Restrictive measures and course of behavioral outcomes in representative adult Greek population during the COVID-19 pandemic: Results on functioning, coping, alcohol/substance abuse, smoking, gambling, pro-social activities and domestic violence from the largest multi-wave COVID-19 online national survey in Greece (COH-FIT).

BACKGROUND

Greece encountered unique COVID-19-pandemic-related challenges, shaped by the country's previous deleterious economic context, an already strained healthcare system and possibly one of Europe's earliest, longest and most stringent restrictive protocols.

OBJECTIVES

To offer comprehensive insights into the longitudinal trajectory of a broad range of behavioral and coping parameters within general adult Greek population across the first two pandemic waves.

METHODS

Multiple-wave, cross-sectional data from the "Collaborative Outcomes study on Health and Functioning during Infection Times" (COH-FIT) assessed four different time points in order to examine outcomes changes from retrospective, pre-pandemic baseline ratings (T0) to three distinct intra-pandemic time points (lockdown 1: T1, between lockdowns: T2, lockdown 2: T3). Outcomes included functioning, subjective resilience, tobacco/alcohol/cannabis/substance consumption, gambling, domestic violence, time spent in different activities, importance of coping strategies and prosocial activity.

RESULTS

We overall evaluated 10,377 participant responses, including 2737 representative-matched participants across T1-T3 (T1: 3940/887, T2: 4675/997, T3: 1668/853 convenience/representative-matched participants). All subjects provided retrospective rating on T0. Results suggest a highly significant pre-to intra-pandemic (T0 vs. T1-T3) drop in functioning and resilience scores. Tobacco, alcohol and cannabis consumption increased from pre-to intra-pandemic each at different pandemic phases. Gambling scores were overall very low and decreased from pre-to all intra-pandemic time-points. Domestic violence showed only an early transient increase (T1), returning to pre-pandemic levels. Individuals spent significantly more hours in social media, internet, gaming, TV, reading, music intra-than pre-pandemic, with the exception of exercise. Highest-rated coping strategies were exercise/walking, internet use, meaningful hobby, social media use and studying/learning. Most results showed notable changes across the assessed intra-pandemic time frames (T1, T2, and T3) normally with lockdowns negatively affecting behavioral and coping strategies (e.g., lower functioning/resilience scores in lockdown T1 and T3 than in T2), suggesting a substantial effect of quarantine lockdown status on many behavioral parameters.

CONCLUSIONS

This is the most extensive multi-wave report on behavioral responses and coping mechanisms across pandemic restriction phases in Greece and can inform national policy towards the enhancement of healthy coping and resilience in similar future conditions.