Loneliness, worries, anxiety, and precautionary behaviours in response to the COVID-19 pandemic: A longitudinal analysis of 200,000 Western and Northern Europeans

Abstract

Background: In response to the COVID-19 pandemic, governments around the world instituted various public-health measures. Our project aimed to highlight the most significant similarities and differences in key mental-health indicators between four Western and Northern European countries, and identify the population subgroups with the poorest mental-health outcomes during the first months of the pandemic.

Methods: We analysed time-series survey data of 205,084 individuals from seven studies from Denmark, France, the Netherlands, and the UK to assess the impact of the pandemic and associated lockdowns. All analyses focused on the initial lockdown phase (March-July 2020). The main outcomes were loneliness, anxiety, and COVID-19-related worries and precautionary behaviours.

Findings: COVID-19-related worries were consistently high in each country but decreased during the gradual reopening phases. While only 7% of the respondents reported high levels of loneliness in the Netherlands, percentages were higher in the rest of the three countries (13-18%). In all four countries, younger individuals and individuals with a history of mental illness expressed the highest levels of loneliness.

Interpretation: The pandemic and associated country lockdowns had a major impact on the mental health of populations, and certain subgroups should be closely followed to prevent negative long-term consequences. Younger individuals and individuals with a history of mental illness would benefit from tailored public-health interventions to prevent or counteract the negative effects of the pandemic. Individuals across Western and Northern Europe have thus far responded in psychologically similar ways despite differences in government approaches to the pandemic.

Funding: See the Funding section.

Keywords: Anxiety; COVID-19; Global health; Governmental interventions; Lockdown; Loneliness; Pandemic; Precautions; Public health; Worries.

Fig. 1

Participating countries and cohorts (N=205,084).

Fig. 2

Governmental intervention timelines for Denmark, France, the Netherlands and the United Kingdom. New hospitalisations / 100,000 population (orange) and cumulative number of deaths / 100,000 population (blue) are presented for Denmark (28 Feb 2020 - 04 Jul 2020), France (28 Feb 2020 - 03 Jul 2020), the Netherlands (27 Feb 2020 - 30 Jun 2020) and the United Kingdom (28 Feb 2020 - 04 Jul 2020). The Oxford COVID-19 Government Response Tracker (OxCGRT) Score [0-100] is presented below the governmental intervention timelines (27 Feb 2020 - 04 Jul 2020).

Fig. 3

Worries and anxiety about the COVID-19 pandemic in Denmark, France, the Netherlands and the United Kingdom (N=140,495). The graph presents weighted means and 95% CIs of levels of worries in individuals from the Epinion general population cohort (N_total=2,123) and the Lifelines cohort (N_total=44,076), and unweighted means and 95% CIs of levels of worries in individuals from the DNBC cohort (N_total=23,029) and the TEMPO cohort (N_total=729). On the same graph, weighted proportions are presented of individuals reporting high levels of anxiety in the UCL COVID-19 Social Study (N_total=70,538).

Fig. 4

Specific worries and precautions in response to the COVID-19 pandemic in Denmark, France, the Netherlands and the United Kingdom (N=99,840). Weighted proportions of individuals answering “Yes” to questions about specific worries and precautions during the corona crisis in the Citizen Science cohort (N=11,494), the Lifelines cohort (N=59,387) and the UCL COVID-19 Social Study (N=28,230), and unweighted proportions of individuals answering “Yes” to questions about specific worries and precautions during the corona crisis in the TEMPO cohort (N=729).

Fig. 5

Loneliness during the COVID-19 pandemic in Denmark, France, the Netherlands and the United Kingdom (N=158,692). Weighted proportions of individuals with high levels of loneliness in the Constances cohort (N=29,974), the Lifelines cohort (N=57,885) and the UCL COVID-19 Social Study (N=28,230), and unweighted proportions of individuals reporting high levels of loneliness in the combined set of Danish citizens from the DNBC cohort (N=24,724), the Citizen Science cohort (N=11,494) and the Epinion cohort (N=6,385).