Impact of COVID-19-lockdown and vulnerability factors on cognitive functioning and mental health in Italian population

The COVID-19 outbreak and its associated restrictive measures, such as lockdown, exposed most individuals to an unprecedented stressful situation, increasing worldwide the prevalence of mental health disorders.

Here, we aimed at exploring for the first time the effect of COVID-19-lockdown on subjective cognitive functioning as well as mental health, in terms of its prevalence and clinical severity. In addition, potential risk factors characterizing more vulnerable groups were investigated. A nationwide cross-sectional online-survey was conducted during the final phase of lockdown in Italy (after 7-10 weeks of home confinement), leading to a sample of 1215 participants.

We found lockdown can have a severe impact on subjective cognitive functioning, along with mental health disorders. Namely, under restrictions, cognitive complaints were mostly perceived in everyday tasks involving attention, temporal orientation and executive functions; while no changes in language abilities were reported. Conversely, a paradoxical effect was observed in memory domain, with people experiencing a reduction of memory failures compared to pre-lockdown times.

Further, higher severity and prevalence of depression, anxiety disorders and of other psychological issues (involving sleep, appetite, libido and hypochondria) were observed – with a prevalence of mild-to-severe depression and anxiety rising up to 32.30% and 35.72% respectively, under restrictions.

Being female, young (<45 years), repeatedly exposed to COVID-19-media, working from home or being unemployed were identified as relevant risk factors for experiencing cognitive worsening and mental health disorders, related to the COVID-19 lockdown. Being resident in high infection-prevalence areas was related to higher level of depression and health anxiety. As lockdown and quarantine measures could be reimposed, health officials have to carefully consider these more vulnerable groups in their decision-making process, to develop an effective global and long-term response to the mental health challenges of this pandemic as well as to implement psychological interventions and specific guidelines, particularly about COVID-19-media exposure.