Psychological symptoms, mental fatigue and behavioural adherence after 72 continuous days of strict lockdown during the COVID-19 pandemic in Argentina
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Abstract
An early and prolonged lockdown was adopted in Argentina during the first wave of COVID-19. Early reports evidenced elevated psychological symptoms.
Aims
To explore if the prolonged lockdown was associated with elevated anxiety and depressive symptoms; if mental fatigue was associated with lockdown adherence (a phenomenon called ‘behavioural fatigue’); and if financial concerns were associated with lockdown adherence and emotional symptoms.
Method
The survey included standardised questionnaires to assess depressive (PHQ-9) and anxious (GAD-7) symptoms, mental fatigue, risk perception, lockdown adherence, financial concerns, daily stress, loneliness, intolerance to uncertainty, negative repetitive thinking and cognitive problems. LASSO regression analyses were carried out to predict depression, anxiety and lockdown adherence
Results
The survey reached 3617 adults (85.2% female) from all provinces of Argentina after 72 days of lockdown. Data were collected between 21 May 2020 and 4 June 2020. In that period, Argentina had an Oxford stringency index of 85/100. Of those surveyed, 45.6% and 27% met the cut-offs for depression and anxiety, respectively. Mental fatigue, cognitive failures and financial concerns were correlated with psychological symptoms, but not with adherence to lockdown. In regression models, mental fatigue, cognitive failures and loneliness were the most important variables to predict depression, intolerance to uncertainty and lockdown difficulty were the most important for anxiety, and perceived threat was the most important for predicting lockdown adherence.
Conclusions
During the extended lockdown, psychological symptoms increased, being enhanced by mental fatigue, cognitive difficulties and financial concerns. We found no evidence of behavioural fatigue. Thus, feeling mentally fatigued is not the same as being behaviourally fatigued.
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SciScore for 10.1101/2021.04.21.21255866: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: As social media platforms were part of the main delivery system, all participants mandatorily gave their informed consent asserting to know their privacy would be protected following the Declaration of Helsinki and national laws.
IRB: The study was approved by the Ethics Committee of Favaloro Foundation.Sex as a biological variable Gender was reduced to three main categories: female, male and other. Randomization not detected. Blinding not detected. Power Analysis not 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 …SciScore for 10.1101/2021.04.21.21255866: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: As social media platforms were part of the main delivery system, all participants mandatorily gave their informed consent asserting to know their privacy would be protected following the Declaration of Helsinki and national laws.
IRB: The study was approved by the Ethics Committee of Favaloro Foundation.Sex as a biological variable Gender was reduced to three main categories: female, male and other. Randomization not detected. Blinding not detected. Power Analysis not 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:The present study has several limitations. First, the survey was disseminated incidentally. Nevertheless, all the country’s provinces were sampled. Also, as the survey was disseminated through social media networks and e-mails, it is possible that a bias occurred towards participants with higher education and income levels. Second, as noted previously, self-report methods may overestimate the rate of psychiatric disorders in comparison with the more reliable gold standard of diagnostic interviews. A recent meta-analysis about the use of the PHQ-9 for the screening of major depressive episodes in primary care found that approximately half of patients with positive screens could be false positives (38). It is important to prudentially consider the present results and to avoid jumping into clinical conclusions. Complementary and more precise procedures should be adopted to confirm or reject any assumption of diagnosis. Third, our sample was unbalanced in gender, with females being overrepresented over other options. Female gender is associated with increased rates of anxiety and depression in epidemiological studies, so sampling bias may have inflated the figures of emotional symptoms of our study. Fourth, due to the observational nature of the study, it is not possible to disentangle the effects produced by the pandemic itself from the impact of the lockdown. Our analyses are not intended to estimate the causal effect between variables nor be an exhaustive analysis of the conte...
Results from TrialIdentifier: No clinical trial numbers were referenced.
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.
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