Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak: insights from the ECLB-COVID19 multicentre study

Achraf Ammar^{1

2}, Khaled Trabelsi^{3

4}, Michael Brach⁵, Hamdi Chtourou^{3

6}, Omar Boukhris^{3

6}, Liwa Masmoudi³, Bassem Bouaziz⁷, Ellen Bentlage⁵, Daniella How⁵, Mona Ahmed⁵, Patrick Mueller^{8

9}, Notger Mueller^{8

9}, Omar Hammouda^{2

3}, Laisa Liane Paineiras-Domingos^{10

11}, Annemarie Braakman-Jansen¹², Christian Wrede¹², Sophia Bastoni^{12

13}, Carlos Soares Pernambuco¹⁴, Leonardo Mataruna¹⁵, Morteza Taheri¹⁶, Khadijeh Irandoust¹⁶, Aïmen Khacharem¹⁷, Nicola L Bragazzi^{18

19}, Jana Strahler²⁰, Jad Adrian²¹, Albina Andreeva²², Jordan M Glenn²³, Nicholas T Bott²⁴, Faiez Gargouri⁷, Lotfi Chaari^{2

5}, Hadj Batatia²⁵, Samira C Khoshnami²⁶, Evangelia Samara²⁷, Vasiliki Zisi²⁸, Parasanth Sankar²⁹, Waseem N Ahmed³⁰, Gamal Mohamed Ali³¹, Osama Abdelkarim^{31

32}, Mohamed Jarraya³, Kais El Abed³, Wassim Moalla³, Mohamed Romdhani⁶, Asma Aloui⁶, Nizar Souissi⁶, Pijnen Lisette Van Gemert¹², Bryan L Riemann³³, Laurel Riemann³⁴, Jan Delhey³⁵, Jonathan Gómez-Raja³⁶, Monique Epstein³⁷, Robbert Sanderman³⁸, Sebastian Schulz³⁹, Achim Jerg³⁹, Ramzi Al-Horani⁴⁰, Taysir Mansi⁴¹, Mohamed Jmail⁴², Fernando Barbosa⁴³, Fernando Ferreira-Santos⁴⁴, Boštjan Šimunič⁴⁵, Rado Pišot⁴⁵, Saša Pišot⁴⁵, Andrea Gaggioli⁴⁶, Piotr Zmijewski⁴⁷, Stephen J Bailey⁴⁸, Jürgen Steinacker³⁹, Karim Chamari^#⁴⁹, Tarak Driss^#⁵⁰, Anita Hoekelmann^#¹

Affiliations

¹ Institute of Sport Science, Otto-von-Guericke University, 39106, Magdeburg, Germany.
² Research Laboratory, Molecular Bases of Human Pathology, LR12ES17, Faculty of Medicine, University of Sfax, Sfax, Tunisia.
³ High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
⁴ Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia.
⁵ Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany.
⁶ Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia.
⁷ Higher Institute of Computer Science and Multimedia of Sfax, University of Sfax, Sfax 3000, Tunisia.
⁸ Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
⁹ Medical Faculty, Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany.
¹⁰ Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
¹¹ Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil.
¹² Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherland.
¹³ Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy.
¹⁴ Laboratório de Fisiologia do Exercício, Estácio de Sá University, Brasil.
¹⁵ Canadian University of Dubai, Faculty of Management, Department of Sport Management, United Arab Emirates, UAE.
¹⁶ Faculty of Social Science, Imam Khomeini International University, Qazvin, Iran.
¹⁷ UVHC, DeVisu, Valenciennes ; LIRTES-EA 7313. Université Paris Est Créteil Val de Marne, France.
¹⁸ Department of Health Sciences, Postgraduate School of Public Health, University of Genoa, Genoa, Italy.
¹⁹ Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada.
²⁰ Department of Psychology and Sport Science, University of Gießen, Gießen, Germany.
²¹ Sports Performance Division, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia.
²² Department of Sports Biomechanics, Moscow Center of Advanced Sport Technologies, 129272 Moscow, Russia.
²³ Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, USA.
²⁴ Clinical Excellence Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, USA.
²⁵ Computer science department, University of Toulouse, IRIT-INP-ENSEEIHT, Toulouse, France.
²⁶ UFR STAPS, UPL, Paris Nanterre University, Nanterre, France.
²⁷ Onassis Cardiac Surgery Center, Athens, Greece.
²⁸ Department of Physical Education and Sports Sciences, University of Thessaly, Greece.
²⁹ Consultant in internal medicine and diabetes, MGM muthoot hospitals pathanamthitta, Kerala, India 689645.
³⁰ Consultant family physician, CRAFT hospital and research centre, Kodungallur, Kerala, India.
³¹ Faculty of Physical Education, Assiut University, Assiut, Egypt.
³² Institute for Sports and Sports Science, Karlsruher Institut für Technologie, Karlsruher, Germany.
³³ Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, USA.
³⁴ PharmD, BCBS; PharmIAD, Inc,Savannah, GA, USA.
³⁵ Institute of Social Science, Otto-von-Guericke University, 39106, Magdeburg, Germany.
³⁶ FundeSalud, Dept. of Health and Social Services, Government of Extremadura, Merida, Spain.
³⁷ The E-Senior Association, Paris, France.
³⁸ Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
³⁹ Sports- and Rehabilitation Medicine, Ulm University Hospital, Leimgrubenweg, Germany.
⁴⁰ Department of Exercise Science, Yarmouk University, Irbid, Jordan.
⁴¹ Faculty of Physical Education, The University of Jordan, Jordan.
⁴² Digital Research Centre of Sfax, Sfax, Tunisia.
⁴³ Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.
⁴⁴ ISCTE-Instituto Universitário de Lisboa, Av. das Forças Armadas, Lisboa, Portugal.
⁴⁵ Institute for Kinesiology Research, Science and Research Centre Koper, Garibaldijeva 1, Koper, Slovenia.
⁴⁶ Catholic University of the Sacred Heart I UNICATT, Milano, Italy.
⁴⁷ Institute of Sport - National Research Institute, 01-982 Warsaw, Poland.
⁴⁸ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough E11 3TU, UK.
⁴⁹ ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar and Laboratory ''Sport Performance Optimization'', (CNMSS); ISSEP Ksar-Said, Manouba University, Tunisia.
⁵⁰ Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2-2APS), UFR STAPS, UPL, Paris Nanterre University, 92000 Nanterre, France.

^# Contributed equally.

PMID: 33795912
PMCID: PMC7996377
DOI: 10.5114/biolsport.2020.96857

Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak: insights from the ECLB-COVID19 multicentre study

Achraf Ammar et al. Biol Sport. 2021 Mar.

. 2021 Mar;38(1):9-21.

doi: 10.5114/biolsport.2020.96857. Epub 2020 Aug 3.

Authors

Affiliations

¹ Institute of Sport Science, Otto-von-Guericke University, 39106, Magdeburg, Germany.
² Research Laboratory, Molecular Bases of Human Pathology, LR12ES17, Faculty of Medicine, University of Sfax, Sfax, Tunisia.
³ High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
⁴ Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia.
⁵ Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany.
⁶ Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia.
⁷ Higher Institute of Computer Science and Multimedia of Sfax, University of Sfax, Sfax 3000, Tunisia.
⁸ Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
⁹ Medical Faculty, Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany.
¹⁰ Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
¹¹ Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil.
¹² Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherland.
¹³ Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy.
¹⁴ Laboratório de Fisiologia do Exercício, Estácio de Sá University, Brasil.
¹⁵ Canadian University of Dubai, Faculty of Management, Department of Sport Management, United Arab Emirates, UAE.
¹⁶ Faculty of Social Science, Imam Khomeini International University, Qazvin, Iran.
¹⁷ UVHC, DeVisu, Valenciennes ; LIRTES-EA 7313. Université Paris Est Créteil Val de Marne, France.
¹⁸ Department of Health Sciences, Postgraduate School of Public Health, University of Genoa, Genoa, Italy.
¹⁹ Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada.
²⁰ Department of Psychology and Sport Science, University of Gießen, Gießen, Germany.
²¹ Sports Performance Division, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia.
²² Department of Sports Biomechanics, Moscow Center of Advanced Sport Technologies, 129272 Moscow, Russia.
²³ Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, USA.
²⁴ Clinical Excellence Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, USA.
²⁵ Computer science department, University of Toulouse, IRIT-INP-ENSEEIHT, Toulouse, France.
²⁶ UFR STAPS, UPL, Paris Nanterre University, Nanterre, France.
²⁷ Onassis Cardiac Surgery Center, Athens, Greece.
²⁸ Department of Physical Education and Sports Sciences, University of Thessaly, Greece.
²⁹ Consultant in internal medicine and diabetes, MGM muthoot hospitals pathanamthitta, Kerala, India 689645.
³⁰ Consultant family physician, CRAFT hospital and research centre, Kodungallur, Kerala, India.
³¹ Faculty of Physical Education, Assiut University, Assiut, Egypt.
³² Institute for Sports and Sports Science, Karlsruher Institut für Technologie, Karlsruher, Germany.
³³ Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, USA.
³⁴ PharmD, BCBS; PharmIAD, Inc,Savannah, GA, USA.
³⁵ Institute of Social Science, Otto-von-Guericke University, 39106, Magdeburg, Germany.
³⁶ FundeSalud, Dept. of Health and Social Services, Government of Extremadura, Merida, Spain.
³⁷ The E-Senior Association, Paris, France.
³⁸ Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
³⁹ Sports- and Rehabilitation Medicine, Ulm University Hospital, Leimgrubenweg, Germany.
⁴⁰ Department of Exercise Science, Yarmouk University, Irbid, Jordan.
⁴¹ Faculty of Physical Education, The University of Jordan, Jordan.
⁴² Digital Research Centre of Sfax, Sfax, Tunisia.
⁴³ Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.
⁴⁴ ISCTE-Instituto Universitário de Lisboa, Av. das Forças Armadas, Lisboa, Portugal.
⁴⁵ Institute for Kinesiology Research, Science and Research Centre Koper, Garibaldijeva 1, Koper, Slovenia.
⁴⁶ Catholic University of the Sacred Heart I UNICATT, Milano, Italy.
⁴⁷ Institute of Sport - National Research Institute, 01-982 Warsaw, Poland.
⁴⁸ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough E11 3TU, UK.
⁴⁹ ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar and Laboratory ''Sport Performance Optimization'', (CNMSS); ISSEP Ksar-Said, Manouba University, Tunisia.
⁵⁰ Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2-2APS), UFR STAPS, UPL, Paris Nanterre University, 92000 Nanterre, France.

^# Contributed equally.

PMID: 33795912
PMCID: PMC7996377
DOI: 10.5114/biolsport.2020.96857

Abstract

Although recognised as effective measures to curb the spread of the COVID-19 outbreak, social distancing and self-isolation have been suggested to generate a burden throughout the population. To provide scientific data to help identify risk factors for the psychosocial strain during the COVID-19 outbreak, an international cross-disciplinary online survey was circulated in April 2020. This report outlines the mental, emotional and behavioural consequences of COVID-19 home confinement. The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists, following a structured review of the literature. The survey was uploaded and shared on the Google online survey platform and was promoted by thirty-five research organizations from Europe, North Africa, Western Asia and the Americas. Questions were presented in a differential format with questions related to responses "before" and "during" the confinement period. 1047 replies (54% women) from Western Asia (36%), North Africa (40%), Europe (21%) and other continents (3%) were analysed. The COVID-19 home confinement evoked a negative effect on mental wellbeing and emotional status (P < 0.001; 0.43 ≤ d ≤ 0.65) with a greater proportion of individuals experiencing psychosocial and emotional disorders (+10% to +16.5%). These psychosocial tolls were associated with unhealthy lifestyle behaviours with a greater proportion of individuals experiencing (i) physical (+15.2%) and social (+71.2%) inactivity, (ii) poor sleep quality (+12.8%), (iii) unhealthy diet behaviours (+10%), and (iv) unemployment (6%). Conversely, participants demonstrated a greater use (+15%) of technology during the confinement period. These findings elucidate the risk of psychosocial strain during the COVID-19 home confinement period and provide a clear remit for the urgent implementation of technology-based intervention to foster an Active and Healthy Confinement Lifestyle AHCL).

Keywords: Behaviours; Depression; Mental wellbeing; Pandemic; Public health; Satisfaction.

PubMed Disclaimer

Conflict of interest statement

All authors declare no competing interest.

Figures

**FIG 1**
Response to the psychological support key question and total score of the mental wellbeing, mood and feelings, and short life satisfaction questionnaires before and during home confinement.

**FIG 2**
Total score of the social participation, physical activity, diet and sleep behaviours questionnaires before and during home confinement.

**FIG 3**
Responses to the Short Technology-use Lockdowns Questionnaire before and during home confinement. Values were computed and reported as mean ± SEM (standard error of the mean). *Significantly different from before confinement at p < 0.05.

See this image and copyright information in PMC

References

1. WHO. Naming the coronavirus disease (COVID-19) and the virus that causes it”. World Health Organization. Archived from the original on 28 February 2020. Retrieved 28 February 2020.
1. EDCD. Situation update worldwide, as of 19 April 2020. https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases. Retrieved 19 April 2020.
1. WHO. Mental health and psychosocial considerations during the COVID-19 outbreak. World Health Organization. https://www.who.int/docs/default-source/coronaviruse/mental-health-consi.... Retrieved 12 April 2020.
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Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak: insights from the ECLB-COVID19 multicentre study

Affiliations

Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak: insights from the ECLB-COVID19 multicentre study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Other Literature Sources

Miscellaneous