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What are the psychological effects of COVID-19?

Text updated on 2020-11-24


Fear of the disease and uncertainty about the course of the epidemic are stressors. In addition, social isolation and the new organization of work are sources of anxiety for the highly social beings that we are: social exchanges and contacts are essential for our well-being! During this epidemic, we can continue to interact in a safe way: let's promote hugs with people in our home but stay at a distance and remain protected when with people from outside our home.

The situation related to COVID-19 is a source of stress for several reasons: the effects of illness, the effects of containment and social isolation, managing the health crisis. 

The COVID-19 epidemic affects a large fraction of the world's countries and severe cases of the disease are responsible for more than one million deaths. Being sick, the fear of getting sick, or having sick relatives is a source of anxiety for many people. 

Added to this are the consequences of the fight against the epidemic, with periods of containment and curfews, some of which are difficult times to live through. Losing a job and having financial difficulties, no longer being able to play sports and getting fresh air, no longer going on cultural outings, spending long days in small accommodations, coming and going within a restricted area, or even fearing that these events will happen, all these factors have an impact on our well-being. During these periods, social interactions, exchanges with our loved ones, family, friends and colleagues are greatly restricted, as is physical contact. The lack of social relationships and not being able to hold our loved ones in our arms can lead to real malaise and affect our mental health. 

Moreover, theuncertainty about the evolution of the pandemic and its duration, the lack of information or, on the contrary, the influx of contradictory and imprecise information, may have led to a lack of confidence of citizens in government and health authorities. This sense of mistrust has impacted people's adherence to health protocols that were not sufficiently explained to the general public. The containment instructions related to the second and third wave of the epidemic have been followed less than during the first containment. This questioning of the authorities' ability to manage the health crisis is generating a feeling of anxiety about the future. 

The effects of COVID-19 on the mental health of individuals are significant and lead to an increase in depressive disorders, anxiety disorders, post-traumatic stress disorder, and a decrease in quality of life. For different reasons, these disorders primarily affect women, young people, and individuals in precarious situations. 

The pandemic is having an impact on the lives of women in particular. At the level of the family, it has been observed that even if men and women are confined together and are therefore present in the home, it has not reduced the inequalities present in the domestic sphere. Women are more often involved in household tasks (meals, shopping, housework) and educational tasks (home schooling, homework, meeting with teachers) than men, which increases their mental load and makes them more vulnerable to stress.

Young people are also particularly affected by the consequences of the epidemic and containment. In this age group, social life, which depends mainly on interactions with other young people and meetings in places that are now closed to the public during the pandemic (universities, libraries, bars, festivals, etc.), is reduced to social networks. In addition, many young people, whether they are students or not, often live in small dwellings, which makes confinement even more difficult. Finally, the conditions of distance-based learning and internships do not allow learning to be as effective as face-to-face learning. See the question What is the effect of school closures on children? All of these conditions affect young people's future prospects and mental health.

In general, crises, whether economic or pandemic, increase socio-economic inequalities. In the context of COVID-19, there is also a stronger effect of the health of people who were in precarious conditions before the crisis.


The pandemic and its consequences may have aroused many emotions and feelings, such as astonishment, fear, anxiety, anger, frustration, resignation, but also acceptance and optimism. It is quite normal to feel one or more of these emotions during this time! Anxiety can lead to sleep problems and increase problems of alcohol or tobacco addiction, which pre-existed COVID-19. It's important to pay attention to how you feel. In case of persistent discomfort, you should not hesitate to consult specialists (psychologists, psychiatrists) so that these issues are treated as quickly as possible and do not become permanent.


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Sources

A survey carried out in France on the first two weeks of confinement in March 2020 on 1,005 people

Presence of sleep disorders in three out of four adults and signs of psychological distress in more than one out of three French people.

This survey, carried out mainly in the 27 countries of the European Union, includes 75,570 individuals and tests the psychological effects of COVID-19 from the March 2020 population containment. The level of stress reported by the population remains moderate. The most important factors of stress are: the state of the national economy, the risk of being hospitalized or dying, the risk of being affected by COVID-19, and not knowing how long the lockdown will last.

Travaglino, G.A., Lieberoth, A., Tran T., Cepulic D., Kowa,M. Coll-Martín, T., Reyna, C., Vestergren, S.& The COVID-Stress International Collaboration (2020), How is COVID 19 affecting Europeans' Lives? Report of the COVID-STRESS global survey.

A survey conducted in Italy among 18,147 people shows that after 3 to 4 weeks of confinement more than 80% of individuals show symptoms of stress, post-traumatic stress disorder and insomnia, with women and young people being more affected.

Rossi, R, Socci, V, Talevi, D, Mensi, S, Niolu, C, Pacitti, F, Marco, A, Rossi, A, Siracusano, A, Di Lorenzo, G. (2020). COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. An N=18,147 web-based survey.

A survey carried out in Italy among 1,321 people in March-April 2020 that looks at the psychological effects of confinement and shows that periods of confinement can be experienced as trauma: 20% of people present symptoms of post-traumatic stress disorder, 69% suffer from anxiety disorders, and 31% suffer from depressive disorders. Those most affected by these disorders are women, individuals from lower socio-economic backgrounds, individuals who have been in contact with COVID-19 patients, individuals in precarious situations, and those vulnerable to COVID-19.

Castelli, L., Di Tella, M., Benfante, A., & Romeo, A. (2020). The spread of COVID-19 in the Italian population: anxiety, depression, and post-traumatic stress symptoms. Can J Psychiatry, 65(10), 731-2.

A study in Malaysia of 1,054 university students showed an increase in anxiety levels during confinement. Factors contributing to increased stress were financial constraints, distance learning, and uncertainty about the future.

Sundarasen, S., Chinna, K., Kamaludin, K., Nurunnabi, M., Baloch, G. M., Khoshaim, H. B., ... & Sukayt, A. (2020). Psychological impact of covid-19 and lockdown among university students in malaysia: Implications and policy recommendations. International Journal of Environmental Research and Public Health, 17(17), 6206.

Survey carried out in France in March-May 2020 during the first containment, with 2,344 participants, 59% of whom were students. The study shows that students are more likely than non-students to present depressive symptoms (32.5% vs 16.2%), anxiety disorders (24.0% vs 14.7%), suicidal thoughts (11.7% vs 7.6%), and stress (33.1% vs 22.1%).

Arsandaux, J., Montagni, I., Macalli, M., Texier, N., Pouriel, M., Germain, R., ... & Tzourio, C. (2020). Higher risk of mental health deterioration during the Covid-19 lockdown among students rather than non-students. The French Confins study. medRxiv.

OkCupid survey that shows that the amount of conversations and "matches" increased between February and March 2020.

https://theblog.okcupid.com/love-in-the-time-of-corona-massive-spikes-in-matching-messaging-and-virtual-dates-around-the-ec12c49eab86

Social isolation and feeling alone are stressors that increase the risk of developing endocrine, cardiovascular and inflammatory pathologies, and increase the probability of mortality.

Steptoe, A., Owen, N., Kunz-Ebrecht, S. R., & Brydon, L. (2004). Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women. Psychoneuroendocrinology, 29(5), 593-611.

Meta-analysis that shows that the feeling of loneliness, whether objective (due to actual social isolation) or subjective (due to the fact that we may feel alone even if people are around us), increases the risk of mortality. Social isolation increases the risk of mortality by 29%, loneliness by 26% and living alone by 32%.

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on psychological science, 10(2), 227-237.

Humans are ultra-social beings. In the course of evolution, a unique form of sociability has emerged in humans that partly explains the specificity of human cognition and morality.

Tomasello, M. (2014). The ultra-social animal. Eur. J. Soc. Psychol. 44: 187-194. doi:10.1002/ejsp.2015

Touch and physical contact are essential for human well-being, both for the cognitive and socio-emotional development of children and for the psychological and physical well-being of adults. Stimulation by touch of receptors on the skin activates areas of the brain involved in the reward and social pleasure circuit. Touch and physical contact strengthen the emotional bonds between humans and in this sense the skin is considered a sensory but also a social organ. Lack of stimulation of these receptors can lead to lack and discomfort.

Jakubiak BK, Feeney BC. 2016. Affectionate touch to promote relational, psychological, and physical well-being in adulthood: a theoretical model and review of the research. Personal. Soc. Psychol. Rev. 21, 228-252. (10.1177/1088868316650307)

Survey carried out in France in November 2020 which shows that 56.2% of French people were confined to their homes whereas during the first confinement, 81% remained confined to their homes. The prevalence of depressive disorders among the French population doubled between late September (11%) and early November (21%) after the implementation of the second confinement. Between the last week of August and the beginning of November, there was a continuous and significant increase in anxiety states (+3 points) as well as a decrease in life satisfaction (-4 points).

Public Health France, Epidemiological point COVID-19 November 12, 2020.

Study conducted in Italy among 8,177 students in Milan during the March 2020 lockdown which shows that living in small, windowless, or poorly furnished accommodation increases the risk of developing depressive symptoms.

Amerio, A.; Brambilla, A.; Morganti, A.; Aguglia, A.; Bianchi, D.; Santi, F.; Costantini, L.; Odone, A.; Costanza, A.; Signorelli, C.; Serafini, G.; Amore, M.; Capolongo, S. COVID-19 Lockdown: Housing Built Environment's Effects on Mental Health. Int. J. Environ. Public Health 2020, 17, 5973.

In a survey conducted during the confinement in April 2020 among 1,642 individuals in Cyprus, the authors show that 23.1% of the individuals suffer from moderate to severe anxiety disorders and 9.2% from moderate to severe depressive disorders. The most affected are women, young people (18-29 years old), students, unemployed, and individuals with psychiatric history.

Solomou, I., & Constantinidou, F. (2020). Prevalence and predictors of anxiety and depression symptoms during the COVID-19 pandemic and compliance with precautionary measures: Age and sex matter. International journal of environmental research and public health, 17(14), 4924.

This article looks at the prevalence of post-traumatic stress disorder in individuals who have recovered from a serious illness. Any decline in the follow-up of patients cured of COVID-19 is not sufficient to study the long-term psychological and psychiatric effects in this disease. However, data collected in the context of other epidemics such as MERS (Middle East Respiratory Syndrome), for example, show that after one year, 42% of people cured of this disease suffer from post-traumatic stress disorder.

Kaseda, E. T., & Levine, A. J. (2020). Post-traumatic stress disorder: a differential diagnostic consideration for COVID-19 survive. The Clinical Neuropsychologist, 1-17.

Study conducted on 402 individuals who had recovered from a severe form of COVID-19, a month after their hospitalization. Patients' responses to mental health questionnaires show that 28% suffer from post-traumatic stress disorder, 31% from depression, 42% from anxiety disorders, 20% from obsessive-compulsive disorders, and 40% from insomnia. In addition, this study looked at the known link between inflammatory response (production of cytokines among others) and depressive disorders. The inflammatory response is associated with depression and anxiety scores. Given the high number of people who had COVID-19 and an associated inflammatory response, the number of people with depressive disorders is expected to increase in the coming months.

Mazza, M. G., De Lorenzo, R., Conte, C., Poletti, S., Vai, B., Bollettini, I., ... & Benedetti, F. (2020). Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain, behavior, and immunity, 89, 594-600.

The closure of schools due to containment weighs more heavily on women than on men. On average, women teleworking take care of children and their education 1.5 hours more per day than men teleworking. Confinement has increased the disparities that existed prior to confinement.

Hupkau, C, and Petrongolo, B (2020). Work, care and gender during the Covid-19 crisis, Paper No' CEPCOVID-19-002: Preprint CEP Covid-19 Analysis.

A survey carried out in France on 1,025 people shows that during confinement, 59% of women consider spending more time than their spouses on household chores or childcare while 25% of men consider spending more time than their spouses on these tasks.

Lévy, JD., Potereau, J., Prunier, A., (2020), L'impact du confinement sur les inégalités femmes/hommes. Harris Interactive in France for the State Secretariat for Gender Equality and the Fight against Discrimination.

Reports of intra-family violence increased by a third during the first confinement in France. Such violence is a risk factor for the appearance of mental pathologies. In France, if you are a victim or if you are aware of a situation of child abuse, you can call 119. If you are a victim or are aware of a situation of violence against a woman, you can call 3919.

Assessment of the activity of 119 (similar to 911 in US/Canada, 999 in UK) - containment period from 18 March to 10 May 2020.

SOS Amitié, a national helpline for people in distress in France, received 1,000 more calls per day in October 2020 than in January-February 2020, before the confinement. The association deplores that "the unprecedented situation of the health crisis due to COVID-19 has generated new suffering or anxiety and, consequently, a significant increase in the number of calls."

SOS Amitié is recruiting 500 volunteers to respond to the increase in distress calls related to COVID-19. Actu.fr. 9 Oct 2020. Last accessed Nov 7 2020.

Further reading

How best to live during the containment and pandemic of COVID-19?

What are the physical effects of confinement and social distancing?