Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, Pisa, Italy.
PLoS One. 2021 Mar 10;16(3):e0248370. doi: 10.1371/journal.pone.0248370. eCollection 2021.
Measures implemented in many countries to contain the COVID-19 pandemic resulted in a change in lifestyle with unpredictable consequences on physical and mental health. We aimed at identifying the variables associated with psychological distress during the lockdown between April and May 2020 in the Italian academic population. We conducted a multicenter cross-sectional online survey (IO CONTO 2020) within five Italian universities. Among about 240,000 individuals invited to participate through institutional communications, 18 120 filled the questionnaire. Psychological distress was measured by the self-administered Hospital Anxiety and Depression Scale (HADS). The covariates collected included demographic and lifestyle characteristics, trust in government, doctors and scientists. Associations of covariates with influenza-like symptoms or positive COVID-19 test and with psychological distress were assessed by multiple regression models at the local level; a meta-analysis of the results was then performed. Severe levels of anxiety or depression were reported by 20% of the sample and were associated with being a student or having a lower income, irrespective of their health condition and worries about contracting the virus. The probability of being severely anxious or depressed also depended on physical activity: compared to those never exercising, the highest OR being for those who stopped during lockdown (1.53; 95% CI, 1.28 to 1.84) and the lowest for those who continued (0.78; 95% CI, 0.64 to 0.95). Up to 21% of severe cases of anxiety or depression might have been avoided if during lockdown participants had continued to exercise as before. Socioeconomic insecurity contributes to increase mental problems related to the COVID-19 pandemic and to the measures to contain it. Maintaining or introducing an adequate level of physical activity is likely to mitigate such detrimental effects. Promoting safe practice of physical activity should remain a public health priority to reduce health risks during the pandemic.
许多国家为控制 COVID-19 大流行而采取的措施改变了人们的生活方式，对身心健康产生了不可预测的影响。我们旨在确定 2020 年 4 月至 5 月意大利学术人群在封锁期间与心理困扰相关的变量。我们在意大利的五所大学内开展了一项多中心横断面在线调查（IO CONTO 2020）。通过机构通讯邀请约 24 万人参与，其中 18120 人填写了问卷。心理困扰通过自我管理的医院焦虑和抑郁量表（HADS）进行衡量。收集的协变量包括人口统计学和生活方式特征、对政府、医生和科学家的信任。在局部水平上，通过多元回归模型评估协变量与流感样症状或 COVID-19 检测阳性以及与心理困扰的关联；然后对结果进行荟萃分析。该样本中有 20%的人报告有严重的焦虑或抑郁症状，且与学生或收入较低有关，而与他们的健康状况和对感染病毒的担忧无关。身体活动也会影响出现严重焦虑或抑郁的概率：与从不锻炼的人相比，在封锁期间停止锻炼的人出现严重焦虑或抑郁的最高比值比（OR）为 1.53（95%CI，1.28 至 1.84），而继续锻炼的人则为最低比值比（0.78；95%CI，0.64 至 0.95）。如果在封锁期间参与者继续像以前一样锻炼，那么可能会避免多达 21%的严重焦虑或抑郁病例。社会经济不安全会增加与 COVID-19 大流行和遏制措施相关的心理问题。保持或引入适当的身体活动水平可能会减轻这种不利影响。促进安全的身体活动实践应仍然是公共卫生的重点，以降低大流行期间的健康风险。
