in the probability of not suffering from insomnia was negative and significant for the younger age group (- 0.269, S.E. 0.060) and for respondents aged 35-54 (- 0.163, S.E. 0.039).ConclusionThere is reason to believe that the emergency policy response to the COVID-19 crisis may have had unintended and possibly scarring effects in terms of increased prevalence of insomnia. The hardest hit were young adults and, to a lesser extent, the middle-aged; however, older respondents (55 +) remained resilient, and their insomnia trajectory bounced back to pre-pandemic levels.

Project description:BackgroundIn January 2020, the coronavirus disease 2019 (COVID-19) started to spread in Italy. The Italian government adopted urgent measures to slow its spread. Enforcing compliance with such measures is crucial in order to enhance their effectiveness. Engaging citizens in the COVID-19 preventive process is urgent today both in Italy and around the world. However, to the best of our knowledge, no previous studies have investigated the role of health engagement in predicting citizens' compliance with health emergency containment measures.MethodAn online survey was administered between February 28 and March 4, 2020 on a representative sample of 1000 Italians. The questionnaire included a measure of health engagement (Patient Health Engagement Scale), a 5-item Likert scale ranging from 1 to 7, resulting in 4 positions that describe the psychological readiness to be active in one's own health management, and a series of ad hoc items intended to measure citizens' perceived susceptibility and severity of the disease, orientation towards health management, trust in institutional bodies, health habits and food consumption. To investigate the relationship between health engagement and these variables, ANOVA analysis, logistic regression and contingency tables with Pearson's chi-squared analysis have been carried out.ResultsLess engaged people show higher levels of perceived susceptibility to the virus and severity of the disease; they are less trustful of scientific and healthcare authorities, they feel less self-effective in managing their own health-both in normal conditions and under stress-and are less prone to cooperate with healthcare professionals. Low levels of health engagement also are associated with a change in the usual purchase behavior.ConclusionsThe Patient Health Engagement model (PHE) provides a useful framework for understanding how people will respond to health threats such as pandemics. Therefore, intervention studies should focus on raising their levels of engagement to increase the effectiveness of educational initiatives intended to promote preventive behaviors.

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Differential effects of COVID-19 and containment measures on mental health: Evidence from ITA.LI—Italian Lives, the Italian household panel

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