Psychological distress during the COVID-19 pandemic in France: a national assessment of at-risk populations

  1. Benjamin Chaix
  2. Guillaume Delamon
  3. Arthur Guillemassé
  4. Benoît Brouard
  5. Jean-Emmanuel Bibault

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Abstract

Lockdowns were implemented to limit the spread of COVID-19. Peritraumatic distress (PD) and post-traumatic stress disorder have been reported after traumatic events, but the specific effect of the pandemic is not well known.

Aim

The aim of this study was to assess PD in France, a country where COVID-19 had such a dramatic impact that it required a country-wide lockdown.

Methods

We recruited patients in four groups of chatbot users followed for breast cancer, asthma, depression and migraine. We used the Psychological Distress Inventory (PDI), a validated scale to measure PD during traumatic events, and correlated PD risk with patients’ characteristics in order to better identify the ones who were the most at risk.

Results

The study included 1771 participants. 91.25% (n=1616) were female with a mean age of 32.8 (13.71) years and 7.96% (n=141) were male with a mean age of 28.0 (8.14) years. In total, 38.06% (n=674) of the respondents had psychological distress (PDI ≥14). An analysis of variance showed that unemployment and depression were significantly associated with a higher PDI score. Patients using their smartphones or computers for more than 1 hour a day also had a higher PDI score (p=0.026).

Conclusion

Prevalence of PD in at-risk patients is high. These patients are also at an increased risk of developing post-traumatic stress disorder. Specific steps should be implemented to monitor and prevent PD through dedicated mental health policies if we want to limit the public health impact of COVID-19 in time.

Trial registration number

NCT04337047 .

Article activity feed

  1. Version published to 10.1136/gpsych-2020-100349
  2. ScreenIT

    SciScore for 10.1101/2020.05.10.20093161: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was registered in the ClinicalTrials.gov database (NCT04337047) and was approved by our internal review board.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are limitations that should be considered when interpreting our results: first, a majority of participants were women (91.25%). This is due in part to the fact that one of the 4 groups explored consisted in breast cancer patients, but it could also show that men are less likely to participate in this kind of online self-reported survey. This fact could potentially bias the results and specifically the value of the features we found to be associated with a PDI over 14 (predictive of PTSD). Another limitation is due to the sampling technique itself, relying on groups of patients already using the chatbots, excluding patients not using them. This study still holds interesting results because of the large cohort of respondents, the adequate geographical spread across France and the sampling time frame that corresponds to the pandemic peak in France. Other studies have been conducted to measure the impact of COVID-19 among the general population. In Italy, Rossi et al conducted a web-based survey on 18,147. They found high rates of negative mental health outcomes three weeks into the COVID-19 lockdown: 37% of the participants declared they had symptoms of PTSD, 17.3% of depression and 20.8% of anxiety. Like in our study, the majority of respondents were women (79.6%). Overall, policy makers are rightfully concerned by the potential negative effects on public health of COVID-19, beyond the pandemics itself. In the UK, psychological first aid guidance has been issued by Mental...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT03556813CompletedArtificial Intelligence vs Physicians for Breast Cancer Pati…
    NCT04337047CompletedDistress in Crisis Situations During COVID-19

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.05.10.20093161v2 on medRxiv
  4. Version published to 10.1101/2020.05.10.20093161v1 on medRxiv