One-Year post lockdown Trajectories of Mental Health and Impact of COVID-19 Lockdown-Related Factors

Mathilde Mongeau ¹ Samantha Huo Yung Kai ^1,2 Vanina Bongard ^1,2,3 Nicola Coley ^1,4,5 Emilie Bérard ^1,2 Jean FERRIERES ^1,2,3*

• ¹ Service d'épidémiologie et de santé publique, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
• ² Artherosclerosis Risk and Treatment Evaluation towards Risk Reduction Epidemiology (ARTERRE) Axe, Centre for Epidemiology and Research in Population health (CERPOP), INSERM-University of Toulouse UPS, Toulouse, France
• ³ Department of Cardiology, Centre Hospitalier Universitaire de Toulouse, Toulouse, Occitanie, France
• ⁴ Aging Research Team, Centre for Epidemiology and Research in Population health (CERPOP), INSERM-University of Toulouse UPS, Toulouse, France
• ⁵ OPeRa, Institut Hospitalo-Universitaire (IHU), Lyon, France

Concerns about the impact of restrictive measures on people's wellbeing, especially mental health, were raised by the COVID-19 pandemic and related lockdown measures. In this study, we examined longitudinal trajectories of mental health during the initial French lockdown period and up to one-year post-lockdown, among a representative sample of French adults aged over 50. We also assessed the impact of COVID-19 lockdown-related factors on mental health. A cohort of 534 individuals was enrolled during the first French lockdown in March 2020, and four telephone interviews were conducted during the lockdown, and at 1-, 6-and 12-months post-lockdown. Mental health was assessed using validated scores of anxiety and depression (GAD-7 and PHQ-9, respectively). Participants undergoing treatment for anxiety or depression at inclusion were excluded. Our analysis revealed a significant decrease in the proportion of individuals experiencing poor mental health (elevated GAD-7 or PHQ-9>4) from lockdown period to 1 month and 6 months post-lockdown. However, this improvement stopped at 12 months post-lockdown, likely reflecting the reinstatement of strict measures in 2021. We used logistic regression to identify factors independently associated with early and long-lasting deterioration in mental health (elevated GAD-7 or PHQ-9>4 at first or second interview that persisted over at least two interviews). History of anxiety, poor perceived global health, female gender, working during lockdown, not being in a relationship, and having a relative suspected of being COVID-positive were significantly associated with deterioration in mental health.Our study highlights factors associated with a mental health impact during and following a lockdown in a representative sample of people, aged over 50 years old, thus at increased risk of severe COVID-19 and more likely to be subject to lockdown measures. These factors could be targeted in public health actions in future pandemics.