Key Takeaways

  • In a survey-based study of US adults, those living in communities in which most people seldom left home at certain times during the COVID-19 pandemic were more likely to report symptoms of depression
  • The link remained strong even after considering COVID-19 activity, weather, and county-level economics
  • Accounting for state-level pandemic restrictions only modestly attenuated the association

BOSTON – Higher levels of depressive symptoms have been reported during the COVID-19 pandemic compared with other times in history, and as much as three times higher than prior to the pandemic. A team led by investigators at Massachusetts General Hospital (MGH) has found that social isolation may have been a contributing factor. Their findings are published in JAMA Network Open.

In surveys conducted between May 2020 and April 2022 that were completed by 192,271 adults living the all 50 US states and the District of Columbia, the average county-level proportion of individuals not leaving home on a daily basis was associated with a greater level of depressive symptoms.

“We integrated our data with another data set compiled by Facebook that looked at aspects of mobility on the basis of an app, including how often people in a particular area left home,” explains lead author Roy H. Perlis, MD, MSc, associate chief of research in the department of psychiatry and director of the Center for Quantitative Health at MGH. “We found that in communities and at times when fewer people left home, levels of depression in our survey were greater.”

This link held even after considering local COVID-19 activity, weather, and county-level economics. Certain pandemic restrictions—in particular, mandatory mask-wearing in public and policies cancelling public events—were modestly related to depressive symptom severity, but these associations were substantially smaller than the magnitude of the association with community mobility.

“In most of the analysis we used cross-sectional data—measurements at the same time of community mobility and depression. But when we looked at the relationship between mobility in a community and subsequent depression, we observed similar effects,” says Perlis.

The investigators note that finding ways to increase social engagement and limit social isolation during times of limited mobility may be important for mitigating the effects of future pandemics or other long-lasting disasters to potentially decrease some of their mental health impacts.

Co-authors include Kristin Lunz Trujillo, PhD, Alauna Safarpour, PhD, Alexi Quintana, BA, Matthew D. Simonson, PhD, Jasper Perlis, Mauricio Santillana, PhD, Katherine Ognyanova, PhD, Matthew A. Baum, PhD, James N. Druckman, PhD, and David Lazer, PhD.

This work was supported by the National Science Foundation, the National Institute of Mental Health, Northeastern University, Harvard Kennedy School of Government, and Rutgers University.

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In July 2022, Mass General was named #8 in the U.S. News & World Report list of "America’s Best Hospitals." MGH is a founding member of the Mass General Brigham healthcare system.