Psychological symptoms, mental fatigue and behavioural adherence after 72 continuous days of strict lockdown during the COVID-19 pandemic in Argentina

Fernando Torrente; Adrian Yoris; Daniel Low; Pablo Lopez; Pedro Bekinschtein; Gustavo H Vázquez; Facundo Manes; Marcelo Cetkovich

doi:10.1192/bjo.2021.1065

Psychological symptoms, mental fatigue and behavioural adherence after 72 continuous days of strict lockdown during the COVID-19 pandemic in Argentina

BJPsych Open. 2021 Dec 10;8(1):e10. doi: 10.1192/bjo.2021.1065. eCollection 2022 Jan.

Authors

Fernando Torrente¹, Adrian Yoris¹, Daniel Low², Pablo Lopez¹, Pedro Bekinschtein¹, Gustavo H Vázquez³, Facundo Manes¹, Marcelo Cetkovich¹

Affiliations

¹ Institute of Neuroscience and Public Policy, INECO Foundation, Argentina; and Institute of Cognitive and Translational Neurosciences, National Council of Science and Technology, INECO Foundation and Favaloro University, Argentina.
² Program in Speech and Hearing Bioscience and Technology, Harvard Medical School and MIT, USA.
³ Department of Psychiatry, Queen's University Medical School, Canada.

Abstract

Background: An early and prolonged lockdown was adopted in Argentina during the first wave of COVID-19. Early reports evidenced elevated psychological symptoms.

Aims: To explore if the prolonged lockdown was associated with elevated anxiety and depressive symptoms; if mental fatigue was associated with lockdown adherence (a phenomenon called 'behavioural fatigue'); and if financial concerns were associated with lockdown adherence and emotional symptoms.

Method: The survey included standardised questionnaires to assess depressive (PHQ-9) and anxious (GAD-7) symptoms, mental fatigue, risk perception, lockdown adherence, financial concerns, daily stress, loneliness, intolerance to uncertainty, negative repetitive thinking and cognitive problems. LASSO regression analyses were carried out to predict depression, anxiety and lockdown adherence.

Results: The survey reached 3617 adults (85.2% female) from all provinces of Argentina after 72 days of lockdown. Data were collected between 21 May 2020 and 4 June 2020. In that period, Argentina had an Oxford stringency index of 85/100. Of those surveyed, 45.6% and 27% met the cut-offs for depression and anxiety, respectively. Mental fatigue, cognitive failures and financial concerns were correlated with psychological symptoms, but not with adherence to lockdown. In regression models, mental fatigue, cognitive failures and loneliness were the most important variables to predict depression, intolerance to uncertainty and lockdown difficulty were the most important for anxiety, and perceived threat was the most important for predicting lockdown adherence.

Conclusions: During the extended lockdown, psychological symptoms increased, being enhanced by mental fatigue, cognitive difficulties and financial concerns. We found no evidence of behavioural fatigue. Thus, feeling mentally fatigued is not the same as being behaviourally fatigued.

Keywords: Fatigue Assessment Scale; Low- and middle-income countries; behavioural fatigue; community mental health; lockdown.