The COVID-19 pandemic and lockdown have caused an increase in symptoms of anxiety and depression in some patients. Simple coping behaviors, such as following a healthy/balanced diet and pursuing hobbies and activities, were found to reduce these symptoms, according to an editorial published in the Journal of Affective Disorders.

Researchers conducted a survey of the general adult population of Spain after the start of the COVID-19 lockdown. The survey was conducted online through social networks and included sociodemographic and labor questions, validated measures of anxiety and depressive symptoms, and single-item questions on risk/severity of COVID-19 for oneself and close relatives, potential recent exposure to positive and/or negative life events unrelated to COVID-19, and receipt of mental health treatment for at least 3 months. The survey also assessed the frequency of participants using coping behaviors within the last 2 weeks such as following a routine, speaking to relatives/friends, exercising, and reading news/updates about COVID-19 frequently.

The anxiety and depression questions followed the Generalized Anxiety Disorder-7 questionnaire and the Patient Health Questionnaire-9, respectively. A total of 5545 adults completed the survey; after exclusion criteria, a total of 4399 respondents were included (mean age, 47 years; 73% women). Sixty-five percent of respondents reported anxiety or depressive symptoms (anxiety: mild, 39%; moderate, 11%; severe 4%; depression: mild, 29%; moderate, 9%; severe, 6%).

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The best predictors of lower anxiety symptoms reported by the authors included following a healthy/balanced diet and not reading news about COVID-19; other predictors included taking the opportunity to pursue hobbies and not talking to relatives/friends very often. For depression, the best predictors included following a healthy/balanced diet, following a routine, not reading news updates about COVID-19, taking the opportunity to pursue hobbies, and spending time outdoors.

“These are behaviors that can be easily advised by health bodies or professionals as well as policy makers, to guide the public during this exceptional emergency,” stated the authors.

Performing relaxing activities was only associated with lower anxiety and depressive symptoms before correction for multiple comparisons, and the benefits of physical exercise or drinking water did not reach statistical significance.

Being young and male also contributed to lower anxiety and depression, while perceived risk of job loss, having COVID-19 symptoms with no diagnosis, having negative life events, and having had mental health treatment for at least 3 months were associated with higher anxiety and depressive symptoms.

The study was funded by the Spanish Ministry of Science and the European Commission.


Fullana MA, Hidalgo-Mazzei D, Vieta E, Radua J. Coping behaviors associated with decreased anxiety and depressive symptoms during the COVID-19 pandemic and lockdown. J Affect Disord. 2020;275:80-81.