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. 2022 Mar 3:67:1604430.
doi: 10.3389/ijph.2022.1604430. eCollection 2022.

Association of Non-Pharmaceutical Interventions to Reduce the Spread of SARS-CoV-2 With Anxiety and Depressive Symptoms: A Multi-National Study of 43 Countries

Kira E Riehm  1 , Elena Badillo Goicoechea  1 , Frances M Wang  1 , Esther Kim  2 , Luke R Aldridge  1 , Carly P Lupton-Smith  1 , Rachel Presskreischer  1 , Ting-Hsuan Chang  1 , Sarah LaRocca  2 , Frauke Kreuter  3   4   5 , Elizabeth A Stuart  1
Affiliations

Association of Non-Pharmaceutical Interventions to Reduce the Spread of SARS-CoV-2 With Anxiety and Depressive Symptoms: A Multi-National Study of 43 Countries

Kira E Riehm et al. Int J Public Health. .

Abstract

Objectives: To examine the association of non-pharmaceutical interventions (NPIs) with anxiety and depressive symptoms among adults and determine if these associations varied by gender and age. Methods: We combined survey data from 16,177,184 adults from 43 countries who participated in the daily COVID-19 Trends and Impact Survey via Facebook with time-varying NPI data from the Oxford COVID-19 Government Response Tracker between 24 April 2020 and 20 December 2020. Using logistic regression models, we examined the association of [1] overall NPI stringency and [2] seven individual NPIs (school closures, workplace closures, cancellation of public events, restrictions on the size of gatherings, stay-at-home requirements, restrictions on internal movement, and international travel controls) with anxiety and depressive symptoms. Results: More stringent implementation of NPIs was associated with a higher odds of anxiety and depressive symptoms, albeit with very small effect sizes. Individual NPIs had heterogeneous associations with anxiety and depressive symptoms by gender and age. Conclusion: Governments worldwide should be prepared to address the possible mental health consequences of stringent NPI implementation with both universal and targeted interventions for vulnerable groups.

Keywords: COVID-19; age; anxiety; depression; gender; non-pharmaceutical interventions.

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Conflict of interest statement

FK consulted with Facebook from August 2018—June 2020. EK and SL are employed at Facebook and assisted with the interpretation of the results and editing of the manuscript. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Temporal Trends in Policies [Panel (A)] and Prevalence of Anxiety and Depressive Symptoms [Panel (B)] (43 countries, 2020).
FIGURE 2
FIGURE 2
Odds Ratios and 95% Confidence Intervals for Associations of Non-Pharmaceutical Interventions with Anxiety and Depressive Symptoms, Stratified by Gender (43 countries, 2020).
FIGURE 3
FIGURE 3
Odds Ratios and 95% Confidence Intervals for Associations of Non-Pharmaceutical Interventions with Anxiety and Depressive Symptoms, Stratified by Age (43 countries, 2020).
See this image and copyright information in PMC

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