Psychological distress associated with COVID-19 quarantine: Latent profile analysis, outcome prediction and mediation analysis

Abstract

Background: Mental health of the population during COVID-19 quarantine could be at risk. Previous studies in short quarantines, found mood-related and anxiety symptomatology. Here we aimed to characterize the subtypes of psychological distress associated with quarantine, assess its prevalence, explore risk/protective factors, and possible mechanisms.

Methods: Online cross-sectional data (n = 4408) was collected during the Argentine quarantine, between 1st-17th April 2020 along a small replication study (n = 644). Psychological distress clusters were determined using latent profile analysis on a wide-range of symptoms using the complete Brief-Symptom Inventory-53. Multinomial and Elastic-net regression were performed to identify risk/protective factors among trait-measures (Personality and Resilience) and state-measures (COVID-19 related fear and coping-skills).

Results: Three latent-classes defined by symptom severity level were identified. The majority of individuals were classified in the mild (40.9%) and severe classes (41.0%). Participants reported elevated symptoms of Phobic-Anxiety (41.3%), Anxiety (31.8%), Depression (27.5%), General-Distress (27.1%), Obsession-Compulsion (25.1%) and Hostility (13.7%). Logistic-regressions analyses mainly revealed that women, young individuals, having a previous psychiatric diagnosis or trauma, having high levels of trait-neuroticism and COVID-related fear, were those at greater risk of psychological distress. In contrast, adults, being married, exercising, having upper-class income, having high levels of trait-resilience and coping-skills, were the most protected. Mediation analysis, showed that state-measures mediated the association between trait-measures and class-membership.

Conclusions: Quarantine was associated intense psychological distress. Attention should be given to COVID-19-related fear and coping-skills as they act as potential mediators in emotional suffering during quarantine.

Keywords: COVID-19; Latent profile analysis; Mental Health; Psychological distress; Quarantine.

Fig. 1

Mean Item Scores of the BSI-53 by Class. Width of the lines represents 95%CI. Vertical dotted lines stand for dimension separation and horizontal dotted lines represent the mean of that dimension. Abbreviations: Som, Somatization items; Ob, Obsession-Compulsion items; Si, Interpersonal-Sensitivity items; Ds, Depression items; As, Anxiety items; Ho, Hostility items; af, Phobic Anxiety items; Ip, Paranoid Ideation items; Ps, Psychoticism items and It, Additional Items.