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Risk and protective factors associated with change in well-being and mental health during the COVID-19 pandemic in South Africa

Risk and protective factors associated with change in well-being and mental health during the COVID-19 pandemic in South Africa

Assim, Ayesha ORCID logoORCID: https://orcid.org/0000-0001-5633-0795, Solmi, Marco, Correll, Christoph U, Thompson, Trevor ORCID logoORCID: https://orcid.org/0000-0001-9880-782X, Estradé, Andrés, Spies, Georgina and Seedat, Soraya (2025) Risk and protective factors associated with change in well-being and mental health during the COVID-19 pandemic in South Africa. Acta Neuropsychiatrica. pp. 1-36. ISSN 0924-2708 (Print), 1601-5215 (Online) (doi:10.1017/neu.2025.10026)

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Abstract

Objective: The COVID-19 pandemic and associated restrictive measures affected the mental health and well-being of individuals globally. We assessed non-modifiable and modifiable factors associated with the change in well-being and mental health from pre- to during the COVID-19 pandemic in South Africa.
Methods: A cross-sectional online survey was conducted from 26-April-2020 to 22-April-2021. Paired samples t-tests were conducted to assess change in well-being (measured on The World Health Organization-Five Well-Being Index (WHO-5)) and mental health (a validated composite psychopathology p-score). Sociodemographic, environmental, clinical and behavioral factors associated with change in outcomes were examined.
Results: The sample comprised of 1866 adults (M age=44.26±17.36 years, female=78.9%). Results indicated a significant decrease in well-being (p<0.001) and increase in p-score (p<0.001) from pre- to during the pandemic. Having a prior mental health condition was associated with a worsening well-being score, while being female was associated with a worsening p-score. Being of Black African descent was associated with improved p-score and higher socioeconomic status (SES) was associated with improved well-being. Factors associated with worsening of both well-being and the p-score included adulthood adversity, financial loss since COVID-19, and placing greater importance on direct contact/interactions and substance use as coping strategies. Higher education level and endorsing studying/learning something new as a very important coping strategy were associated with improved well-being and p-score.
Conclusion: Findings inform the need for targeted interventions to reduce and prevent adverse well-being and mental health outcomes during a pandemic, especially among vulnerable groups.

Item Type: Article
Uncontrolled Keywords: COVID-19, pandemic, risk factors, protective factors, mental health, well-being
Subjects: B Philosophy. Psychology. Religion > BF Psychology
H Social Sciences > HD Industries. Land use. Labor > HD61 Risk Management
R Medicine > R Medicine (General)
Faculty / School / Research Centre / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Chronic Illness and Ageing
Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified: 08 Jul 2025 14:53
URI: https://gala.gre.ac.uk/id/eprint/50807

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