Effect of lifting COVID-19 lockdown measures on mental well-being: a prospective quasi-experimental approach

Abstract

Background Lockdown measures have been pointed out as causes of mental distress during the COVID-19 pandemic. This study aimed to assess the effect of lifting lockdown measures on mental well-being, globally and across income, education, and caregiver status. Methods We used a community longitudinal study implemented in Portugal in 2020 and 2021. Using self-reported fear, insomnia symptoms, and negative feelings, we estimated the effect of lockdown lift with interrupted time series analysis and generalized estimating equations. Results In 2020, lockdown lift was associated with lower odds of negative feelings (OR=0.75, 95%CI 0.68-0.83) and insomnia symptoms (OR=0.72, 95%CI 0.65-0.80), while feelings of fear were higher (OR=1.39, 95%CI 1.27-1.52). In 2021, odds of feelings of fear were lower (OR=0.92, 95%CI 0.86- 0.99), while for the negative feelings and insomnia symptoms no association was found. Negative feelings and insomnia symptoms negative trends stabilized after the lockdown lift in both periods, while for feelings of fear the trend became positive. Estimates were similar across socioeconomic strata, though the most deprived groups consistently showed higher symptom burden. Conclusion Improvements in mental distress occurred after the lockdown lift but differently across periods and depending on the symptoms analysed.