The Psychological Impact of ‘Mild Lockdown’ in Japan during the COVID-19 Pandemic: A Nationwide Survey under a Declared State of Emergency

  1. Tetsuya Yamamoto
  2. Chigusa Uchiumi
  3. Naho Suzuki
  4. Junichiro Yoshimoto
  5. Eric Murillo-Rodriguez

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Abstract

This study examined the psychological distress caused by non-coercive lockdown (mild lockdown) in Japan. An online survey was conducted with 11,333 people (52.4% females; mean age = 46.3 ± 14.6 years, range = 18–89 years) during the mild lockdown in the seven prefectures most affected by COVID-19 infection. Over one-third (36.6%) of participants experienced mild-to-moderate psychological distress (Kessler Psychological Distress Scale [K6] score 5–12), while 11.5% reported serious psychological distress (K6 score ≥ 13). The estimated prevalence of depression (Patient Health Questionnaire-9 score ≥ 10) was 17.9%. Regarding the distribution of K6 scores, the proportion of those with psychological distress in this study was significantly higher when compared with the previous national survey data from 2010, 2013, 2016, and 2019. Healthcare workers, those with a history of treatment for mental illness, and younger participants (aged 18–19 or 20–39 years) showed particularly high levels of psychological distress. Psychological distress severity was influenced by specific interactional structures of risk factors: high loneliness, poor interpersonal relationships, COVID-19-related sleeplessness and anxiety, deterioration of household economy, and work and academic difficulties. Even when non-coercive lockdowns are implemented, people’s mental health should be considered, and policies to prevent mental health deterioration are needed. Cross-disciplinary public–private sector efforts tailored to each individual’s problem structure are important to address the mental health issues arising from lockdown.

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    SciScore for 10.1101/2020.07.17.20156125: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: All participants voluntarily responded to the anonymous survey and provided informed consent online.
    IRB: This study was approved by the Research Ethics Committee at the Graduate School of Social and Industrial Science and Technology, Tokushima University (no.212) and was performed according to the ethical standards of the 1964 Declaration of Helsinki and its amendments.
    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:
    This study had some limitations. Given that we employed a cross-sectional design, it is difficult to examine the long-term impact of mild lockdown and the causal effect of risk and preventive factors. Longer-term follow-up is needed to clarify the evolution of prevalence and causal relationships, such as what variables mitigate or exacerbate the effects of mild lockdown. Additionally, while the results indicate demographic characteristics that may be risk factors for psychological distress, the analysis remains at an exploratory level, because this study provides a preliminary report of the effects of mild lockdown. Considering that different psychological burdens among healthcare workers depend on their job duties 54, further elaboration with specific groups is needed. Considering the stressful situations and problems specific to each group would allow the proposal of strategies optimised for each group to effectively alleviate psychological distress. Moreover, because we obtained data only from an online survey, the psychological distress of those without online access remains unexamined. Therefore, it is necessary to combine other methods besides online research to improve the generalisability of the results. Finally, it is difficult to make a simple comparison of the magnitude of the impact of lockdown with coercion and mild lockdown. To make a detailed comparison, consideration of various differences between studies, such as the human suffering caused by COVID-19, the ti...

    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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  2. Version published to 10.3390/ijerph17249382
  3. Version published to 10.1101/2020.07.17.20156125v2 on medRxiv
  4. Version published to 10.1101/2020.07.17.20156125v1 on medRxiv