The network of stress-related states and depression and anxiety symptoms during the COVID-19 lockdown

Background: The coronavirus (COVID-19) pandemic and the social distancing protocols used to impede the spread of the virus may have severe mental health consequences. The purpose of this study was to investigate the network of components of pandemic-related negative psychological states (i.e., fear of infection, financial worries, loneliness) and symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD). Methods: Data from 10,061 Norwegian adults recruited through an online survey during a period of strict social distancing protocols were analyzed by cross-sectional network methods. Results: Of the infection fears, fear of being infected, fear of dying from the coronavirus and fear of significant others dying from it had notable connections to the GAD symptoms anxiety and/or fear of awful events. The financial worry component worry about personal economy was connected to the MDD symptom sleep problems and to the GAD symptom generalized worry. Each of the loneliness components was connected to a specific MDD symptom. Depressed mood, low energy and worthlessness had the highest strength centrality among the MDD symptoms; generalized worry, uncontrollability of worry, and trouble relaxing among the GAD symptoms; fear of dying from the virus among the fear of infection components; and feeling isolated among the loneliness components. Limitations: Full random sampling was not conducted, although the sample turned out to be relatively representative of the Norwegian population. Conclusions: Some components of the pandemic-related distressing states of fear of infection, financial worry and loneliness seem to be associated with specific symptoms of MDD and GAD.