BACKGROUND: Although several studies have documented the impact of the COVID-19 pandemic on mental health, the long-term effects remain unclear. AIMS: To examine longitudinal changes in mental health before and during the consecutive COVID-19 waves in a well-established probability sample. METHOD: An online survey was completed by the participants of the COVID-19 add-on study at four time points: pre-COVID-19 period (2014-2015, n = 1823), first COVID-19 wave (April to May 2020, n = 788), second COVID-19 wave (August to October 2020, n = 532) and third COVID-19 wave (March to April 2021, n = 383). Data were collected via a set of validated instruments, and analysed with latent growth models. RESULTS: During the pandemic, we observed a significant increase in stress levels (standardised β = 0.473, P < 0.001) and depressive symptoms (standardised β = 1.284, P < 0.001). The rate of increase in depressive symptoms (std. covariance = 0.784, P = 0.014), but not in stress levels (std. covariance = 0.057, P = 0.743), was associated with the pre-pandemic mental health status of the participants. Further analysis showed that secondary stressors played a predominant role in the increase in mental health difficulties. The main secondary stressors were loneliness, negative emotionality associated with the perception of COVID-19 disease, lack of resilience, female gender and younger age. CONCLUSIONS: The surge in stress levels and depressive symptoms persisted across all three consecutive COVID-19 waves. This persistence is attributable to the effects of secondary stressors, and particularly to the status of mental health before the COVID-19 pandemic. Our findings reveal mechanisms underlying the surge in mental health difficulties during the COVID-19 waves, with direct implications for strategies promoting mental health during pandemics.

• Klíčová slova
• COVID-19, depressive symptoms, longitudinal, stress levels, stressors,
• Publikační typ
• časopisecké články MeSH

The unpredictable spread of the COVID-19 pandemic, national lockdowns, and public health measures implemented in the Czech Republic had a negative effect on older adults' mental health and loneliness. The 2,631 older adults in 2020 and 2,083 older adults in 2021 used in this study formed a nationally representative sample of the Survey of Health, Ageing and Retirement in Europe (SHARE). Almost every third older adult experienced feelings of loneliness in both stages of the COVID-19 outbreak. Loneliness increased in 2021 in those individuals who reported their physical health as poor, who felt nervous, sad or depressed, and who had ever left their home since the outbreak. According to age-related drivers of loneliness, feelings of loneliness were prevalent (40% vs. 45%) among younger retirees in both waves. In both data sets, declared feelings of sadness or depression were the strongest sustainable predictor of loneliness (2020 and 2021 models, OR = 3.69; 95% CI [2.90, 4.69] and OR = 2.55; [1.97, 3.30]). Being a woman and feeling nervous equated with a higher likelihood of feeling lonely compared to counterparts. Policy makers should therefore aim to carefully improve psychosocial and health-related consequences faced by this vulnerable population during the pandemic and beyond.

• Klíčová slova
• COVID-19, SHARE study, loneliness, mental health,
• Publikační typ
• časopisecké články MeSH

The COVID-19 outbreak has raised questions about how vulnerable groups experience the pandemic. Research that focuses on the view of individuals with pre-existing mental health conditions is still limited, and so are cross-country comparative surveys. We gathered our sample of qualitative data during the first lockdown after governmental measures against the spread of the SARS-CoV-2 virus came into force in Austria, Czechia, Germany, and Slovakia. A total of n = 1690 psychotherapists from four middle European countries answered the question of how the COVID-19 pandemic was addressed in sessions by their patients during the early stage of unprecedented public health conditions. We employed a descriptive qualitative methodology to determine themes following levels of the social-ecological model (SEM) regarding how the COVID-19 pandemic affected patients. At the public policy level, stressful environmental conditions concerned the governmental mitigation efforts. At the level of community/society, reported key themes were employment, restricted access to educational and health facilities, socioeconomic consequences, and the pandemic itself. Key themes at the interpersonal level regarded forced proximity, the possibility of infection of loved ones, childcare, and homeschooling. Key themes at the individual level were the possibility of contracting COVID-19, having to stay at home/isolation, and a changing environment. Within the SEM framework, adaptive and maladaptive responses to these stressors were reported, with more similarities than differences between the countries. A quantification of word stems showed that the maladaptive reactions predominated.

• Klíčová slova
• COVID-19, adaptive responses, maladaptive responses, mental health, pandemic, psychotherapy, social environment, stressors,
• MeSH
• COVID-19 * epidemiologie   MeSH
• kontrola infekčních nemocí MeSH
• lidé MeSH
• pandemie MeSH
• psychoterapeuti MeSH
• SARS-CoV-2 MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

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.

• Klíčová slova
• COVID-19, depressive symptoms, feeling of loneliness, risk factors, stress levels,
• Publikační typ
• časopisecké články MeSH