Could the Associations of Changes in Living Arrangement with Mental Disorders Be Moderated or Mediated During COVID-19 Pandemic?

Guan, Ming

PURPOSE: Changes in living arrangement was one of the most well-established risk factors for mental disorders, but little evidence came from moderating or mediating effect during COVID-19 pandemic. This study aimed to determine whether associations of changes in living arrangement with mental disorders could be moderated or mediated during COVID-19 pandemic. METHODS: Data were a cross-sectional and international population-based survey data collected as part of theCOVID-19 pandemic. Participants included nationally representative general population probability samples of adults (≥18 years) during COVID-19 pandemic (N=16,784). Main mental measures were reflected by loneliness assessed by UCLA Loneliness Scale Version 3, anxiety assessed by Generalised Anxiety Disorder 2-item, and depressed mood assessed by The Patient Health Questionnaire-2 in the survey. With control variables, all the mediation models were conducted by Stata mode. Potential influencing effects of social contact and social support as moderators were analyzed using Hayes’s PROCESS macro. RESULTS: Among the participants, prevalence of mental disorders was high. Logistic regression indicated that changes in living arrangement had significant associations with anxiety (AOR=1.127, 95% CI: 1.018–1.249) and depression (AOR =1.142, 95% CI: 1.027–1.269). Mediation models indicated that indirect, direct, and total effects of changes in living arrangement on mental disorders through COVID-symptoms; change in alcohol use; and social contact were significant. Indirect, direct, and total effects of changes in living arrangement on loneliness and depression through social support were significant. Moderation analysis indicated that moderation model 1 in AF Hayes Process procedure was accepted. CONCLUSION: This study indicated that associations of changes in living arrangement with mental disorders could be mediated by COVID-symptoms, changes in alcohol use, social contact, and social support and moderated by social support during COVID-19 pandemic. The finding in this study might provide better understanding of the mechanisms by which social support might contribute to the resolving mental disorders.