Drastic Reductions in Mental Well-Being Observed Globally During the COVID-19 Pandemic: Results From the ASAP Survey

Most countries affected by the COVID-19 pandemic have repeatedly restricted public life to control the contagion However, the health impact of confinement measures is hitherto unclear We performed a multinational survey investigating changes in mental and physical well-being (MWB/PWB) during the first wave of the pandemic A total of 14,975 individuals from 14 countries provided valid responses Compared to pre-restrictions, MWB, as measured by the WHO-5 questionnaire, decreased considerably during restrictions (68 1 +/- 16 9 to 51 9 +/- 21 0 points) Whereas 14 2% of the participants met the cutoff for depression screening pre-restrictions, this share tripled to 45 2% during restrictions Factors associated with clinically relevant decreases in MWB were female sex (odds ratio/OR = 1 20, 95% CI: 1 11-1 29), high physical activity levels pre-restrictions (OR = 1 29, 95% CI 1 16-1 42), decreased vigorous physical activity during restrictions (OR = 1 14, 95% CI: 1 05-1 23), and working (partially) outside the home vs working remotely (OR = 1 29, 95% CI: 1 16-1 44/OR = 1 35, 95% CI: 1 23-1 47) Reductions, although smaller, were also seen for PWB Scores in the SF-36 bodily pain subscale decreased from 85 8 +/- 18 7% pre-restrictions to 81 3 +/- 21 9% during restrictions Clinically relevant decrements of PWB were associated with female sex (OR = 1 62, 95% CI: 1 50-1 75), high levels of public life restrictions (OR = 1 26, 95% CI: 1 18-1 36), and young age (OR = 1 10, 95% CI: 1 03-1 19) Study findings suggest lockdowns instituted during the COVID-19 pandemic may have had substantial adverse public health effects The development of interventions mitigating losses in MWB and PWB is, thus, paramount when preparing for forthcoming waves of COVID-19 or future public life restrictions