Substance Use and Mental Health during the First COVID-19 Lockdown in Germany: Results of a Cross-Sectional Survey
Abstract
:1. Introduction
2. Material and Methods
2.1. Design and Sampling
2.2. Measures
2.3. Statistical Analysis
3. Results
3.1. Sociodemographics
3.2. Mental Health
3.3. Drug Consumption during the First Lockdown
3.4. Alcohol and Mental Health
3.5. Nicotine and Mental Health
3.6. THC and Mental Health
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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n | % | |
---|---|---|
Gender Identity | 2327 | |
Female | 1595 | 67.3 |
Male | 732 | 30.9 |
Diverse | 35 | 1.5 |
Age | 2369 | |
18–24 | 351 | 14.8 |
25–34 | 485 | 20.5 |
35–44 | 477 | 20.1 |
45–54 | 435 | 18.4 |
55–64 | 439 | 18.5 |
≥65 | 182 | 7.7 |
Education | 2359 | |
University or university of applied sciences diploma | 1228 | 51.8 |
Completed vocational education | 285 | 12.0 |
Completion of secondary school | 833 | 35.2 |
Other/none | 13 | 0.5 |
Employment status | 2363 | |
Full-time employed | 853 | 36.0 |
Part-time employed | 605 | 25.5 |
Student | 418 | 17.6 |
Retired | 247 | 10.4 |
Unemployed | 94 | 4.0 |
Other | 146 | 6.2 |
Monthly net income | 2284 | |
<1000 Euros | 604 | 25.5 |
1000–2000 Euros | 742 | 31.3 |
2000–3000 Euros | 599 | 25.3 |
More than 3000 Euros | 339 | 14.3 |
Financial losses due to the Corona pandemic | 2360 | |
no financial losses | 1600 | 67.5 |
very small financial losses | 401 | 16.9 |
significant financial losses | 243 | 10.3 |
very strong financial losses | 62 | 2.6 |
the income has completely disappeared | 54 | 2.3 |
Children in household | 2354 | |
0 | 1746 | 73.7 |
1 | 241 | 10.2 |
2 | 269 | 11.4 |
3 | 74 | 3.1 |
≥4 | 24 | 0.9 |
Preexisting chronic conditions | ||
cardiovascular diseases/hypertension | 335 | 14.1 |
weakened immune system | 261 | 11.0 |
high obesity | 241 | 10.2 |
chronic respiratory diseases | 173 | 7.3 |
diabetes mellitus | 88 | 3.7 |
cancer | 74 | 3.1 |
chronic liver diseases | 21 | 0.9 |
M | MD | SD | Min | Max | >Cut-Off | |
---|---|---|---|---|---|---|
Depressive Symptoms (PHQ-9) | 7.1 | 6 | 5.9 | 0 | 27 | 25.9% |
Generalized Anxiety (GAD-7) | 6.6 | 5 | 5.3 | 0 | 21 | 23.3% |
Loneliness | 1.6 | 1 | 2.2 | 0 | 11 | 23.3% |
Burdens of social isolation during lockdown | 3.5 | 3 | 1.4 | 1 | 6 | -- |
n | % | |||||
Suicidal thoughts during lockdown | 938 | |||||
Never | 580 | 61.8 | ||||
rarely (once) | 193 | 20.6 | ||||
sometimes (2 times) | 92 | 9.8 | ||||
often (3–4 times) | 31 | 3.3 | ||||
very often (5 times or more) | 42 | 4.5 |
Alcohol Consumption Last 12 Months n = 2207 | Nicotine Consumption Last 12 Months n = 920 | THC Consumption Last 12 Months n = 478 | ||||
---|---|---|---|---|---|---|
n | % | n | % | n | % | |
Gender Identity | 2148 | 895 | 465 | |||
Female | 1458 | 66.1 | 565 | 63.1 | 267 | 57.4 |
Male | 659 | 29.8 | 311 | 34.7 | 180 | 38.7 |
Diverse | 31 | 1.4 | 19 | 2.1 | 18 | 3.9 |
Age | 2144 | 896 | 464 | |||
18–24 | 327 | 15.3 | 164 | 18.3 | 121 | 26.1 |
25–34 | 446 | 20.8 | 237 | 26.5 | 147 | 31.7 |
35–44 | 434 | 20.2 | 180 | 20.1 | 89 | 19.2 |
45–54 | 388 | 18.1 | 173 | 19.3 | 61 | 13.1 |
55–64 | 391 | 18.2 | 118 | 13.2 | 42 | 9.1 |
≥65 | 158 | 7.4 | 24 | 2.7 | 4 | 0.9 |
Education | 2145 | 890 | 462 | |||
University or university of applied sciences diploma | 1145 | 53.4 | 405 | 45.5 | 212 | 45.9 |
Completed vocational education | 249 | 11.6 | 116 | 13.0 | 55 | 11.9 |
Completion of secondary school | 743 | 34.6 | 367 | 41.2 | 195 | 42.2 |
Other/none | 8 | 0.4 | 2 | 0.2 | 0 | 0.0 |
Employment status | 2202 | 918 | 478 | |||
Full-time employed | 809 | 36.7 | 338 | 36.8 | 170 | 35.6 |
Part-time employed | 567 | 25.7 | 225 | 24.5 | 107 | 22.4 |
Student | 401 | 18.2 | 207 | 22.5 | 131 | 27.4 |
Retired | 215 | 9.8 | 46 | 5.0 | 16 | 3.3 |
Unemployed | 79 | 3.6 | 49 | 5.3 | 22 | 4.6 |
Other | 131 | 5.9 | 53 | 5.8 | 32 | 6.7 |
Monthly net income | 2076 | 881 | 458 | |||
<1000 Euros | 541 | 26.1 | 261 | 29.6 | 165 | 36.0 |
1000–2000 Euros | 673 | 32.4 | 310 | 35.2 | 153 | 33.4 |
2000–3000 Euros | 549 | 26.4 | 208 | 23.6 | 100 | 21.8 |
More than 3000 Euros | 313 | 15.1 | 102 | 11.6 | 40 | 8.7 |
Financial losses due to the Corona pandemic | 2200 | 917 | 477 | |||
no financial losses | 1487 | 67.6 | 585 | 63.8 | 289 | 60.6 |
very small financial losses | 381 | 17.3 | 164 | 17.9 | 80 | 16.8 |
significant financial losses | 222 | 10.1 | 115 | 12.5 | 68 | 14.3 |
very strong financial losses | 61 | 2.8 | 32 | 3.5 | 18 | 3.8 |
the income has completely disappeared | 49 | 2.2 | 21 | 2.3 | 22 | 4.6 |
Preexisting chronic conditions | 2207 | 920 | 478 | |||
cardiovascular diseases/hypertension | 300 | 13.6 | 108 | 11.7 | 41 | 8.6 |
weakened immune system | 225 | 10.2 | 108 | 11.7 | 74 | 15.5 |
high obesity | 214 | 9.7 | 85 | 9.2 | 37 | 7.7 |
chronic respiratory diseases | 155 | 7.0 | 69 | 7.5 | 38 | 7.9 |
diabetes mellitus | 79 | 3.6 | 31 | 3.4 | 9 | 1.9 |
cancer | 69 | 3.1 | 19 | 2.1 | 4 | 0.8 |
chronic liver diseases | 15 | 0.7 | 6 | 0.7 | 3 | 0.6 |
Substance Use | n | % |
---|---|---|
Alcohol | ||
Alcohol use last 12 months | 2207 | 94.0 |
Alcohol use during lockdown | 2184 | |
no consumption/less than before | 661 | 30.3 |
unchanged | 900 | 41.2 |
more than before | 623 | 28.5 |
Nicotine | ||
Nicotine use last 12 months | 920 | 45.6 |
Nicotine use during lockdown | 907 | |
no consumption/less than before | 298 | 32.9 |
unchanged | 348 | 38.4 |
more than before | 261 | 28.8 |
THC | ||
THC use last 12 months | 478 | 23.5 |
THC use during lockdown | 467 | |
no consumption/less than before | 247 | 52.9 |
unchanged | 124 | 26.6 |
more than before | 96 | 20.6 |
Drug Purchase during Lockdown | THC (n = 187) | Amphetamine (n = 28) | Methamphetamine (n = 8) | Cocaine (n = 29) | Ecstasy (n = 25) | |||||
---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | |
Easier than before the lockdown | 4 | 2.1 | 2 | 7.1 | 1 | 12.5 | 1 | 3.4 | 2 | 8.0 |
Same as before the lockdown | 155 | 82.9 | 18 | 64.3 | 4 | 50.0 | 23 | 79.3 | 17 | 68.0 |
More difficult than before the lockdown, at a lower or the same price | 19 | 10.2 | 6 | 21.4 | 2 | 25.0 | 3 | 10.3 | 4 | 16.0 |
More difficult than before the lockdown, at a higher price | 9 | 4.8 | 2 | 7.1 | 1 | 12.5 | 2 | 6.9 | 2 | 8.0 |
Variable | No Increase in Alcohol Use | Increase in Alcohol Use | Test-Statistic | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
95% CI | Effect size | ||||||||||
N | M (SD) | N | M (SD) | t-test | LL | UL | p-value | Cohens d | |||
Age | 1258 | 43.04 (15.88) | 606 | 40.36 (13.27) | 3.83 | 1.31 | 4.06 | 0.001 | 0.19 | ||
Mental health | |||||||||||
Depression (PHQ-9 score) | 1210 | 6.30 (6.63) | 561 | 8.35 (5.91) | −6.89 | −2.63 | −1.47 | 0.001 | 0.37 | ||
Anxiety (GAD-7 score) | 1190 | 5.81 (5.04) | 571 | 7.85 (5.39) | −7.58 | −2.57 | −1.51 | 0.001 | 0.39 | ||
Loneliness (score) | 1290 | 2.56 (2.42) | 623 | 3.18 (2.68) | −4.87 | −0.87 | −0.37 | 0.001 | 0.25 | ||
N | % | N | % | X2 | p-value | Phi | |||||
Gender | 2126 | ||||||||||
Female | 1069 | 70.4 | 375 | 61.8 | 16.69 | 0.001 | 0.089 | ||||
Male | 433 | 28.5 | 218 | 35.9 | |||||||
Diverse | 17 | 1.1 | 14 | 2.3 | |||||||
Monthly net income | 2056 | ||||||||||
<1.000 Euros | 386 | 26.3 | 150 | 25.5 | 0.49 | 0.921 | |||||
1.000–2.000 Euros | 480 | 32.7 | 188 | 32.0 | |||||||
2.000–3.000 Euros | 387 | 26.4 | 158 | 26.9 | |||||||
More than 3.000 Euros | 215 | 14.6 | 92 | 15.6 | |||||||
Mental health | |||||||||||
Depression (PHQ-9 ≥ 10) | 1298 | 28.2 | 535 | 36.1 | 11.09 | 0.001 | 0.08 | ||||
Anxiety (GAD-7 ≥ 10) | 1436 | 21.5 | 571 | 34.0 | 33.76 | 0.001 | 0.13 | ||||
Loneliness (cut-off ≥ 3) | 671 | 43.1 | 313 | 50.2 | 9.25 | 0.002 | 0.07 | ||||
Significant financial losses from the Corona pandemic | 1556 | 4.1 | 621 | 7.2 | 9.16 | 0.002 | 0.07 | ||||
N | Mdn (IQR) | M | N | Mdn (IQR) | M | Mann–Whitney-U | p-value | r | |||
Burdens of social distancing | 1558 | 3 (2) | 3.36 | 623 | 4 (2) | 3.76 | 405,484.50 | 0.001 | 0.13 | ||
Suicidal thoughts during lockdown | 577 | 1 (1) | 1.59 | 275 | 1 (1) | 1.81 | 70,896.50 | 0.004 | 0.10 |
Variable | No Increase in Nicotine Use | Increase in Nicotine Use | Test-Statistic | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
95% CI | Effect size | ||||||||||
N | M (SD) | N | M (SD) | t-test | LL | UL | p-value | Cohens d | |||
Age | 450 | 40.08 (13.92) | 254 | 37.96 (12.66) | 1.99 | 0.34 | 4.19 | 0.023 | 0.16 | ||
Mental health | |||||||||||
Depression (PHQ-9 score) | 435 | 7.24 (6.15) | 244 | 10.12 (6.28) | −5.82 | −3.86 | −1.91 | 0.001 | −0.47 | ||
Anxiety (GAD-7 score) | 428 | 6.39 (5.41) | 242 | 9.49 (5.65) | −7.01 | −3.97 | −2.23 | 0.001 | −0.56 | ||
Loneliness (score) | 460 | 2.81 (2.53) | 261 | 3.62 (2.50) | −4.15 | −1.19 | −0.43 | 0.001 | −0.32 | ||
N | % | N | % | X2 | p-value | Phi | |||||
Gender | 883 | ||||||||||
Female | 399 | 63.5 | 160 | 62.7 | 0.61 | 0.739 | |||||
Male | 217 | 34.6 | 88 | 34.5 | |||||||
Diverse | 12 | 1.9 | 7 | 2.7 | |||||||
Monthly net income | 869 | ||||||||||
<1.000 Euros | 181 | 29.3 | 75 | 29.9 | 7.39 | 0.060 | |||||
1.000–2.000 Euros | 222 | 35.9 | 88 | 35.1 | |||||||
2.000–3.000 Euros | 134 | 21.7 | 69 | 27.5 | |||||||
More than 3.000 Euros | 81 | 13.1 | 19 | 2.2 | |||||||
Mental health | |||||||||||
Depression (PHQ-9 ≥ 10) | 180 | 32.4 | 112 | 46.9 | 14.96 | 0.001 | 0.14 | ||||
Anxiety (GAD-7 ≥ 10) | 140 | 23.2 | 112 | 46.3 | 44.09 | 0.001 | 0.23 | ||||
Loneliness (cut-off ≥ 3) | 302 | 46.7 | 161 | 61.7 | 16.60 | 0.001 | 0.14 | ||||
Significant financial losses from the Corona pandemic | 32 | 5.0 | 21 | 8.0 | 3.17 | 0.075 | |||||
N | Mdn (IQR) | M | N | Mdn (IQR) | M | Mann–Whitney-U | p-value | r | |||
Burdens of social distancing | 645 | 3 (3) | 3.44 | 261 | 4 (2) | 3.97 | 66,379.50 | 0.001 | 0.17 | ||
Suicidal thoughts during lockdown | 275 | 1 (1) | 1.67 | 141 | 1 (1) | 1.92 | 17,111.00 | 0.028 | 0.11 |
Variable | No Increase in THC Use | Increase in THC Use | Test-Statistic | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
95% CI | Effect size | ||||||||||
N | M (SD) | N | M (SD) | t-test | LL | UL | p-value | Cohens d | |||
Age | 182 | 33.86 (12.49) | 94 | 34.87 (12.70) | 0.62 | −2.16 | 4.13 | 0.537 | |||
Mental health | |||||||||||
Depression (PHQ-9 score) | 172 | 8.42 (5.95) | 92 | 10.63 (7.00) | −2.57 | −3.90 | −0.51 | 0.006 | −0.35 | ||
Anxiety (GAD-7 score) | 179 | 7.69 (5.64) | 89 | 9.31 (5.95) | −2.18 | −3.09 | −0.16 | 0.015 | −0.28 | ||
Loneliness (score) | 189 | 3.26 (2.45) | 96 | 3.70 (2.43) | −1.42 | −1.04 | −0.17 | 0.079 | |||
N | % | N | % | X2 | p-value | Phi | |||||
Gender | 454 | ||||||||||
Female | 209 | 58.2 | 54 | 56.8 | 0.07 | 0.968 | |||||
Male | 136 | 37.9 | 37 | 38.9 | |||||||
Diverse | 14 | 3.9 | 4 | 4.2 | |||||||
Monthly net income | 448 | ||||||||||
<1.000 Euros | 130 | 36.7 | 35 | 37.2 | 3.06 | 0.383 | |||||
1.000–2.000 Euros | 112 | 31.6 | 37 | 39.4 | |||||||
2.000–3.000 Euros | 79 | 22.3 | 16 | 17.0 | |||||||
More than 3.000 Euros | 33 | 9.3 | 6 | 6.4 | |||||||
Mental health | |||||||||||
Depression (PHQ-9 ≥ 10) | 136 | 41.2 | 44 | 51.2 | 2.75 | 0.097 | |||||
Anxiety (GAD-7 ≥ 10) | 114 | 32.7 | 36 | 40.4 | 1.91 | 0.167 | |||||
Loneliness (cut-off ≥ 3) | 207 | 55.8 | 61 | 63.5 | 1.87 | 0.171 | |||||
Significant financial losses from the Corona pandemic | 28 | 7.6 | 12 | 12.5 | 2.36 | 0.124 | |||||
N | Mdn (IQR) | M | N | Mdn (IQR) | M | Mann–Whitney-U | p-value | r | |||
Burdens of social distancing | 370 | 4 (2) | 3.62 | 96 | 4 (2) | 3.93 | 15,520.00 | 0.051 | |||
Suicidal thoughts during lockdown | 201 | 1 (1) | 1.74 | 57 | 1 (2) | 1.95 | 5264.50 | 0.295 |
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Deimel, D.; Firk, C.; Stöver, H.; Hees, N.; Scherbaum, N.; Fleißner, S. Substance Use and Mental Health during the First COVID-19 Lockdown in Germany: Results of a Cross-Sectional Survey. Int. J. Environ. Res. Public Health 2022, 19, 12801. https://doi.org/10.3390/ijerph191912801
Deimel D, Firk C, Stöver H, Hees N, Scherbaum N, Fleißner S. Substance Use and Mental Health during the First COVID-19 Lockdown in Germany: Results of a Cross-Sectional Survey. International Journal of Environmental Research and Public Health. 2022; 19(19):12801. https://doi.org/10.3390/ijerph191912801
Chicago/Turabian StyleDeimel, Daniel, Christine Firk, Heino Stöver, Nicolas Hees, Norbert Scherbaum, and Simon Fleißner. 2022. "Substance Use and Mental Health during the First COVID-19 Lockdown in Germany: Results of a Cross-Sectional Survey" International Journal of Environmental Research and Public Health 19, no. 19: 12801. https://doi.org/10.3390/ijerph191912801