The Psychological Impact of ‘Mild Lockdown’ in Japan during the COVID-19 Pandemic: A Nationwide Survey under a Declared State of Emergency

Abstract

This study examined the psychological distress caused by non-coercive lockdown (mild lockdown) in Japan. An online survey was conducted with 11,333 people (52.4% females; mean age = 46.3 ± 14.6 years, range = 18–89 years) during the mild lockdown in the seven prefectures most affected by COVID-19 infection. Over one-third (36.6%) of participants experienced mild-to-moderate psychological distress (Kessler Psychological Distress Scale [K6] score 5–12), while 11.5% reported serious psychological distress (K6 score ≥ 13). The estimated prevalence of depression (Patient Health Questionnaire-9 score ≥ 10) was 17.9%. Regarding the distribution of K6 scores, the proportion of those with psychological distress in this study was significantly higher when compared with the previous national survey data from 2010, 2013, 2016, and 2019. Healthcare workers, those with a history of treatment for mental illness, and younger participants (aged 18–19 or 20–39 years) showed particularly high levels of psychological distress. Psychological distress severity was influenced by specific interactional structures of risk factors: high loneliness, poor interpersonal relationships, COVID-19-related sleeplessness and anxiety, deterioration of household economy, and work and academic difficulties. Even when non-coercive lockdowns are implemented, people’s mental health should be considered, and policies to prevent mental health deterioration are needed. Cross-disciplinary public–private sector efforts tailored to each individual’s problem structure are important to address the mental health issues arising from lockdown.

Worries about COVID-19 infection and psychological distress at work and while commuting

“…Excessive anxiety and depression may be symptoms of psychological distress. Previous studies have shown that people with a history of psychiatric disorders are more anxious and show greater psychological distress during the COVID-19 pandemic 21 . However, because it is easier to confirm feelings of worry than to make a psychiatric diagnosis, we believe that it is useful to identify the presence of worry among workers for determining health status.…”

Loneliness and Its Associated Factors Nine Months after the COVID-19 Outbreak: A Cross-National Study

“…Loneliness in old age is generally acknowledged as an urgent public health problem [ 44 ], particularly in those living without a spouse or partner. In turn, during the COVID-19 pandemic, loneliness was found to be associated with higher levels of psychological distress [ 12 ] and even with malnutrition [ 45 ].…”

“…Moreover, people were encouraged to stay at home in relative isolation to prevent viral spread, and non-essential businesses were temporarily closed [ 3 ], leading to a sharp increase in unemployment rates internationally [ 4 ]. The restrictive social distancing policies and the general sense of uncertainty during the COVID-19 outbreak ultimately reduced contact between people and instigated a growing worldwide concern about increased loneliness [ 5 , 6 , 7 , 8 ] and more mental health problems in the general population [ 9 , 10 , 11 , 12 , 13 ].…”

Reduction of Human Mobility Matters during Early COVID-19 Outbreaks: Evidence from India, Japan and China

“…However, D oc could be high in Japan regardless of the testing kit and hospital bed availability if people fail to recognize the serious risks and are unwilling to be admitted to the hospital [ 36 ]. The general public in Japanese only became aware of the severity of the epidemic after a nationwide lockdown was initiated on 7 April [ 37 ], which is beyond the range of our data availability. Comparatively, the correlation reached 35% to 62% in India and China because the calculation begins from the date the cordon sanitaire was implemented.…”