Background: Studies report a strong impact of the COVID-19 pandemic and related stressors on the mental well-being of the general population. In this paper, we investigated whether COVID-19 related concerns and social adversity affected schizotypal traits, anxiety, and depression using structural equational modelling. In mediation analyses, we furthermore explored whether these associations were mediated by healthy (sleep and physical exercise) or unhealthy behaviours (drug and alcohol consumption, excessive media use).
Methods: We assessed schizotypy, depression, and anxiety as well as healthy and unhealthy behaviours and a wide range of sociodemographic scores using online surveys from residents of Germany and the United Kingdom over 1 year during the COVID-19 pandemic. Four independent samples were collected (April/May 2020: N=781, September/October 2020: N=498, January/February 2021: N=544, May 2021: N=486). The degree of schizotypy was measured using the Schizotypal Personality Questionnaire (SPQ), anxiety, and depression symptoms were surveyed with the Symptom Checklist (SCL-27), and healthy and unhealthy behaviours were assessed with the Coronavirus Health Impact Survey (CRISIS). Structural equation models were used to consider the influence of COVID-19 related concerns and social adversity on depressive and anxiety-related symptoms and schizotypal traits in relation to certain healthy (sleep and exercise) and unhealthy behaviours (alcohol and drug consumption, excessive media use).
Results: The results revealed that COVID-19 related life concerns were significantly associated with schizotypy in the September/October 2020 and May 2021 surveys, with anxiety in the September/October 2020, January/February 2021, and May 2021 surveys, and with depressive symptoms in all surveys. Social adversity significantly affected the expression of schizotypal traits and depressive and anxiety symptoms in all four surveys. Importantly, we found that excessive media consumption (>4 hr per day) fully mediated the relationship between COVID-19 related life concerns and schizotypal traits in the January/February 2021 survey. Furthermore, several of the surveys showed that excessive media consumption was associated with increased depressive and anxiety-related symptoms in people burdened by COVID-19 related life.
Conclusions: The ongoing uncertainties of the pandemic and the restrictions on social life have a strong impact on mental well-being and especially the expression of schizotypal traits. The negative impact is further boosted by excessive media consumption, which is especially critical for people with high schizotypal traits.
Funding: FK received funding from the European Union's Horizon 2020 (Grant number 754,462). SN received funding from the Cundill Centre for Child and Youth Depression at the Centre for Addiction and Mental Health, Toronto, Canada and the Wellcome Trust Institutional Strategic Support Fund from the University of Cambridge.
Keywords: COVID-19; Schizotypy; epidemiology; global health; human; media consumption; medicine; mental health.
The 2020 COVID-19 pandemic, and the measures different governments took to contain it, harmed many people’s mental well-being. The restrictions, combined with pandemic-related uncertainty, caused many individuals to experience increased stress, depression, and anxiety. Many people turned to unhealthy behaviours to cope, including consuming more alcohol or drugs, using media excessively, developing poor sleeping habits, or reducing the amount of exercise they did. Stress, drugs, poor sleep, and uncertainty can increase an individual’s risk of developing psychotic symptoms, including delusions, hallucinations, or difficulty thinking clearly. These symptoms may be temporary or part of a more lasting condition, like schizophrenia. The risk of developing these symptoms increases in people with ‘schizotypal traits’, such as a lack of close relationships, paranoia, or unusual or implausible beliefs. These individuals may be especially vulnerable to the harmful mental health effects of the pandemic. Daimer et al. demonstrated that people who were more worried about their life stability or financial situation during the 2020 COVID-19 pandemic had worse mental well-being than those who felt secure. In the experiments, volunteers completed a series of online mental health questionnaires at four different time points during the pandemic. People who reported feeling lonely, having negative thoughts, or experiencing fewer positive social interactions had more symptoms of mental illness. People who experienced more life disruptions also reported more anxiety or depression symptoms and more schizotypal traits. Daily consumption of at least four hours of digital media exacerbated negative mental health symptoms, and people with more pandemic-related life concerns also spent more time on digital media Daimer et al. suggest that increased media consumption among people with pandemic-related hardships may have increased mental health symptoms and schizotypal traits in these individuals. The survey results suggest that maintaining a healthy lifestyle, including meaningful relationships, is essential to staying mentally healthy during extreme situations like a global pandemic. Protective interventions – such as strengthening social support networks, providing mental health education, or increasing mental healthcare provisions – are essential to prevent poor mental health outcomes during future crises.
© 2022, Daimer et al.