Demographics Associated With Stress, Severe Mental Distress, and Anxiety Symptoms During the COVID-19 Pandemic in Japan: Nationwide Online Survey

Midorikawa, Haruhiko; Tachikawa, Hirokazu; Taguchi, Takaya; Shiratori, Yuki; Takahashi, Asumi; Takahashi, Sho; Nemoto, Kiyotaka; Arai, Tetsuaki

BACKGROUND: With the spread of the coronavirus disease (COVID-19), the deterioration of public mental health has become a major global and social problem. OBJECTIVE: The purpose of this study was to elucidate the relationship between the three mental health problems associated with COVID-19-perceived stress, severe mental distress, and anxiety symptoms-and various demographic factors including occupation. METHODS: A nationwide online questionnaire survey was conducted in Japan from August 4 to 31, 2020. In addition to sociodemographic data, the degree of perceived stress, severe mental distress, and anxiety symptoms associated with COVID-19 were measured. After performing a descriptive statistical analysis, factors related to stress, severe mental distress, and anxiety symptoms were analyzed using logistic regression analysis. RESULTS: A total of 6,547 respondents submitted complete survey responses, among whom 34.9% felt intense stress associated with COVID-19, 17.1% were depressed, and 13.5% had severe anxiety symptoms. The logistic regression analysis showed that, each of the three mental health problems were prevalent in females; non-binary gender; people in their 50s, and 60s and above; respondents who have visited psychiatrists; and those currently in psychiatric care. Severe mental distress and anxiety symptoms were associated with the number of effective lifestyle coping strategies during the lockdown period. Only severe mental distress was prevalent in teenagers and respondents in their 20s, and students tended to suffer from stress and severe mental distress. As for occupation, working in nursing care and welfare, education and research, and medical and health sectors was associated with stress; however, working in these occupations was not associated with severe mental distress and anxiety symptoms. Unemployment was associated with severe mental distress and anxiety symptoms. All three mental health problems were prevalent in part-time workers and those working in entertainment and arts. CONCLUSIONS: Gender, age, occupation, history of psychiatric visits, and stress coping mechanisms were associated with mental health during the COVID-19 pandemic, but their associations with stress, severe mental distress, and anxiety symptoms differed. In addition, the actual state of mental health varied according to the respondents' occupation. It is necessary to consider the impact of the COVID-19 pandemic on mental health, not only at the individual level but also at the occupational level.