Does peritraumatic distress predict PTSD, depression and anxiety symptoms during and after COVID-19 lockdown in France? A prospective longitudinal study.

Abstract Background COVID-19 peritraumatic distress (CPD), an emerging trauma-related psychopathology, involves immediate physiological arousal as well as emotional and cognitive responses to the threat of the COVID-19 outbreak. This study examined the prevalence of and temporal changes in CPD, its early and follow-up predictors and the extent to which it was predictive of mental health problems. Methods The study took a two-wave design approach and was conducted during and 3-4 months after the nationwide lockdown in France. Baseline participants were 1,123 (79.5% women; M age = 33.82; range: 18-80). They completed validated measures assessing CPD, posttraumatic stress (PTS), depression, and anxiety symptoms. Descriptive, correlational, and path model analyses were used. Findings Both baseline and follow-up groups presented similar psychosocial profiles. Overall, 35.5% (95% Confidence Interval [CI]: 32.7-38.4) baseline participants and 17.2% (95% CI: 12.6-22.7) follow-up participants developed clinical cases of CPD. The baseline CPD levels predicted 14 to 20% of the variances of PTS (b = 0.55), depression (b = 0.16) and anxiety symptoms (b = 0.16). After accounting for the effect of the baseline CPD levels, the current CPD levels predicted the three investigated mental health outcomes in high proportions (43 to 47%). Further findings revealed important temporal changes in baseline predictors of CPD. However, the chronic CPD and PTS symptoms were prevalent among students and individuals developing worries about the COVID-19 crisis while depression and anxiety symptoms were prevalent among single people and those with pre-existing mental health problems. Limitations Data from self-report measures of mental health were used. The dropout rate between the two time assessments was relatively high. Conclusions These longitudinal findings call for clinical efforts in assessment of and intervention in trauma-related distress. These efforts should be put into the predictive role of CPD in subsequent development of PTS symptoms and comorbidities as long as the health, social and economic consequences of the pandemic linger.