The Transition of Social Isolation and Related Psychological Factors in 2 Mild Lockdown Periods During the COVID-19 Pandemic in Japan : Longitudinal Survey Study

Background: Lockdowns and stay-at-home orders announced internationally for COVID-19 have led to physical and social distancing, with reports of many individuals experiencing social isolation (SI) and loneliness. Although the emergency declaration in Japan was declared as a “mild” lockdown requested by the government without penalties for violations, the lockdown measures, including SI, had several influences on people’s lives and mental health as in other countries. Furthermore, Japan declared a state of emergency multiple times; thus, it is necessary to examine the influence of the transition of SI caused by repeated emergency declarations and the deterioration of mental health associated with these changes. Objective: This study longitudinally investigated the transition of SI and its related factors during the mild lockdown under 2 declared states of emergency in Japan and analyzed psychosocial characteristics by extracting clusters where people with specific transition patterns of SI predominated. Methods: We collected data on 7893 inhabitants (3694 [46.8%] women, 49.6 [SD 13.7] years old) living in the 7 prefectures where the initial emergency declaration was applied. The investigations took place online in the final phase of the first and second states of emergency: phase 1 (between May 11 and 12, 2020) and phase 2 (between February 24 and 28, 2021). Nonparametric Bayesian coclustering was used to visualize the exhaustive interaction structure between the transition pattern of SI and the psychosocial variables. Results: There were no improvements in social networks and loneliness between the 2 phases, although psychological distress significantly improved and depression slightly decreased. Overall, 3868 (49%) of the 7893 participants remained socially isolated through phases 1 and 2, and 947 (12%) were socially isolated in phase 2, even though they were not socially isolated in phase 1. More participants experienced persistent SI in unmarried, childless, and low-household-income groups. The persistent-SI group had fewer cohabitants than other transition pattern groups. The nonparametric Bayesian coclustering results showed that most clusters, including participants without SI throughout phases 1 and 2, had healthy behaviors, more interactions, good relationships, and less loneliness and psychological stress. Furthermore, the cluster in which relationships deteriorated in phase 1 recovered in phase 2. Comparatively, the clusters with SI throughout phases 1 and 2 were divided into clusters with increased loneliness and psychological stress; clusters were close to participants’ average scores in this study. The clusters with increased loneliness and psychological stress were notable for deteriorating relationships and less online interaction. Conclusions: This study revealed the actual state of transition of SI and related psychological, social, and behavioral factors under repeated declarations of a state of emergency. These results should help construct intervention methods that fit individual characteristics of people in SI during a pandemic

Alcohol Use and Its Related Psychosocial Effects during the Prolonged COVID-19 Pandemic in Japan : A Cross-Sectional Survey

We conducted a large-scale survey in the Japanese population, about one year after the initial declaration of the state of emergency, to investigate alcohol use under the prolonged coronavirus disease 2019 (COVID-19) pandemic and its related psychosocial and demographic characteristics. The survey was conducted online between 15 and 20 June 2021. A total of 11,427 participants were included in the analysis (48.5% female, 48.82 ± 13.30 years, range = 20–90 years). Compared with females, males were more prevalent in the hazardous user and the potential alcoholism group and were less prevalent in the no alcohol-related problem group. However, the prevalence of potential alcoholism among the participants in our study was higher than that previously reported. This trend was particularly pronounced in women. The presence of potential alcoholism was related to a deteriorated psychological status, particularly depression and anxiety, and various difficulties in their daily lives due to the COVID-19 pandemic. In the future, intervention methods and systems should be developed to provide optimal assistance to people with psychological problems who are vulnerable to alcohol-related problems during the COVID-19 pandemic, while conducting further long-term follow-up studies

Effects of Interoceptive Sensibility on Mental Health during the Coronavirus Disease 2019 Pandemic

The current coronavirus disease 2019 pandemic has been reported to influence interoceptive sensibility. This study focused on adaptive and maladaptive aspects of interoceptive sensibility and examined how each aspect of interoceptive sensibility affects depression, anxiety, and somatization symptoms under the mild lockdown in Japan, which was not enforceable and a non-punitive lockdown. We used data from 10,672 participants who lived in prefectures where the emergency declaration was first applied in Japan. Interoceptive sensibility was measured by the Multidimensional Assessment of Interoceptive Awareness (MAIA). The findings show that Noticing, a subscale of the MAIA, significantly contributed to the worsening of psychological and somatic symptoms (all ps < 0.001). Conversely, Not-Distracting, Not-Worrying, Self-Regulation, and Trusting significantly contributed to the decrease of these symptoms (all ps < 0.05). The findings suggest that two aspects of interoceptive sensibility affected mental health in different ways during the mild lockdown. Mindfulness and mindfulness-based interventions would be effective in terms of enhancing adaptive aspects of interoceptive sensibility

A real-time survey on the psychological impact of mild lockdown for COVID-19 in the Japanese population

To deter the spread of the coronavirus disease 2019 (COVID-19), many countries have imposed a lockdown with restrictions. On 7 April 2020, the Japanese government declared a state of emergency over the COVID-19 outbreak. Japan was in “mild lockdown” which was not enforceable and non-punitive with the declaration. We conducted an online survey to investigate factors associated with psychological distress in the “mild lockdown” under a declared state of emergency for COVID-19. We collected data on 11,333 inhabitants (52.4% women, 46.3 ± 14.6 years) living in the seven prefectures where the declaration was first applied. The investigation dates of this study, 11 and 12 May 2020, were in the final phase of the state of emergency. The survey was conducted in real-time to minimize participants’ recall bias. In addition to psychological inventories often used worldwide, the questionnaires used in this survey included lifestyle and stress management items related to COVID-19 and various socio-demographic items including occupation (e.g. healthcare worker) or income

Social isolation and its psychosocial factors in mild lockdown for the COVID-19 pandemic : a cross-sectional survey of the Japanese population

Objective This study investigated the sociodemographic, behavioural and psychological characteristics of socially isolated individuals during the ‘mild lockdown’ period of COVID-19 in Japan. Design A cross-sectional study. Setting The seven prefectures where the emergency declaration was first applied in Japan. Participants We collected data on 11 333 individuals (52.4% women, 46.3±14.6 years) living in the seven prefectures where the emergency declaration was first applied. The online survey was performed between 11 May and 12 May 2020, in the final phase of the state of emergency. Primary outcome measures Lubben Social Network Scale (LSNS-6) Results We found that male sex (95% CI 1.60 to 1.98), middle age (95% CI 1.55 to 1.93) and lower income (eg, annual household income <2.0 million: 95% CI 2.29 to 3.54) predicted social isolation; being a student was a protective factor against social isolation (95% CI 0.26 to 0.62). In the comparisons of each item of the LSNS-6 by sociodemographic characteristics, men were more likely to have fewer people to talk to about their personal problems (95% CI −0.37 to −0.28) and to seek help from (95% CI −0.39 to −0.30), and the middle-aged group had a lower social network of friends. Additionally, social isolation was associated with decreased online interaction with familiar people (95% CI −1.28 to −1.13) and decreased optimistic thinking under mild lockdown (95% CI −0.97 to −0.86). Conclusions We identified the sociodemographic and psychological characteristics associated with social isolation under mild lockdown. These results are expected to be a useful resource for identifying which groups may require intervention to improve their social interactions in order to preserve their mental health during the pandemic

Socio-economic and behavioral characteristics associated with COVID-19 vaccine hesitancy under a declared state of emergency in Japan

Evidence regarding coronavirus disease 2019 vaccination indicates that some people hesitate to be vaccinated, and previous studies demonstrate the variables that influence hesitancy to vaccinate. However, they have not limited the target population to areas where infection is prominent. This study aimed to clarify the characteristics of people living in these areas who hesitate to be vaccinated and recommend effective approaches to encourage vaccination. The survey was conducted online between February 24 and March 1, 2021, during which the 2nd state of emergency was declared in Japan. The analytic sample comprised 17,582 unvaccinated individuals (mean age = 48.6 ± 13.8, range = 18–90 years). The t-test results indicate that current or past treatment for physical illness exerted a strong influence on vaccine hesitancy (ds = 0.30). Similarly, multiple regression analyses revealed that understanding the importance and necessity for preventive behaviors had the greatest influence on the intention to vaccinate (β = 0.48). Regarding recommendations to promote willingness to be vaccinated, our findings indicated that clear explanation of the reasons for the necessity for these behaviors and collaboration between representatives of various communities would effectively encourage vaccination

Internet Addiction Among Employed Adults

Background: The prevalence of Internet addiction (IA) among employed adults has not been reported using a large sample. To clarify the actual status of addictive Internet use among employed adults, this study aimed to evaluate the prevalence and the risk factors of IA and at-risk IA among employed adults in Japan. Methods: This cross-sectional study surveyed all junior and senior high school personnel in Shimane Prefecture, a rural area in Japan. Eligible participants included 3,211 junior and senior high school personnel (1,259 men and 1,952 women). Participants completed a questionnaire on their activities and factors related to Internet use. Results: The prevalence of IA and at-risk IA was 0.03% and 4.82%, respectively. Furthermore, game playing was shown to be the Internet activity most closely associated with at-risk IA. Conclusions: This study showed that around 5% of school personnel in a rural area in Japan are at risk for developing addiction to the Internet and that using the Internet for game playing is related to at-risk IA. Our results suggest that employed adults should be instructed to use the Internet properly

Mental health and social isolation under repeated mild lockdowns in Japan

The influence of repeated lockdowns on mental health and social isolation is unknown. We conducted a longitudinal study of the influence of repeated mild lockdowns during two emergency declarations in Japan, in May 2020 and February 2021. The analyses included 7893 people who participated in all online surveys. During repeated mild lockdowns, mental and physical symptoms decreased overall, while loneliness increased and social networks decreased. Subgroup analyses revealed that depression and suicidal ideation did not decrease only in the younger age group (aged 18–29 years) and that younger and middle-aged people (aged 18–49 years), women, people with a history of treatment for mental illness, and people who were socially disadvantaged in terms of income had higher levels of mental and physical symptoms at all survey times. Additionally, comprehensive extraction of the interaction structure between depression, demographic attributes, and psychosocial variables indicated that loneliness and social networks were most closely associated with depression. These results indicate that repeated lockdowns have cumulative negative effects on social isolation and loneliness and that susceptible populations, such as young people and those with high levels of loneliness, require special consideration during repeated lockdown situations

Effect of day-to-day variations in adrenal cortex hormone levels on abdominal symptoms

<p>Abstract</p> <p>Introduction</p> <p>The hypothalamic-pituitary-adrenal axis is known to be related to abdominal symptoms, and the relationship between abdominal pain and cortisol secretory patterns has been previously investigated using a cross-sectional approach. Here, we investigated the effect of day-to-day variations in salivary cortisol and dehydroepiandrosterone-sulfate levels on abdominal symptoms in healthy individuals.</p> <p>Methods</p> <p>Eleven college students (4 males and 7 females) participated in this study. The participants were asked to collect their saliva immediately after awakening and before bedtime for eight consecutive days. They also completed a questionnaire about abdominal symptoms before bedtime. The linear mixed model was applied to analyze the effects of the day-by-day variability or the 8-day average adrenal hormone level (at awakening, before bedtime, slope from awakening to bedtime) on abdominal symptoms.</p> <p>Results</p> <p>The day-to-day variability of cortisol levels before bedtime was negatively related with loose stool, while the day-to-day variability of the cortisol slope was positively correlated with loose stool. A low 8-day average dehydroepiandrosterone-sulfate level at awakening was positively related with frequent bowel movements, loose stool, and long bouts of severe abdominal pain. Likewise, a low 8-day average dehydroepiandrosterone-sulfate slope was positively related with long bouts of abdominal pain.</p> <p>Conclusions</p> <p>Low cortisol levels before bedtime and a steeper diurnal cortisol slope during the day may be related to bouts of diarrhea during the day.</p

The association between problematic internet use and neck pain among Japanese schoolteachers

Objectives: Problematic internet use (PIU) has been suggested in relation to psychological symptoms among schoolteachers, but the relationship with physical symptoms remains unclear. We examined whether PIU or longer Internet usage time is associated with neck pain in schoolteachers. Methods: We conducted a cross-sectional study among 2582 teachers aged 20 years or older (35.6% women) in Shimane and Tottori, Japan in 2018. Neck pain was defined as ≥5 points on the Neck Disability Index. The Compulsive Internet Use Scale (CIUS) was used to assess PIU. Internet usage time on weekdays and weekends was divided into five groups: 0, 1–29, 30–59, 60–119, and ≥120 min/day. Logistic regression analysis was conducted to examine the association of the CIUS score and Internet usage time on weekdays or weekends with neck pain, adjusting for sex, age, position at school, insomnia, and psychological distress. Results: We observed 800 (31.0%) teachers with neck pain. The median (interquartile range) of their CIUS scores was 7 (2, 14). A higher CIUS score was independently associated with a higher prevalence of neck pain (odds ratio of 4th vs. 1st quartiles, 1.41; 95% confidence interval, 1.06–1.87; trend P = .006). Compared with non-Internet users, Internet users on weekdays had almost double the odds of neck pain although the difference did not reach the customary level for designating statistical significance. Conclusions: In conclusion, teachers with higher scores in CIUS were associated with a higher prevalence of neck pain in Japan, suggesting adults with PIU being at risk of physical disorders