Assessing fear and anxiety regarding COVID-19 viral infection is essential for investigating mental health during this epidemic. We have developed and validated a Japanese-language version of The Fear of COVID-19 Scale (FCV-19S) based on a large, nationwide residential sample (n = 6,750) recruited through news and social media responding to an online version of the questionnaire. Data was collected from August 4–25, 2020. Results correlated with K6, GAD-7 and IES-R psychological scales, and T-tests and analysis of variance identified associated factors. All indices indicated the two-factor modelemotional fear reactionsandsymptomatic expressions of feara better fit for our data than a single-factor model in Confirmatory Factor Analysis (χ²= 164.16, p<0.001, CFI 0.991, TLI = 0.985, RMSEA = 0.043). Socio-demographic factors identified as disaster vulnerabilities such as female sex, sexual minority, elderly, unemployment, and present psychiatric history associated with higher scores. However, respondent or family member experience of infection risk, or work/school interference from confinement, had greatest impact. Results suggest necessity of mental health support during this pandemic similar to other disasters.

The Fear of coronavirus disease 2019 (COVID-19) Scale (FCV-19S) is a seven-item self-administered psychological scale for measuring the fear of this disease. The scale has been widely adapted and validated worldwide. This study aimed to propose a cut-off score for the validated Japanese version of the FCV-19S. We conducted a nationwide online survey and included 26,286 respondents in the analysis. Respondents answered questions on their sociodemographic characteristics, and using the FCV-19S and six-item Kessler Psychological Distress Scale, we measured psychological distress and assessed whether the fear of COVID-19 interfered with their daily lives. A total score of ≥21 points was considered adequate to identify those with psychological distress or difficulties in daily living because of the fear of COVID-19. This cut-off score will contribute to mental health assessment during the COVID-19 pandemic.

Objective: This study aims to elucidate the complex relationship among social isolation, loneliness, and perception of social isolation and its influence on depressive symptoms by evaluating a hypothetical model. This understanding is essential for the formulation of effective intervention strategies. Methods: We conducted an online survey on Japanese adults (N = 3,315) and used the six-item Lubben Social Network Scale to assess the size of their social networks. We employed a single question to gauge their perception of social isolation. Loneliness was assessed using the three-item UCLA Loneliness Scale, and depressive symptoms were examined using the Patient Health Questionnaire-9. Structural equation modeling was employed to test the hypothesized model. Results: The final model demonstrated satisfactory fit with data (χ² (1) = 3.73; not significant; RMSEA = 0.03; CFI = 1.00; TLI = 1.00). The size of social network demonstrated a weak negative path to loneliness and depressive symptoms (β = −.13 to −.04). Notably, a strong positive association existed between perception of social isolation and loneliness (β = .66) and depressive symptoms (β = .27). Additionally, a significant positive relationship was found between loneliness and depressive symptoms (β = .40). Mediation analysis indicated that perception of social isolation and loneliness significantly intensified the relationships between social networks and depressive symptoms. Conclusions: Results indicate that interventions of psychological approaches, such as cognitive–behavioral therapy, are effective in reducing the perception of social isolation and loneliness, which may lead to the prevention of depressive symptoms. Future longitudinal studies are expected to refine and strengthen the proposed model.

Background: With the spread of COVID-19, the deterioration of public mental health has become a major global and social problem. Objective: The purpose of this study was to elucidate the relationship between the 3 mental health problems associated with COVID-19, that is, perceived stress, severe mental distress, and anxiety symptoms, and the various demographic factors, including occupation. Methods: A nationwide web-based questionnaire survey was conducted in Japan from August 4 to 31, 2020. In addition to sociodemographic data, the degrees of perceived stress, severe mental distress, and anxiety symptoms associated with COVID-19 were measured. After performing a descriptive statistical analysis, factors related to stress, severe mental distress, and anxiety symptoms were analyzed using logistic regression analysis. Results: A total of 8203 respondents submitted survey responses, among whom 34.9% (2861/8203) felt intense stress associated with COVID-19, 17.1% (1403/8203) were depressed, and 13.5% (1110/8203) had severe anxiety symptoms. The logistic regression analysis showed that each of the 3 mental health problems were prevalent in females, nonbinary gender, people in their 50s, 60s and older, respondents who visited psychiatrists, and those currently in psychiatric care. Severe mental distress and anxiety symptoms were associated with the number of effective lifestyle coping strategies during the lockdown period. Severe mental distress was only prevalent in teenagers and respondents in their 20s, as students tended to develop stress and severe mental distress. With regard to occupation, working in nursing care and welfare, education and research, and medical and health sectors was associated with stress; however, working in these occupations was not associated with severe mental distress and anxiety symptoms. Unemployment was associated with severe mental distress and anxiety symptoms. All 3 mental health problems were prevalent in part-time workers and those working in entertainment and arts sectors. Conclusions: Gender, age, occupation, history of psychiatric visits, and stress coping mechanisms were associated with mental health during the COVID-19 pandemic, but their associations with stress, severe mental distress, and anxiety symptoms differed. In addition, the actual state of mental health varied according to the respondents’ occupation. It is necessary to consider the impact of the COVID-19 pandemic on mental health not only at the individual level but also at the occupational level.

Background: The coronavirus disease (COVID) 2019 pandemic has been reported to have resulted in psychological disturbances. The Japanese term “hikikomori” refers to a state of preferring to stay at home. The COVID pandemic provided an opportunity to extend our current understanding of hikikomori by examining the psychological states of individuals who were in this state under lockdown, during which, paradoxically, their condition may have been adaptive. Methods: We administered a questionnaire to examine psychological changes among 600 people with hikikomori traits in Japan. The Hospital Anxiety and Depression Scale (HADS), Subjective Stress Scale, and Stigma Questions for hikikomori were administered retrospectively at three time points. We also collected descriptive data regarding the participants’ coping strategies. Results: The participants’ sense of stigma regarding hikikomori was improved during the pandemic, whereas depression and anxiety worsened. The participants with ‘definite’ hikikomori (they met the diagnostic criteria) reported more severe depression and anxiety than those with ‘possible’ hikikomori. Their coping strategies were adaptive to the pandemic situation. Conclusion: Although the sense of stigma against hikikomori was improved and adaptive strategies were employed, the participants with hikikomori experienced a worsening of depression and anxiety during the COVID lockdowns. The improvement of stigma and the participants’ indoor adaptive coping strategies could not ameliorate the mental state of hikikomori. Therapeutic interventions should be considered in the future for definite hikikomori meeting the criteria.