Caution when linking COVID-19 to mental health consequences.

The coronavirus pandemic has been influencing our lives since the beginning of 2020, forcing health professionals to exhausting work shifts in order to provide patients with the best possible care, workers to lose their jobs or to adapt to smart-working, researchers to close their laboratories, teachers to find new ways of providing education.

We are all troubled to varying degrees: the sudden change in our daily life patterns could have a negative impact on the mental health of those markedly affected (Kawohl and Nordt, 2020). The question is: to what extent are we affected and to what degree did our mental health worsen as a consequence of the lockdown? Prospective evidence of changes in the levels of psychological distress before, during and after isolation so far is lacking. To our knowledge, only one prospective study investigated such changes during the outbreak in China (Wang et al., 2020). Some authors provided interesting cross-sectional data (Moccia et al., 2020), but unfortunately no control population could be assessed (the whole of Italy was put into lockdown). Most of the evidence from studies on the effects of previous lockdowns (Brooks et al., 2020 Mar) is heterogeneous both in methodology and results, and thus the claims of media or researchers of a future “psychological pandemic” (Thakur and Jain, 2020) do not appear to be evidence-based.

“Caution” should be the keyword when reporting opinions or data from cross-sectional studies, especially in the absence of proper controls for lockdown. The effects of social isolation on mental health are poorly understood, and worldwide dissemination of putative catastrophic psychological consequences can do worse than restrictive measures per se: people in need may not seek help if they perceive that being in pain after isolation is common (as may occur after collective traumatic experiences); others may experience worsening symptoms due to social pressure or develop fictious symptomatology. Furthermore, also somatic symptom disorders could be exacerbated by intense fear of being infected (Colizzi et al., 2020). It is of utmost importance to protect those most vulnerable from a sort of Werther (copycat) effect (Sonneck et al., 1994) which could lead susceptible subjects to experience greater damage from the depiction of lockdown on the part of media and researchers than by the lockdown itself (Mental health and psychosocial considerations during the COVID-19 outbreak [Internet]).

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.