Understanding Mental Health in Crisis: Key Determinants of Psychological Distress in Belgium during the first weeks of COVID-19 Lockdown

Aims: The COVID-19 pandemic has significantly impacted global mental health. At the onset of the pandemic (2020), Belgians experienced increased anxiety, depression, and psychological distress compared to 2018 due to the outbreak and the associated public health measures. Understanding the drivers of this distress is crucial for mitigating mental health effects in future crises. This study examines determinants of psychological distress in Belgium during the March 2020 lockdown, using data from the Great Corona Study (GCS). Methods: Data were drawn from the second wave of the GCS, a citizen science initiative conducted in Belgium on March 24, 2020, with 332,169 respondents. Psychological distress was measured using the General Health Questionnaire-12 (GHQ-12), applying a 2/3 cutoff to classify distress levels. To identify predictor variables, a random forest algorithm and literature review reduced 207 initial variables to 16. A generalized linear model was then used to examine associations between predictors and psychological distress Results: Psychological distress was significantly associated with various demographic, social, occupational, and health-related factors. Younger individuals, women, and residents of Wallonia or Brussels exhibited higher odds of distress. Household composition, and the frequency of real-life social interactions significantly influenced distress levels. Occupational status played a key role, with part-time employees and working students exhibiting higher levels of distress. At the same time retired individuals with no current occupation showed lower odds. Perceived workplace safety and compliance with public health measures also significantly impacted distress levels. Lastly, individuals experiencing influenza-like or COVID-19 symptoms had substantially higher odds of psychological distress. Conclusions: Our findings highlight significant sociodemographic, occupational, and health-related predictors of psychological distress during the initial COVID-19 lockdown in Belgium. Young adults, women, individuals with limited in-person interactions, and those experiencing influenza-like illness or COVID-19 symptoms were particularly vulnerable. Additionally, perceptions of others' adherence to preventive measures played a crucial role in mental well-being. These results highlight the complex interplay between individual and environmental factors in shaping psychological distress, providing valuable insights for future public health policies and mental health interventions during crises.