Effects of Covid-19 lockdown on mental health and sleep disturbances, results from an Italian survey

Voglino, G; Gualano, M R; Lo Moro, G; Bert, F; Siliquini, R

BACKGROUND: The Covid-19 pandemic is affecting different aspects of our society and brand-new conditions are expected after the lockdown. Italy was the first European country that entered a nationwide lockdown during the COVID-19 pandemic. Since quarantine can impact on mental health, this study aimed to estimate the prevalence of depressive symptoms, anxiety symptoms and sleeping disturbances in the Italian population during lockdown. The factors that might influence such outcomes were explored. METHODS: The COvid COllateral ImpactS (COCOS) project was a national cross-sectional survey performed during the last 14 days of the Italian lockdown. Questionnaires were online and included items on socio-demographics, behaviours, and healthcare access. Depression was assessed through the Patient Health Questionnaire-2, anxiety through the Generalized Anxiety Disorder-2. Participants referring sleep disturbances completed the Insomnia Severity Index. Descriptive analyses, univariable and multivariable logistic regressions were performed (p-value<0.05 significant). RESULTS: The sample size was 1515. Females were 65.6%, and the median age was 42 years (IQR=23). Depression and anxiety symptoms prevalence were 24.7% and 23.2%. The 42.2% had sleep disturbances and, among them, 17.4% reported moderate/severe insomnia. Being female, increased time spent on internet, and avoidance of activities for peer pressure increased the likelihood of at least one of mental health outcomes. Increasing age, not experiencing work-related troubles, being married/cohabitant reduced such probability. Females and participants with chronic conditions resulted positively associated with sleep disturbances. CONCLUSIONS: The results showed a high prevalence of mental health issues. Since the impact might be long-lasting, it is crucial to study effective interventions, specifically planning strategies for more vulnerable groups, e.g. youths, and considering the role of internet. KEY MESSAGES: A high prevalence of mental issues and sleep disturbances was recorded during the last week of the lockdown. Age, gender, marital status and the time spent on internet affected mental health while gender and presence of chronic conditions were predictors of sleep disturbances.