General Mental Health, Loneliness, and Life Satisfaction in the Context of COVID-19 Policies: A 2-Year Cohort Study in the Netherlands, April 2020–January 2022

Abstract

Objective: Although the COVID-19 pandemic has affected mental health, understanding who has been affected most and why is incomplete. We sought to understand changes in mental health in the context of transmission numbers and pandemic (social) restrictions and whether changes in mental health varied among population groups. Methods: We analyzed data from 92 062 people (aged ≥16 years and able to read Dutch) who participated in the Corona Behavioral Unit cohort study at the National Institute for Public Health and the Environment, the Netherlands, from April 17, 2020, through January 25, 2022. Participants self-reported mental well-being through multiple rounds of surveys. We used a multivariable linear mixed-effects model to analyze loneliness, general mental health, and life satisfaction. Results: As strictness of pandemic prevention measures and social restrictions increased, people’s feelings of loneliness increased and mental health and life satisfaction decreased. As restrictions were relaxed, loneliness decreased and general mental health improved. Younger people (aged 16-24 y) versus older people (aged ≥40 y), people with low (vs high) education levels, and people living alone (vs living together) were more likely to have negative well-being outcomes. We observed that trajectories over time differed considerably only by age, with participants aged 16-24 years affected substantially more than participants aged ≥40 years by pandemic social restrictions. These patterns were consistent across multiple waves of SARS-CoV-2 infection. Conclusions: Our findings suggest that the social restrictions imposed by the Dutch government during the study period were associated with reduced mental well-being, especially among younger people. However, people appeared resilient as they recovered during periods when restrictions were relaxed. Monitoring and supporting well-being, in particular to reduce loneliness, may help younger people during periods of intense social restrictions.

Letter to the Editor: Author reply to Letter to the Editor regarding ‘What happened to the predicted COVID-19-induced suicide epidemic, and why?’

“…We cannot discount that some individual's mental health may have been affected badly, but this medium-term null effect would imply that others equally flourished from lockdowns if that were the case. The same lockdown resilience has been observed in Europe (Danielsen et al, 2023;Van den Boom et al, 2023). While we acknowledge that no doubt for some lockdowns had a significant effect, the evidence from overall mortality over the time of COVID-19 and since, and the mental health sequelae specifically to lockdown periods, rather than other COVID impacts, do not indicate that lockdowns were either a 'deadly policy option' or even had significant medium-term mental health consequences.…”

Cohort profile: The Corona Behavioral Unit cohort, a longitudinal mixed-methods study on COVID-19-related behavior, well-being and policy support in the Netherlands

“…We found that younger participants (under 40s and even more so with the under 26 age group) reported increasingly higher levels of loneliness throughout the pandemic compared to older participants, particularly in times when COVID-19 preventive measures were stricter [ 17 ]. Younger participants were also more likely to report both positive (eg, working from home) and negative effects (eg, impact on social life) [ 18 ].…”

Psychosocial determinants of handwashing and physical distancing behaviour during the Covid-19 pandemic in the Netherlands: a longitudinal analysis

“…We used individual-level data from the Corona Behavioural Unit Covid-19 Cohort, a dynamic cohort study conducted between April 2020 and September 2022 among the Dutch population by the National Institute for Public Health and The Environment (RIVM) (van den Boom et al, 2023). We used data up until round 18 for distancing (conducted in January 2022) and round 19 for handwashing (conducted March 2022), because after these moments, the Dutch government no longer included these measures in their behavioural policy.…”