Psychological well-being during the COVID-19 pandemic in Italy assessed in a four-waves survey

Abstract

COVID-19 pandemic had a negative impact on the mental health and well-being (WB) of citizens. This cross-sectional study included 4 waves of data collection aimed at identifying profiles of individuals with different levels of WB. The study included a representative stratified sample of 10,013 respondents in Italy. The WHO 5-item well-being scale (WHO-5) was used for the assessment of WB. Different supervised machine learning approaches (multinomial logistic regression, partial least-square discriminant analysis-PLS-DA-, classification tree-CT-) were applied to identify individual characteristics with different WB scores, first in waves 1-2 and, subsequently, in waves 3 and 4. Forty-one percent of participants reported "Good WB", 30% "Poor WB", and 28% "Depression". Findings carried out using multinomial logistic regression show that Resilience was the most important variable able for discriminating the WB across all waves. Through the PLS-DA, Increased Unhealthy Behaviours proved to be the more important feature in the first two waves, while Financial Situation gained most relevance in the last two. COVID-19 Perceived Risk was relevant, but less than the other variables, across all waves. Interestingly, using the CT we were able to establish a cut-off for Resilience (equal to 4.5) that discriminated good WB with a probability of 65% in wave 4. Concluding, we found that COVID-19 had negative implications for WB. Governments should support evidence-based strategies considering factors that influence WB (i.e., Resilience, Perceived Risk, Healthy Behaviours, and Financial Situation).

Figure 1

Percentages of WHO-5 categories across 4 waves in the Italian survey (N = 10,013).

Figure 2

Partial Least Square-Discriminant Analysis (PLS-DA): loading plots on the first component of the PLS-DA. WB status: Well-being status: red 0 = Depression; gray 1 = Poor Well-being; green 2 = Well-being. Loadings plot assigns to each variable bar the sample group colour for which the mean is maximum.

Figure 3

Pruned classification trees. WB status: Well-being status: red 0 = Depression; gray 1 = Poor Well-being; green 2 = Well-being. Resilience range = 1 to 7; COVID-19 Perceived Risk range = -3.3 to 2.5; Trust in Healthcare Institutions range = -2.9 to 1.8; Financial Situation: 1 = Improved, 2 = Remains the same, 3 = Worse.