COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany
BackgroundWith the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may nega...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-05-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1141433/full |
| _version_ | 1827943069797842944 |
|---|---|
| author | Felix G. Wittmann Andrea Zülke Alexander Pabst Melanie Luppa Jochen René Thyrian Jochen René Thyrian Jochen René Thyrian Anika Kästner Wolfgang Hoffmann Wolfgang Hoffmann Hanna Kaduszkiewicz Juliane Döhring Catharina Escales Jochen Gensichen Isabel Zöllinger Robert Philipp Kosilek Birgitt Wiese Anke Oey Hans-Helmut König Christian Brettschneider Thomas Frese Steffi G. Riedel-Heller |
| author_facet | Felix G. Wittmann Andrea Zülke Alexander Pabst Melanie Luppa Jochen René Thyrian Jochen René Thyrian Jochen René Thyrian Anika Kästner Wolfgang Hoffmann Wolfgang Hoffmann Hanna Kaduszkiewicz Juliane Döhring Catharina Escales Jochen Gensichen Isabel Zöllinger Robert Philipp Kosilek Birgitt Wiese Anke Oey Hans-Helmut König Christian Brettschneider Thomas Frese Steffi G. Riedel-Heller |
| author_sort | Felix G. Wittmann |
| collection | DOAJ |
| description | BackgroundWith the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may negatively affect mental health by loneliness and social isolation, which constitute risk factors for depressiveness. We aimed to analyse the impact of perceived restriction due to government measures on depressive symptoms and investigated stress as mediator in an at-risk-population in Germany.MethodsData were collected in April 2020 from the population of the AgeWell.de-study, including individuals with a Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score ≥9, using the depression subscale of the Brief Symptom Inventory (BSI-18) and the Perceived Stress Scale (PSS-4). Feeling restricted due to COVID-19 government measures was surveyed with a standardized questionnaire. Stepwise multivariate regressions using zero-inflated negative binomial models were applied to analyse depressive symptoms, followed by a general structural equation model to assess stress as mediator. Analysis were controlled for sociodemographic factors as well as social support.ResultsWe analysed data from 810 older adults (mean age = 69.9, SD = 5). Feeling restricted due to COVID-19 government measures was linked to increased depressiveness (b = 0.19; p < 0.001). The association was no longer significant when adding stress and covariates (b = 0.04; p = 0.43), while stress was linked to increased depressive symptoms (b = 0.22; p < 0.001). A final model confirms the assumption that the feeling of restriction is mediated by stress (total effect: b = 0.26; p < 0.001).ConclusionWe found evidence that feeling restricted due to COVID-19 government measures is associated with higher levels of depressive symptoms in older adults at increased risk for dementia. The association is mediated by perceived stress. Furthermore, social support was significantly associated with less depressive symptoms. Thus, it is of high relevance to consider possible adverse effects of government measures related to COVID-19 on mental health of older people. |
| first_indexed | 2024-03-13T10:09:54Z |
| format | Article |
| id | doaj.art-ca92ab0a7f944f6c824a042ebd9e871a |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-13T10:09:54Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-ca92ab0a7f944f6c824a042ebd9e871a2023-05-22T04:54:42ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-05-011110.3389/fpubh.2023.11414331141433COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in GermanyFelix G. Wittmann0Andrea Zülke1Alexander Pabst2Melanie Luppa3Jochen René Thyrian4Jochen René Thyrian5Jochen René Thyrian6Anika Kästner7Wolfgang Hoffmann8Wolfgang Hoffmann9Hanna Kaduszkiewicz10Juliane Döhring11Catharina Escales12Jochen Gensichen13Isabel Zöllinger14Robert Philipp Kosilek15Birgitt Wiese16Anke Oey17Hans-Helmut König18Christian Brettschneider19Thomas Frese20Steffi G. Riedel-Heller21Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyInstitute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyInstitute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyInstitute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyInstitute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, GermanyGerman Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, GermanyFaculty V: School of Life Sciences, University of Siegen, Siegen, GermanyInstitute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, GermanyInstitute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, GermanyGerman Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, GermanyInstitute of General Practice, University of Kiel, Kiel, GermanyInstitute of General Practice, University of Kiel, Kiel, GermanyInstitute of General Practice, University of Kiel, Kiel, GermanyInstitute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, GermanyInstitute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, GermanyInstitute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, GermanyHannover Medical School, Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover, GermanyHannover Medical School, Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover, GermanyDepartment of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, GermanyDepartment of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, GermanyInstitute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), GermanyInstitute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, GermanyBackgroundWith the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may negatively affect mental health by loneliness and social isolation, which constitute risk factors for depressiveness. We aimed to analyse the impact of perceived restriction due to government measures on depressive symptoms and investigated stress as mediator in an at-risk-population in Germany.MethodsData were collected in April 2020 from the population of the AgeWell.de-study, including individuals with a Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score ≥9, using the depression subscale of the Brief Symptom Inventory (BSI-18) and the Perceived Stress Scale (PSS-4). Feeling restricted due to COVID-19 government measures was surveyed with a standardized questionnaire. Stepwise multivariate regressions using zero-inflated negative binomial models were applied to analyse depressive symptoms, followed by a general structural equation model to assess stress as mediator. Analysis were controlled for sociodemographic factors as well as social support.ResultsWe analysed data from 810 older adults (mean age = 69.9, SD = 5). Feeling restricted due to COVID-19 government measures was linked to increased depressiveness (b = 0.19; p < 0.001). The association was no longer significant when adding stress and covariates (b = 0.04; p = 0.43), while stress was linked to increased depressive symptoms (b = 0.22; p < 0.001). A final model confirms the assumption that the feeling of restriction is mediated by stress (total effect: b = 0.26; p < 0.001).ConclusionWe found evidence that feeling restricted due to COVID-19 government measures is associated with higher levels of depressive symptoms in older adults at increased risk for dementia. The association is mediated by perceived stress. Furthermore, social support was significantly associated with less depressive symptoms. Thus, it is of high relevance to consider possible adverse effects of government measures related to COVID-19 on mental health of older people.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1141433/fullCOVID-19government measuresdepressionstressolder peoplesocial support |
| spellingShingle | Felix G. Wittmann Andrea Zülke Alexander Pabst Melanie Luppa Jochen René Thyrian Jochen René Thyrian Jochen René Thyrian Anika Kästner Wolfgang Hoffmann Wolfgang Hoffmann Hanna Kaduszkiewicz Juliane Döhring Catharina Escales Jochen Gensichen Isabel Zöllinger Robert Philipp Kosilek Birgitt Wiese Anke Oey Hans-Helmut König Christian Brettschneider Thomas Frese Steffi G. Riedel-Heller COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany Frontiers in Public Health COVID-19 government measures depression stress older people social support |
| title | COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany |
| title_full | COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany |
| title_fullStr | COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany |
| title_full_unstemmed | COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany |
| title_short | COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany |
| title_sort | covid 19 government measures and their impact on mental health a cross sectional study of older primary care patients in germany |
| topic | COVID-19 government measures depression stress older people social support |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1141433/full |
| work_keys_str_mv | AT felixgwittmann covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT andreazulke covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT alexanderpabst covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT melanieluppa covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT jochenrenethyrian covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT jochenrenethyrian covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT jochenrenethyrian covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT anikakastner covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT wolfganghoffmann covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT wolfganghoffmann covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT hannakaduszkiewicz covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT julianedohring covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT catharinaescales covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT jochengensichen covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT isabelzollinger covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT robertphilippkosilek covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT birgittwiese covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT ankeoey covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT hanshelmutkonig covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT christianbrettschneider covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT thomasfrese covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany AT steffigriedelheller covid19governmentmeasuresandtheirimpactonmentalhealthacrosssectionalstudyofolderprimarycarepatientsingermany |