The Transition of Social Isolation and Related Psychological Factors in 2 Mild Lockdown Periods During the COVID-19 Pandemic in Japan: Longitudinal Survey Study

Abstract

Background Lockdowns and stay-at-home orders announced internationally for COVID-19 have led to physical and social distancing, with reports of many individuals experiencing social isolation (SI) and loneliness. Although the emergency declaration in Japan was declared as a “mild” lockdown requested by the government without penalties for violations, the lockdown measures, including SI, had several influences on people’s lives and mental health as in other countries. Furthermore, Japan declared a state of emergency multiple times; thus, it is necessary to examine the influence of the transition of SI caused by repeated emergency declarations and the deterioration of mental health associated with these changes. Objective This study longitudinally investigated the transition of SI and its related factors during the mild lockdown under 2 declared states of emergency in Japan and analyzed psychosocial characteristics by extracting clusters where people with specific transition patterns of SI predominated. Methods We collected data on 7893 inhabitants (3694 [46.8%] women, 49.6 [SD 13.7] years old) living in the 7 prefectures where the initial emergency declaration was applied. The investigations took place online in the final phase of the first and second states of emergency: phase 1 (between May 11 and 12, 2020) and phase 2 (between February 24 and 28, 2021). Nonparametric Bayesian coclustering was used to visualize the exhaustive interaction structure between the transition pattern of SI and the psychosocial variables. Results There were no improvements in social networks and loneliness between the 2 phases, although psychological distress significantly improved and depression slightly decreased. Overall, 3868 (49%) of the 7893 participants remained socially isolated through phases 1 and 2, and 947 (12%) were socially isolated in phase 2, even though they were not socially isolated in phase 1. More participants experienced persistent SI in unmarried, childless, and low-household-income groups. The persistent-SI group had fewer cohabitants than other transition pattern groups. The nonparametric Bayesian coclustering results showed that most clusters, including participants without SI throughout phases 1 and 2, had healthy behaviors, more interactions, good relationships, and less loneliness and psychological stress. Furthermore, the cluster in which relationships deteriorated in phase 1 recovered in phase 2. Comparatively, the clusters with SI throughout phases 1 and 2 were divided into clusters with increased loneliness and psychological stress; clusters were close to participants’ average scores in this study. The clusters with increased loneliness and psychological stress were notable for deteriorating relationships and less online interaction. Conclusions This study revealed the actual state of transition of SI and related psychological, social, and behavioral factors under repeated declarations of a state of emergency. These results should help construct intervention methods that fit individual characteristics of people in SI during a pandemic.

Changes in social isolation and loneliness prevalence during the COVID-19 pandemic in Japan: The JACSIS 2020–2021 study

“…The responses included seven options: “almost every day (6–7 times a week),” “4–5 times a week,” “2–3 times a week,” “once a week,” “2–3 times a month,” “once a month,” and “rarely.” The total frequency of contact was calculated based on a previous article ( 7 ). We applied the sum of the frequency of contact using the eight questions and regarded contacts less than once a week in the total frequency of contact as social isolation because people who had contacts less than once a week were reportedly more likely to have higher risks of all-cause mortality and onset of dementia and disability ( 18 ).…”

“…Overall, poorer levels of social isolation and loneliness were observed during the strict lockdown periods, whereas better levels were observed during the reopening phases. Sugaya et al reported no improvement in social isolation and loneliness between May 2020 and February 2021 among Japanese people, whereas psychological distress and depression significantly decreased ( 18 ).…”

Change in Alcohol Use during the Prolonged COVID-19 Pandemic and Its Psychosocial Factors: A One-Year Longitudinal Study in Japan

“…However, this "mild lockdown" [15] in Japan still affected people's lives in many ways, including lifestyle changes due to remote working and online learning as well as financial hardship due to reduced income and unemployment [16]. Indeed, the prolonged COVID-19 pandemic and repeated declarations of a state of emergency were responsible for maintaining the unfavorable psychological state of the Japanese population [17,18].…”

A 2-year longitudinal study examining the change in psychosocial factors under the COVID-19 pandemic in Japan

“…In addition, several previous studies have suggested that not all psychosocial variables may have changed uniformly during the pandemic. For example, no improvements were observed in severe social isolation or loneliness among the Japanese population 7 between the two survey phases, although psychological distress improved significantly and depression decreased slightly.…”