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.

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.

Background: The COVID-19 pandemic led to significant lifestyle changes and uncertainties, triggering a secondary wave of mental health issues in society. University students are especially susceptible to mental disorders. International students are considered more vulnerable due to limited emotional and financial support from their families and difficulties accessing community support. Hence, we conducted a longitudinal analysis to compare depressive symptoms among international students before and during the pandemic. Methods: Data from depression screenings conducted at the University of Tsukuba in 2019 and 2020 were utilized. We included all students enrolled in 2019 who underwent health check-ups in both 2019 and 2020. Participants completed the Patient Health Questionnaire-9 (PHQ-9), enabling a comparison of item scores between domestic and international students. Psychopathological network analysis was employed to examine relationships among the items. Results: Prior to the pandemic, international students generally exhibited relatively good mental health compared with domestic students. During the 2020 pandemic, no significant difference was observed, but international students tended to demonstrate better mental health. However, network analysis revealed intergroup variations in the relationships among PHQ-9 items, with concentration problems and suicidal thoughts being more prominent among international students. Conclusion: This study’s findings suggest that young people studying abroad experience mental health crises similar to their domestic counterparts. Nevertheless, the patterns of these crises may differ between the two groups.