TY - JOUR
T1 - The Mental Health Paradox of COVID-19 Prevention
T2 - Adherence, Fatigue, and Depression in a Longitudinal Perspective
AU - Jin, Jiahui
AU - Lai, Daniel W.L.
AU - Yan, Elsie
AU - Lee, Vincent W.P.
N1 - This research was funded by the Health and Medical Research Fund (Grant Number: COVID190216), internal funding of The Hong Kong Polytechnic University (Grant Number: P0038248), and University Grants Committee Research Matching Grant Scheme at Hong Kong Baptist University.
PY - 2025/4/15
Y1 - 2025/4/15
N2 - OBJECTIVES: The COVID-19 pandemic presented significant challenges, particularly the psychological impact of prolonged preventive measures. This study aimed to explore the longitudinal relationships among adherence, anti-pandemic fatigue, and depression, focusing on how these dynamics evolved. METHODS: A prospective longitudinal survey was conducted among 627 adults in Hong Kong during the pandemic across 3 waves. Repeated measures ANOVA, cross-lagged path modeling, and mediation model were employed to assess temporal relationships among adherence, anti-pandemic fatigue, and depression.RESULTS: Adherence at T3 significantly predicted T4's anti-pandemic fatigue (B = 0.196, SE = 0.055) and depression (B = 1.690, SE = 0.247), and anti-pandemic fatigue significantly predicted T4's depression (B = 0.684, SE = 0.260). These effects diminished at later waves, reflecting psychological relief as restrictions eased. Notably, adherence was found to increase anti-pandemic fatigue, which in turn exacerbated depressive symptoms. CONCLUSION: While relationships varied over the 3 time points, the longitudinal design has clarified the causal inference. The study highlights the mental toll of prolonged restrictions and emphasizes the importance of designing integrative strategies that support adherence while addressing fatigue and depression. These findings offer actionable insights for primary care and community health programs in managing future public health emergencies.
AB - OBJECTIVES: The COVID-19 pandemic presented significant challenges, particularly the psychological impact of prolonged preventive measures. This study aimed to explore the longitudinal relationships among adherence, anti-pandemic fatigue, and depression, focusing on how these dynamics evolved. METHODS: A prospective longitudinal survey was conducted among 627 adults in Hong Kong during the pandemic across 3 waves. Repeated measures ANOVA, cross-lagged path modeling, and mediation model were employed to assess temporal relationships among adherence, anti-pandemic fatigue, and depression.RESULTS: Adherence at T3 significantly predicted T4's anti-pandemic fatigue (B = 0.196, SE = 0.055) and depression (B = 1.690, SE = 0.247), and anti-pandemic fatigue significantly predicted T4's depression (B = 0.684, SE = 0.260). These effects diminished at later waves, reflecting psychological relief as restrictions eased. Notably, adherence was found to increase anti-pandemic fatigue, which in turn exacerbated depressive symptoms. CONCLUSION: While relationships varied over the 3 time points, the longitudinal design has clarified the causal inference. The study highlights the mental toll of prolonged restrictions and emphasizes the importance of designing integrative strategies that support adherence while addressing fatigue and depression. These findings offer actionable insights for primary care and community health programs in managing future public health emergencies.
KW - adherence
KW - anti-pandemic fatigue
KW - COVID-19
KW - depression
KW - preventative measures
UR - https://www.scopus.com/pages/publications/105003618069
U2 - 10.1177/21501319251334207
DO - 10.1177/21501319251334207
M3 - Journal article
C2 - 40233310
AN - SCOPUS:105003618069
SN - 2150-1319
VL - 16
JO - Journal of primary care & community health
JF - Journal of primary care & community health
ER -
