A 16-Month Longitudinal Investigation of Risk and Protective Factors for Mental Health Outcomes Throughout Three National Lockdowns and a Mass Vaccination Campaign: Evidence from a Weighted Israeli Sample During COVID-19

  1. Nimrod Hertz-Palmor
  2. Shachar Ruppin
  3. Noam Matalon
  4. Mariela Mosheva
  5. Shirel Dorman-Ilan
  6. Asia Avinir
  7. Ehud Mekori-Domachevsky
  8. Ilanit Hasson-Ohayon
  9. Raz Gross
  10. Doron Gothelf
  11. Itai M. Pessach
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Abstract

Background

The COVID-19 pandemic is an ongoing global crisis, with a multitude of factors that affect mental health worldwide. Here, we explore potential predictors for the emergence and maintenance of depression, anxiety, and posttraumatic stress symptoms (PTSS) in the general population in Israel.

Methods

Across the span of 16 months, 2,478 people completed a repeated self-report survey which inquired psychiatric symptoms and pandemic related stress factors (PRSF). PRSF were divided into four clusters of environmental stressors: financial, health-related, fatigue and sense of protection by authorities. We applied mixed-effects linear models to assess how each stressor contributes to depression, anxiety and PTSS at each time point, alongside a longitudinal exploration among participants who completed at least two consecutive surveys (n=400).

Results

Fatigue was the strongest predictor for depression, anxiety and PTSS at all time points (standardized βbetween 0.28-0.60,p<.0001), and predicted deterioration overtime (βbetween 0.22-0.36,p<.0001). Financial concerns associated with depression and anxiety at all time points (βbetween 0.13- 0.26,p<.01), and with their deterioration overtime (βbetween 0.16-0.18,p<.0001), while health related concerns were uniquely associated with anxiety and PTSS at all time points (βbetween 0.14-0.29,p<.01) and their deterioration (βbetween 0.11-0.16,p<.001), but not with depression. Improvement in sense of protection overtime associated with decrease in depression and anxiety (βbetween −0.09 to −0.16,p<.01).

Conclusions

Our findings accentuate the multitude of risk factors for psychiatric morbidity during COVID-19, and the dynamics in their association with different aspects of psychopathology at various time points.

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