Choi Juhee, Son Gaeun, Kim Ye-Seul, Choi Kee-Hong, Kim Jungeun, Park Subin
School of Psychology, Korea University, Seoul, Republic of Korea.
KU Mind Health Institute, Korea University, Seoul, Republic of Korea.
PLoS One. 2025 Sep 10;20(9):e0330118. doi: 10.1371/journal.pone.0330118. eCollection 2025.
The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected physical and mental health. Since the onset of the pandemic, the prevalence of depression and anxiety has significantly increased. Quarantine and social distancing, implemented to control the spread of COVID-19, have exacerbated social isolation. This study aimed to longitudinally examine how the severity of depression and anxiety, along with COVID-19 diagnosis, influenced the trajectory of social isolation throughout the pandemic.
This longitudinal study collected data from South Korea in three waves: 2021, 2022, and 2023. The final sample included 2,395 participants (mean age = 46.32, SD = 16.47) who completed a face-to-face interview survey. Depressive symptoms were measured using the Patient Health Questionnaire-9, while anxiety was assessed using the Generalized Anxiety Disorder-7. Social isolation was evaluated using the Loneliness and Social Isolation Scale. The data were analyzed using multilevel modeling with a three-way interaction design.
A significant three-way interaction was found between time, depression severity, and COVID-19 diagnosis, while anxiety severity showed no significant interaction. Among the participants diagnosed with COVID-19, those with severe depressive symptoms exhibited an increase in social isolation over time. The positive effect of time was strengthened when the depression severity was severe, whereas it was weakened in participants with moderate or mild depressive symptoms. For participants without a COVID-19 diagnosis, social isolation tended to decrease over time across all levels of depressive symptoms, excluding cases with no depressive symptoms.
The three-way interaction results indicated that the severity of depressive symptoms and COVID-19 diagnosis status significantly influenced social isolation trajectory over time. Individuals diagnosed with COVID-19, particularly those experiencing severe depression, have an increased risk of worsening social isolation over time. This underscores the need for intensive and sustained psychological support and intervention for vulnerable individuals.
2019年冠状病毒病（COVID-19）大流行对身心健康产生了深远影响。自大流行开始以来，抑郁症和焦虑症的患病率显著上升。为控制COVID-19传播而实施的隔离和社交距离措施加剧了社会隔离。本研究旨在纵向考察抑郁症和焦虑症的严重程度以及COVID-19诊断如何在整个大流行期间影响社会隔离的轨迹。
这项纵向研究分三波从韩国收集数据：2021年、2022年和2023年。最终样本包括2395名参与者（平均年龄=46.32，标准差=16.47），他们完成了面对面访谈调查。使用患者健康问卷-9测量抑郁症状，使用广泛性焦虑障碍-7评估焦虑症。使用孤独和社会隔离量表评估社会隔离。数据采用具有三向交互设计的多层次模型进行分析。
在时间、抑郁严重程度和COVID-19诊断之间发现了显著的三向交互作用，而焦虑严重程度未显示出显著的交互作用。在被诊断为COVID-19的参与者中，那些有严重抑郁症状的人随着时间的推移社会隔离有所增加。当抑郁严重程度严重时，时间的积极影响得到加强，而在中度或轻度抑郁症状的参与者中则减弱。对于未被诊断为COVID-19的参与者，在所有抑郁症状水平上（不包括无抑郁症状的情况），社会隔离往往随着时间的推移而减少。
三向交互作用结果表明，抑郁症状的严重程度和COVID-19诊断状态随时间显著影响社会隔离轨迹。被诊断为COVID-19的个体，尤其是那些患有严重抑郁症的个体，随着时间的推移社会隔离恶化的风险增加。这凸显了对弱势群体进行强化和持续心理支持及干预的必要性。
