Slackening of COVID-19 social isolation measures and resilience in young adults: a longitudinal study on medium-term effects on loneliness

Background Social isolation to contain the COVID-19 pandemic affected young adult mental health, partly through loneliness. Resilience is a protective factor for anxiety and depression after exposure to a stressor such as a pandemic. Medium-term effects of the COVID-19 pandemic on young adult mental health are yet to be defined. Aims This longitudinal study aimed to evaluate if slackening of social isolation reduced loneliness in young adult living in two European countries, and if this was positively related to their mental health care needs status. Methods A two-phase online survey was conducted from spring 2020 (T1) to summer 2020 (T2). The primary outcomes were the Resilience Scale for Adults (RSA) and the University of California Los Angeles (UCLA) Loneliness Scale. Participants reported mental health care needs before and during lockdown: professional help-seeking, psychotropic drugs use, and admission to a psychiatric department. Results There were 88 participants at T2 (retention rate 35%), of whom 78.4% were female, with a mean age of 22±2.4 years. They were grouped according to mental health care needs change. UCLA scale score decreased in 51 (58.0%) participants from T1 to T2. The group who experienced an increase in mental health care needs displayed a more significant decrease in the UCLA scale compared to the other groups (adjusted p=0.02 and 0.01). The difference of UCLA scale scores from T1 to T2 was positively correlated with the RSA score at T1 (p=0.02). Limitations This longitudinal design provides robust evidence, but the drop-off (attrition 65%) is a significant limitation. Our research was explorative and the results need to be confirmed in future studies. Conclusions Loneliness decreased in line with the slackening of social isolation. Resilience predicts the positive medium-term outcome of loneliness. Thus, interpersonal social support and resilience seem particularly beneficial for young adult mental health. Early assessment of resilience in large-scale disasters could represent a powerful tool for identifying at-risk subjects. Future research should focus on the long-term effects of the COVID-19 pandemic on young adult mental health.