Mental health during the COVID-19 pandemic: Survey results published by the Advanced Telecommunications Research Institute

A research group from the Advanced Telecommunications Research Institute (ATR), KDDI Research, and others have published their findings that "the COVID-19 pandemic affects different mental health factors at different times." The study statistically examined the timeline of the impact of the pandemic on people's mental health using large-scale data, and the findings revealed that people are under severe stress from the prolonged COVID-19 pandemic. The research findings were published in the international psychiatry journal Translational Psychiatry.

In the survey study, various psychiatric symptoms in a general group (3,935 participants) that were collected just before the pandemic were followed up for approximately one and a half years. From December 2019, immediately before the COVID-19 pandemic, to August 2020, December 2020, and April 2021 during the pandemic, they received 3,935 responses (of which 2,274 participants took part in the entire survey) from men and women in their 20s to 60s. The survey was concerned with nine types of psychiatric symptoms: anxiety, depression, internet dependence, obsessive-compulsive disorder, alcohol dependence, social phobia, social avoidance, autism, and attention deficit hyperactivity disorder. As a result of looking at changes in multiple symptoms at a group (principal component) level, they clarified the existence of a "common psychiatric burden component" and an "depression / anxiety component" that peaked early on in the pandemic, as well as a "social withdrawal component" that peaked a year later.

A change in one psychiatric symptom does not mean that all symptoms deteriorated during the pandemic; however, it may be helpful to also focus on symptoms that do not worsen, such as depressive symptoms and alcohol problems. For example, even if alcohol problems reduced in most people (perhaps due to the lack of drinking opportunities during the pandemic), some people may depend on alcohol to handle the heightened anxiety and depression caused by the pandemic. In such cases, alcohol alone may not be a problem, but alcohol problems linked to anxiety and mood depression may increase.

To extract these kinds of groups of symptoms that change together (principal components), the identified symptoms were analyzed through the "principal component analysis" technique. This approach allowed them to classify four types of changes in psychiatric symptoms during the COVID-19 pandemic: 1. a "common psychiatric symptom component" from which many psychiatric symptom interactions were extracted; 2. a "social isolation component" such as internet dependence and social anxiety; 3. an "alcohol-related component"; and 4. an "anxiety and depression component." They found that three of these components deteriorated during the pandemic, each peaking at a different time. More concretely, the "common psychiatric burden component" and the "depression / anxiety component" peaked immediately after the pandemic started, while the "social isolation component" continued to deteriorate from the early stages of the pandemic to the present. Furthermore, a generalized linear regression analysis was used to determine the risk of deterioration for each component. It showed that all three components that deteriorated during the pandemic were more likely to be worse for women than men. There appears to be an urgent need to reduce the physical and mental burdens on women due to the COVID-19 pandemic.

Meanwhile, it was found that the "common psychiatric burden component" and the "depression/ anxiety component" were significantly affected by reduced income during the pandemic, while the gradually worsening "social withdrawal component" did not easily deteriorate for people with changing levels of communication with other people and those who were either employers or self-employed. The importance of occupation type for the "social withdrawal component" has been attributed to the magnitude of the effects of work environment and relationships, such as telework and other forms of work and connections with colleagues. One of the authors of the research article, Associate Professor Shuken Boku from the Department of Neuropsychiatry, Kumamoto University Hospital, noted that as the pandemic persists, issues of social anxiety and internet dependence have emerged: "Social anxiety and internet dependence cause social withdrawal, which can further aggravate social anxiety and internet dependence. This vicious cycle requires early countermeasures. It is important to maintain social connectedness, such as increasing online face-to-face opportunities during telework and regular video calls with family members whom you cannot meet as often as before."