UFR SHS, laboratoire CRFDP, Université Rouen Normandie, Bâtiment Freinet, Place Emile Blondel, 76821 Mont-Saint-Aignan Cedex, France.
CRIRAVS HP-HM, Hôpital Sainte-Marguerite, 270, bd Sainte-Marguerite, 13274 Marseille cedex 09, France; Association Interdisciplinaire post-Universitaire de Sexologie (AIUS), 21, place Alexandre Labadie, 13001 Marseille, France.
Encephale. 2022 Apr;48(2):118-124. doi: 10.1016/j.encep.2021.03.002. Epub 2021 Apr 1.
The aim of this article was to study the impact of the COVID19 lockdown on anxiety and depressive symptoms on the basis of responses to an online survey from 1753 French-speaking subjects, conducted between April 27 and May 11, 2020.
Using a biopsychosocial model, the effects of socio-demographic characteristics (age, gender at birth, socio-professional category, sexual orientation), lockdown conditions (material factors: urban density of the place of residence, surface area of the place of residence during lockdown), social characteristics: living with a partner during lockdown, presence of children during lockdown) and psychosocial history (attachment styles) on anxiety - evaluated on the GAD7 - and depression - evaluated on the MDI - were investigated. Ordinal regression analyses were conducted.
The rates of depression observed (moderate or severe depression: 22.5%) and anxiety (moderate or severe anxiety: 18.4%) were higher than usual but lower than what has been documented in other studies on the effects of lockdown. Women appeared to be more vulnerable than men (Anxiety: AOR=1.647, CI 95%=1.647-2.530; Depression: AOR=1.622, CI 95%=1.274-2.072). Bisexual individuals had an increased likelihood of anxiety symptoms (AOR=1.962, CI 95%=1.544-2.490) and depression (AOR=1.799, CI 95%=1.394-2.317). For homosexuals, only links with depression were observed (AOR=1.757, CI 95%=1.039-2.906). People in a situation of economic vulnerability were more prone to anxiety disorders (e.g. people with no working activity: AOR=1.791, CI 95%=1.147-2.790) or depression (e.g. people with no working activity: AOR=2.581, CI 95%=1.633-4.057). Links with attachment styles were also found. Fearful subjects were particularly vulnerable (anxiety: AOR=2.514, CI 95%=1.985-3.190; depression: AOR=2.521, CI 95%=1.938-3.289), followed by subjects with an anxious attachment style (anxiety: AOR=1.949, CI 95%=1.498-2.540; depression: AOR=1.623, CI 95%=1.207-2.181). The impact of lockdown on avoidant subjects only concerned depression (AOR=1.417, CI 95%=1.034-1.937). Being with a partner during lockdown appeared to have a protective effect against depression (AOR=.693, CI 95%=.555-.866). Neither the presence of children, the surface area of the lockdown residence, nor the population density of the place of residence was associated with anxiety or depression.
The impact of lockdown on mental health depends on a range of dimensions that need to be apprehended in order to tailor post-lockdown psychological and social support. Management based on a biopsychosocial approach should be favored.
本研究旨在通过对 2020 年 4 月 27 日至 5 月 11 日期间进行的一项针对 1753 名讲法语的对象的在线调查，基于对焦虑和抑郁症状的反应，研究 COVID19 封锁对其的影响。
使用生物心理社会模型，研究了社会人口统计学特征（年龄、出生时的性别、社会职业类别、性取向）、封锁条件（物质因素：居住地的城市密度、封锁期间的居住地面积）、社会特征（封锁期间与伴侣同住、封锁期间有孩子）和心理社会史（依恋风格）对焦虑（用 GAD7 评估）和抑郁（用 MDI 评估）的影响。进行了有序回归分析。
观察到的抑郁率（中度或重度抑郁：22.5%）和焦虑率（中度或重度焦虑：18.4%）高于平常，但低于其他研究中记录的封锁对心理健康的影响。女性比男性更容易受到影响（焦虑：AOR=1.647，95%CI=1.647-2.530；抑郁：AOR=1.622，95%CI=1.274-2.072）。双性恋个体出现焦虑症状的可能性增加（AOR=1.962，95%CI=1.544-2.490）和抑郁（AOR=1.799，95%CI=1.394-2.317）。对于同性恋者，只观察到与抑郁的关联（AOR=1.757，95%CI=1.039-2.906）。经济脆弱的人更容易出现焦虑障碍（例如无工作活动的人：AOR=1.791，95%CI=1.147-2.790）或抑郁（例如无工作活动的人：AOR=2.581，95%CI=1.633-4.057）。还发现了与依恋风格的关联。恐惧的人特别脆弱（焦虑：AOR=2.514，95%CI=1.985-3.190；抑郁：AOR=2.521，95%CI=1.938-3.289），其次是焦虑依恋风格的人（焦虑：AOR=1.949，95%CI=1.498-2.540；抑郁：AOR=1.623，95%CI=1.207-2.181）。封锁对回避者的影响仅涉及抑郁（AOR=1.417，95%CI=1.034-1.937）。在封锁期间与伴侣同住似乎对抑郁有保护作用（AOR=.693，95%CI=.555-.866）。儿童的存在、封锁期间的居住面积或居住地的人口密度都与焦虑或抑郁无关。
封锁对心理健康的影响取决于一系列需要综合考虑的维度，以便为封锁后的心理和社会支持提供个性化服务。应该优先考虑基于生物心理社会方法的管理。
