COVID-19 lockdown effects on mood: impact of sex, age, and underlying disease

Pantea Kiani, Pauline A. Hendriksen, Jessica Balikji, Noortje R. Severeijns, Annabel S.M. Sips, Gillian Bruce, Johan Garssen, Joris C. Verster*

*Corresponding author for this work

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Coronavirus 2019 (COVID-19) lockdown periods had a significant negative impact on people’s lives and psychological well-being. However, the impact of lockdowns differed between individuals. This study aimed to identify vulnerable groups and investigated the relationship between mood and perceived immune fitness and the number and severity of coronavirus 2019 (COVID-19) symptoms during the first COVID-19 lockdown in the Netherlands. In addition, the impact of emotion regulation and other preventive measures was considered. The aim of the study was to identify possible differences according to sex, age, and the presence of underlying disease. A two-part online survey among N = 1415 individuals of the Dutch population (18 to 94 years old) was conducted in the summer of 2020. N = 541 of these participants also completed part 2 of the survey. A series of questionnaires was completed on mood, quality of life, lifestyle, immune fitness, and the number and severity of COVID-19 symptoms. Retrospectively, the period before the first lockdown (15 January–14 March 2020) was compared with the first lockdown (15 March–11 May 2020). The analysis revealed that the lockdown period was associated with significantly poorer mood, poorer immune fitness, and reduced quality of life. Poorer mood was associated with a significantly reduced immune fitness and a significant increase in the number and severity of COVID-19 symptoms. Mood changes did not differ significantly between men and women. Some mood effects were significantly more pronounced for individuals with underlying diseases (depression, fatigue, and stress) and younger individuals (depression and loneliness). Regarding lifestyle factors, no significant lockdown effects were seen according to underlying disease status. During the lockdown period, women reported a decline in nutrition scores, which was not seen in men, whereas they reported receiving more support from family and friends than men. Regarding age, younger individuals reported a significantly greater negative impact on physical activity and being active than the older participants. No differential effects for the groups were found for health correlates. In conclusion, significant negative lockdown effects on mood, quality of life, and immune fitness were observed across the population. The effects were significantly more pronounced among young individuals and those with underlying disease.
Original languageEnglish
Pages (from-to)307-323
Number of pages17
JournalPsychiatry International
Issue number4
Publication statusPublished - 13 Oct 2023


  • COVID-19
  • lockdown
  • immune fitness
  • mood
  • quality of life
  • coping
  • underlying disease
  • age
  • sex


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