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Accepted manuscript

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

Published online by Cambridge University Press:  02 July 2025

Ayesha Assim Open the ORCID record for Ayesha Assim [Opens in a new window] ,
Marco Solmi ,
Christoph U Correll ,
Trevor Thompson ,
Andrés Estradé ,
Georgina Spies  and
Soraya Seedat
Ayesha Assim*
Affiliation:
Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
Marco Solmi
Affiliation:
Department of Psychiatry, University of Ottawa, Ontario, Canada Regional Centre for the Treatment of Eating Disorders and On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa Ontario Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
Christoph U Correll
Affiliation:
Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, New York, USA Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York, USA DZPG, German Center for Mental Health, Partner Site Berlin, Germany
Trevor Thompson
Affiliation:
Centre for Chronic Illness and Ageing, University of Greenwich, London, United Kingdom
Andrés Estradé
Affiliation:
Early Psychosis: Interventions and Clinical-detection (EPIC) Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
Georgina Spies
Affiliation:
South African PTSD Research Program of Excellence, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
Soraya Seedat
Affiliation:
South African PTSD Research Program of Excellence, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
*
*Corresponding author: Ayesha Assim, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa, PO Box 241; Cape Town, 80. Email address: ayesha2022@sun.ac.za, Tel: +27 21 938 9210
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Abstract

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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.

Keywords

COVID-19pandemicrisk factorsprotective factorsmental healthwell-being

Information

Type
Original Article
Information
Acta Neuropsychiatrica , Accepted manuscript , pp. 1 - 36
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Scandinavian College of Neuropsychopharmacology

Footnotes

a

The first two authors contributed equally to this work.