Hecker Irwin, Wallez Solène, Scarlett Honor, Ayuso-Mateos José Luis, Bryant Richard, Caggiu Giulia, Conflitti Claudia, Gémes Katalin, Haro Josep Maria, Lorant Vincent, Mediavilla Roberto, Mittendorfer-Rutz Ellenor, Monistrol-Mula Anna, Compagnoni Matteo Monzio, Petri-Romão Papoula, Pinucci Irene, Sijbrandij Marit, Stoffers-Winterling Jutta, Walter Henrik, Mary-Krause Murielle, Melchior Maria
Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, Paris, France.
Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
PLoS One. 2025 Jul 31;20(7):e0317272. doi: 10.1371/journal.pone.0317272. eCollection 2025.
This study aims to understand the relationship between the experience of psychological distress and compliance with COVID-19 sanitary measures. We testeed whether this relationship was modified by individuals' gender and socioeconomic status (i.e., educational level and employment).
Data from four European cohort studies (n = 13,635), were analysed using an Individual Participant Data (IPD) meta-analytic approach. Mixed effect models were employed to examine associations between mental health difficulties and compliance with sanitary measures, as well as effect modification by socioeconomic status. Statistical models were stratified by gender.
We found a statistically significant association between mental health difficulties and increased compliance with sanitary measures in women, while amongst men the statistically significant association observed was opposite. Moreover, there was a statistically significant interaction between participants' educational level and mental health difficulties amongst men only, indicating especially low compliance levels with COVID-19 sanitary measures amongst individuals with only primary schooling and who reported psychological distress.
The association between psychological distress and compliance with sanitary measures is complex-positive in women, negative in men. Men experiencing mental health difficulties, especially those with lower educational attainment, exhibit low levels of compliance with sanitary measures. These results suggest that psychological distress and its possible consequences should be considered when designing measures addressing infectious disease spread.
本研究旨在了解心理困扰经历与对新冠疫情防控措施的依从性之间的关系。我们检验了这种关系是否会因个体的性别和社会经济地位（即教育水平和就业情况）而有所改变。
使用个体参与者数据（IPD）荟萃分析方法，对来自四项欧洲队列研究（n = 13,635）的数据进行了分析。采用混合效应模型来检验心理健康问题与对防控措施的依从性之间的关联，以及社会经济地位对这种关联的影响。统计模型按性别分层。
我们发现，心理健康问题与女性对防控措施依从性的增加之间存在统计学上的显著关联，而在男性中观察到的统计学显著关联则相反。此外，仅在男性参与者的教育水平和心理健康问题之间存在统计学上的显著交互作用，这表明仅接受过小学教育且报告有心理困扰的个体对新冠疫情防控措施的依从性特别低。
心理困扰与对防控措施的依从性之间的关联很复杂——在女性中呈正相关，在男性中呈负相关。有心理健康问题的男性，尤其是那些教育程度较低的男性，对防控措施的依从性较低。这些结果表明，在设计应对传染病传播的措施时，应考虑心理困扰及其可能产生的后果。
