A longitudinal study of mental health before and during COVID-19 lockdown in the French population

BACKGROUND: The impact of general population lockdown implemented in the face of the COVID-19 epidemic needs to be evaluated. We describe here a longitudinal study on the mental health of adults in France. METHODS: We did a secondary analysis of a web-based cohort, initially set up to study home and leisure injuries, in order to measure the consequences of the national lockdown implemented in France from 17 March 2020 to 11 May 2020, and to assess potential vulnerability and resilience factors. Eligible participants were invited to answer an online questionnaire designed to assess their living conditions and health during lockdown. Comparisons were done with answers provided 4.8 years earlier on average. RESULTS: On 15th April 2020, we sent email invitations to 9598 participants recruited between November 2014 and December 2019 and 1237 volunteers took part in the study by completing the online questionnaire. The proportion of those with anxiety symptoms markedly increased from 17.3 to 20.1%. The average self-rated level of mental health decreased from 7.77 to 7.58. Women, the elderly and the youngest appeared to be more vulnerable. A small living space (less than 30 m(2)) was associated with an increase in depression symptoms (PHQ-9 score), and poorer self-rated physical health at recruitment was associated with an increase in anxiety symptoms (GAD-7 score). On the contrary, the average self-rated level of physical health markedly increased from 7.44 to 7.94 between recruitment and lockdown, and the proportion of those who reported a level of 9 or 10 jumped from 25.7% at recruitment to 43.1% during lockdown. CONCLUSIONS: Mental health deteriorated during lockdown in France during the 2020 COVID-19 crisis. Overall, self-rated physical health improved but those who experienced a worse physical health were more likely to report anxiety symptoms

Mental and physical health among the French population before and during the first and second COVID-19 lockdowns: Latent class trajectory analyses using longitudinal data

International audienceBACKGROUND: The French government issued national COVID-19-related confinement and stay-at-home orders depending on different epidemic levels in a bid to stem the coronavirus pandemic and its resurgence. The long-term impact of lockdown measures on the general population may vary. We aimed to identify and characterize self-reported mental and physical health trajectories in the French population from pre-lockdown to the first and second COVID-19 lockdowns and to identify factors associated with health status variation patterns. METHODS: We did a secondary analysis of the MAVIE cohort in France. Volunteers of this national cohort were recruited between November 2014 and December 2019, and information was collected at recruitment (pre-lockdown), April-May 2020 (the first lockdown), and October-December 2020 (the second lockdown). Latent class mixed models were built to identify distinct anxiety (as measured by GAD-7) and depressive (as measured by PHQ-9) symptoms, and self-perceived mental and physical health trajectories. Factors associated with status variation were identified by multinomial regression. RESULTS: A total of 613 participants with data in all three data collection waves were included. Respondents spent almost half as much time on traditional media, websites and social media during the second lockdown as during the first. Mean anxiety scores were 1.96, 2.37 and 2.82 at pre-lockdown, and the first and second lockdowns, respectively. Mean depressive scores were 3.12, 3.36 and 3.95, respectively. Latent class mixed models fitted two and three distinct trajectory classes respectively for anxiety symptoms ('no pre-pandemic anxiety, slightly increase', 58.9%; 'consistently fair', 41.1%) and depressive symptoms ('consistently very low', 34.6%; 'consistently low', 56.1%; 'increasing and clinically significant at the second lockdown', 9.3%), and four classes for self-perceived mental and physical health. Females were more likely to belong to trajectories of the most vulnerable one as regard to the symptoms of anxiety and depression, and self-perceived mental health. The younger participants were also more vulnerable to anxiety symptoms and those with a clinical diagnosis or a positive COVID-19 test for the participant or relatives were more likely to belong to vulnerable trajectories for depressive symptoms and self-perceived mental health. Females were more likely to present the deteriorating self-perceived physical health trajectory. CONCLUSION: A continuing increase in the mean scores of anxiety and depression symptoms was observed throughout the two lockdown periods in France. Further analyses revealed distinct patterns with a small fraction of volunteers experiencing worsening mental and health symptoms. This vulnerable small part of the population requires targeted support