Recent reports suggest that the COVID-19 lockdown resulted in changes in mental health, however, potential age-related changes and risk factors remain unknown. We measured COVID-19 lockdown-induced stress levels and the severity of depressive symptoms prior to and during the COVID-19 lockdown in different age groups and then searched for potential risk factors in a well-characterized general population-based sample. A total of 715 participants were tested for mental distress and related risk factors at two time-points, baseline testing prior to COVID-19 and follow-up testing during COVID-19, using a battery of validated psychological tests including the Perceived Stress Scale and the Patient Health Questionnaire. Longitudinal measurements revealed that the prevalence of moderate to high stress and the severity of depressive symptoms increased 1.4- and 5.5-fold, respectively, during the COVID-19 lockdown. This surge in mental distress was more severe in women, but was present in all age groups with the older age group exhibiting, cross-sectionally, the lowest levels of mental distress prior to and during the lockdown. Illness perception, personality characteristics such as a feeling of loneliness, and several lifestyle components were found to be associated with a significant increase in mental distress. The observed changes in mental health and the identified potential risk factors underlying these changes provide critical data justifying timely and public emergency-tailored preventive, diagnostic, and therapeutic mental health interventions, which should be integrated into future public health policies globally.

Department of Global Health and Population Harvard TH Chan School of Public Health Harvard University Boston MA United States

Department of Neurology Barrow Neurological Institute Phoenix AZ United States

Division of Neurology University Medical Centre Ljubljana Slovenia

Division of Preventive Cardiology Department of Cardiovascular Medicine Mayo Clinic Rochester MN United States

Kardiovize Study International Clinical Research Centre St Anne's University Hospital Brno Czechia

Translational Neuroscience and Aging Program Centre for Translational Medicine International Clinical Research Centre St Anne's University Hospital Brno Czechia

Translational Neuroscience and Aging Program Mayo Clinic Rochester MN United States

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