Associations of lockdown stringency and duration with Google searches for mental health terms during the COVID-19 pandemic: A nine-country study

Rosa, Pedro Antonio de la; Cowden, Richard G.; Filippis, Renato de; Jerotić, Stefan; Nahidi, Mahsa; Őri, Dorottya; Orsolini, Laura; Nagendrappa, Sachin; Costa, Mariana Pinto da; Ransing, Ramdas; Saeed, Fahimeh; Shoib, Sheikh; Turan, Serkan; Ullah, Irfan; Vadivel, Ramyadarshni; Ramalho, Rodrigo

doi:10.1016/j.jpsychires.2022.03.026

Cited by 26 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A meta-analysis of depression outcomes across 33 countries found that the prevalence of clinical depression was significantly lower in countries where stringent policies were implemented in early 2020 [ 12 ]. This is consistent with another cross-country study showing that overall stringency was associated with lower Google searches for “depression,” but no evidence for “anxiety” in 2020 [ 13 ]. However, a recent study using longitudinal data between April 2020 and June 2021 from 15 countries showed that higher policy stringency and number of deaths were both associated with poor mental health outcomes [ 14 ].…”

Section: Introductionsupporting

confidence: 90%

Depressive and anxiety symptoms in adults during the COVID-19 pandemic in England: A panel data analysis over 2 years

Steptoe

Fancourt

2023

PLoS Med

View full text Add to dashboard Cite

Background There has been much research into the mental health impact of the Coronavirus Disease 2019 (COVID-19) pandemic and how it is related to time-invariant individual characteristics. However, there is still a lack of research showing long-term trajectories of mental health across different stages of the pandemic. And little is known regarding the longitudinal association of time-varying factors with mental health outcomes. This study aimed to provide a longitudinal profile of how mental health in adults changed across different stages of the COVID-19 pandemic and to examine their longitudinal associations with time-varying contextual (e.g., COVID-19 policy response and pandemic intensity) and individual level factors. Methods and findings This study used data from a large panel study of over 57,000 adults living in England, who were followed up regularly for 2 years between March 2020 and April 2022. Mental health outcomes were depressive and anxiety symptoms. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and anxiety symptoms by the Generalized Anxiety Disorder assessment (GAD-7). Entropy balancing weights were applied to restore sample representativeness. After weighting, approximately 50% of participants were female, 14% from ethnic minority backgrounds, with a mean age of 48 years. Descriptive analyses showed that mental health changes were largely in line with changes in COVID-19 policy response and pandemic intensity. Further, data were analysed using fixed-effects (FE) models, which controlled for all time-invariant confounders (observed or not). FE models were fitted separately across 3 stages of the COVID-19 pandemic, including the first national lockdown (21/03/2020–23/08/2020), second and third national lockdowns (21/09/2020–11/04/2021), and “freedom” period (12/04/2021–14/11/2021). We found that more stringent policy response (measured by stringency index) was associated with increased depressive symptoms, in particular, during lockdown periods (β = 0.23, 95% confidence interval (CI) = [0.18 to 0.28], p < 0.001; β = 0.30, 95% CI = [0.21 to 0.39], p < 0.001; β = 0.04, 95% CI = [−0.03 to 0.12], p = 0.262). Higher COVID-19 deaths were also associated with increased depressive symptoms, but this association weakened over time (β = 0.29, 95% CI = [0.25 to 0.32], p < 0.001; β = 0.09, 95% CI = [0.05 to 0.13], p < 0.001; β = −0.06, 95% CI = [−0.30 to 0.19], p = 0.655). Similar results were also found for anxiety symptoms, for example, stringency index (β = 0.17, 95% CI = [0.12 to 0.21], p < 0.001; β = 0.13, 95% CI = [0.06 to 0.21], p = 0.001; β = 0.10, 95% CI = [0.03 to 0.17], p = 0.005), COVID-19 deaths (β = 0.07, 95% CI = [0.04 to 0.10], p < 0.001; β = 0.04, 95% CI = [0.00 to 0.07], p = 0.03; β = 0.16, 95% CI = [−0.08 to 0.39], p = 0.192). Finally, there was also evidence for the longitudinal association of mental health with individual level factors, including confidence in government/healthcare/essentials, COVID-19 knowledge, COVID-19 stress, COVID-19 infection, and social support. However, it is worth noting that the magnitudes of these longitudinal associations were generally small. The main limitation of the study was its non-probability sample design. Conclusions Our results provided empirical evidence on how changes in contextual and individual level factors were related to changes in depressive and anxiety symptoms. While some factors (e.g., confidence in healthcare, social support) clearly acted as consistent predictors of depressive and/or anxiety symptoms, other factors (e.g., stringency index, COVID-19 knowledge) were dependent on the specific situations occurring within society. This could provide important implications for policy making and for a better understanding of mental health of the general public during a national or global health crisis.

show abstract

Section: Introductionsupporting

confidence: 90%

Depressive and anxiety symptoms in adults during the COVID-19 pandemic in England: A panel data analysis over 2 years

Steptoe

Fancourt

2023

PLoS Med

View full text Add to dashboard Cite

show abstract

“…A meta-analysis of depression outcomes across 33 countries found that the prevalence of clinical depression was significantly lower in countries where stringent policies were implemented in early 2020 [10]. This is consistent with another cross-country study showing that overall stringency was associated with lower Google searches for 'depression', but no evidence for 'anxiety' in 2020 [11]. However, a recent study using longitudinal data between April 2020 and June 2021 from 15 countries showed that higher policy stringency and number of deaths were both associated with poor mental health outcomes [12].…”

Section: Introductionsupporting

confidence: 58%

Depressive and anxiety symptoms during the COVID-19 pandemic: A two-year follow-up

Steptoe

Fancourt

2022

Preprint

View full text Add to dashboard Cite

Background: There has been much research into the mental health impact of the COVID-19 pandemic and how it is related to time-invariant individual characteristics (e.g. age and gender). However, there is still a lack of research showing long-term trajectories of mental health across different stages of the pandemic. And little is known regarding the longitudinal association of time-varying contextual and individual factors (e.g. COVID-19 policy response and pandemic intensity) with mental health outcomes. This study aimed to provide a longitudinal profile of how depressive and anxiety symptoms changed by month between March 2020 and April 2022, and to examine their longitudinal associations with time-varying contextual and individual level factors. Methods and findings: Drawing data from a large panel study of over 58,000 adults living in England, we showed that mental health changes were largely in line with changes in COVID-19 policy response and pandemic intensity. Further, data were analysed using fixed-effects, with models fitted separately across three stages of the COVID-19 pandemic. We found that more stringent policy response was associated with increased mental health symptoms, in particular during lockdown periods. Higher COVID-19 deaths were also associated with poorer mental health, but this association weakened over time. Finally, there was also evidence for the longitudinal association of mental health with individual level factors, including confidence in government/healthcare/essentials, COVID-19 knowledge, COVID-19 stress, COVID-19 infection and social support. Conclusions: Our results provided empirical evidence on how changes in contextual and individual level factors were related to depressive and anxiety symptoms. While some factors clearly acted as consistent predictors of mental health during a pandemic, other factors were dependent on the specific situations occurring within society. This could provide important implications for policy making and for a better understanding of mental health of the general public during a national or global health crisis.

show abstract

“…Over the years, Google Trends has been used to explore various topics and phenomena related to psychiatry and mental health (Nuti et al, 2014 ; Mavragani and Ochoa, 2019 ), such as depression (Monzani et al, 2021 ; Silverio-Murillo et al, 2021 ; de la Rosa et al, 2022 ; Wang et al, 2022 ), anxiety (Monzani et al, 2021 ; de la Rosa et al, 2022 ; Lekkas et al, 2022 ), suicide (Kristoufek et al, 2016 ; Parker et al, 2017 ; Silverio-Murillo et al, 2021 ; de la Rosa et al, 2022 ), insomnia (Sycińska-Dziarnowska et al, 2021 ; Lekkas et al, 2022 ), stress (Silverio-Murillo et al, 2021 ), substance use disorder (Parker et al, 2017 ; Alibudbud and Cleofas, 2022 ), neurocognitive disorder (Piamonte et al, 2021 ), and mental health, itself (Alibudbud, 2022b ). It has also been used to explore online interests and concerns about mental health service providers such as psychiatrists and psychologists (Sycińska-Dziarnowska et al, 2021 ).…”

Section: Google Trends For Health Researchmentioning

confidence: 99%

“…It has also been used to explore online interests and concerns about mental health service providers such as psychiatrists and psychologists (Sycińska-Dziarnowska et al, 2021 ). Likewise, it has been utilized in psychiatric and mental health research by using search volumes worldwide and among and between countries (Monzani et al, 2021 ; Silverio-Murillo et al, 2021 ; Sycińska-Dziarnowska et al, 2021 ; Alibudbud, 2022b ; Alibudbud and Cleofas, 2022 ; de la Rosa et al, 2022 ; Lekkas et al, 2022 ; Wang et al, 2022 ). It has also been used to analyze specific psychiatric disciplines, such as social psychiatry (Alibudbud, 2022a ).…”

Section: Google Trends For Health Researchmentioning

confidence: 99%

Google Trends for health research: Its advantages, application, methodological considerations, and limitations in psychiatric and mental health infodemiology

Alibudbud

2023

Front. Big Data

View full text Add to dashboard Cite

The high utilization of infodemiological tools for psychiatric and mental health topics signals the emergence of a new discipline. Drawing on the definition of infodemiology by Eysenbach, this emerging field can be termed “psychiatric and mental health infodemiology,” defined as the science of distribution and determinants of information in an electronic medium, including the internet, or in a population to inform mental health services and policies. Since Google Trends is one of its popular tools, this minireview describes its advantages, application, methodological considerations, and limitations in psychiatric and mental health research. The advantage of Google Trends is the nature of its data, which may represent the actual behavior rather than their users' stated preferences in real-time through automatic anonymization. As such, it can provide readily available data about sensitive health topics like mental disorders. Therefore, Google Trends has been used to explore public concerns, interests, and behaviors about psychiatric and mental health phenomena, service providers, and specific disciplines. In this regard, several methodological can be considered by studies using Google Trends, including documenting their exact keywords, query category, time range, location, and date of retrieval. Likewise, its limitations should be accounted for in its interpretation, including restricted representation of people who use the Google search engine, limited validity in areas with low internet penetration or freedom of speech, does not provide absolute search volumes, unknown sampled queries, and limited transparency in its algorithm, especially the terms and idioms it subsumes under its “topic” keywords.

show abstract

Associations of lockdown stringency and duration with Google searches for mental health terms during the COVID-19 pandemic: A nine-country study

Cited by 26 publications

References 25 publications

Depressive and anxiety symptoms in adults during the COVID-19 pandemic in England: A panel data analysis over 2 years

Depressive and anxiety symptoms in adults during the COVID-19 pandemic in England: A panel data analysis over 2 years

Depressive and anxiety symptoms during the COVID-19 pandemic: A two-year follow-up

Google Trends for health research: Its advantages, application, methodological considerations, and limitations in psychiatric and mental health infodemiology

Contact Info

Product

Resources

About