There is no multi-country/multi-language study testing a-priori multivariable associations between non-modifiable/modifiable factors and validated wellbeing/multidimensional mental health outcomes before/during the COVID-19 pandemic. Moreover, studies during COVID-19 pandemic generally do not report on representative/weighted non-probability samples. The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is a multi-country/multi-language survey conducting multivariable/LASSO-regularized regression models and network analyses to identify modifiable/non-modifiable factors associated with wellbeing (WHO-5)/composite psychopathology (P-score) change. It enrolled general population-representative/weighted-non-probability samples (26/04/2020-19/06/2022). Participants included 121,066 adults (age=42±15.9 years, females=64 %, representative sample=29 %) WHO-5/P-score worsened (SMD=0.53/SMD=0.74), especially initially during the pandemic. We identified 15 modifiable/nine non-modifiable risk and 13 modifiable/three non-modifiable protective factors for WHO-5, 16 modifiable/11 non-modifiable risk and 10 modifiable/six non-modifiable protective factors for P-score. The 12 shared risk/protective factors with highest centrality (network-analysis) were, for non-modifiable factors, country income, ethnicity, age, gender, education, mental disorder history, COVID-19-related restrictions, urbanicity, physical disorder history, household room numbers and green space, and socioeconomic status. For modifiable factors, we identified medications, learning, internet, pet-ownership, working and religion as coping strategies, plus pre-pandemic levels of stress, fear, TV, social media or reading time, and COVID-19 information. In multivariable models, for WHO-5, additional non-modifiable factors with |B|>1 were income loss, COVID-19 deaths. For modifiable factors we identified pre-pandemic levels of social functioning, hobbies, frustration and loneliness, and social interactions as coping strategy. For P-scores, additional non-modifiable/modifiable factors were income loss, pre-pandemic infection fear, and social interactions as coping strategy. COH-FIT identified vulnerable sub-populations and actionable individual/environmental factors to protect well-being/mental health during crisis times. Results inform public health policies, and clinical practice.
Collaborative outcomes study on health and functioning during infection times (COH-FIT): Insights on modifiable and non-modifiable risk and protective factors for wellbeing and mental health during the COVID-19 pandemic from multivariable and network analyses / Solmi, M.; Thompson, T.; Cortese, S.; Estradé, A.; Agorastos, A.; Radua, J.; Dragioti, E.; Vancampfort, D.; Thygesen, L. C.; Aschauer, H.; Schlögelhofer, M.; Aschauer, E.; Schneeberger, A.; Huber, C. G.; Hasler, G.; Conus, P.; Cuénod, K. Q. D.; von Känel, R.; Arrondo, G.; Fusar-Poli, P.; Gorwood, P.; Llorca, P. M.; Krebs, M. O.; Scanferla, E.; Kishimoto, T.; Rabbani, G.; Skonieczna-Żydecka, K.; Brambilla, P.; Favaro, A.; Takamiya, A.; Zoccante, L.; Colizzi, M.; Bourgin, J.; Kamiński, K.; Moghadasin, M.; Seedat, S.; Matthews, E.; Wells, J.; Vassilopoulou, E.; Gadelha, A.; Su, K. P.; Kwon, J. S.; Kim, M.; Lee, T. Y.; Papsuev, O.; Manková, D.; Boscutti, A.; Gerunda, C.; Saccon, D.; Righi, E.; Monaco, F.; Croatto, G.; Cereda, G.; Demurtas, J.; Brondino, N.; Veronese, N.; Enrico, P.; Politi, P.; Ciappolino, V.; Pfennig, A.; Bechdolf, A.; Meyer-Lindenberg, A.; Kahl, K. G.; Domschke, K.; Bauer, M.; Koutsouleris, N.; Winter, S.; Borgwardt, S.; Bitter, I.; Balazs, J.; Czobor, P.; Unoka, Z.; Mavridis, D.; Tsamakis, K.; Bozikas, V. P.; Tunvirachaisakul, C.; Maes, M.; Rungnirundorn, T.; Supasitthumrong, T.; Haque, A.; Brunoni, A. R.; Costardi, C. G.; Schuch, F. B.; Polanczyk, G.; Luiz, J. M.; Fonseca, L.; Aparicio, L. V.; Valvassori, S. S.; Nordentoft, M.; Vendsborg, P.; Hoffmann, S. H.; Sehli, J.; Sartorius, N.; Heuss, S.; Guinart, D.; Hamilton, J.; Kane, J.; Rubio, J.; Sand, M.; Koyanagi, A.. - In: EUROPEAN NEUROPSYCHOPHARMACOLOGY. - ISSN 0924-977X. - 90:(2025), pp. 1-15. [10.1016/j.euroneuro.2024.07.010]
Collaborative outcomes study on health and functioning during infection times (COH-FIT): Insights on modifiable and non-modifiable risk and protective factors for wellbeing and mental health during the COVID-19 pandemic from multivariable and network analyses
Righi E.;
2025
Abstract
There is no multi-country/multi-language study testing a-priori multivariable associations between non-modifiable/modifiable factors and validated wellbeing/multidimensional mental health outcomes before/during the COVID-19 pandemic. Moreover, studies during COVID-19 pandemic generally do not report on representative/weighted non-probability samples. The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is a multi-country/multi-language survey conducting multivariable/LASSO-regularized regression models and network analyses to identify modifiable/non-modifiable factors associated with wellbeing (WHO-5)/composite psychopathology (P-score) change. It enrolled general population-representative/weighted-non-probability samples (26/04/2020-19/06/2022). Participants included 121,066 adults (age=42±15.9 years, females=64 %, representative sample=29 %) WHO-5/P-score worsened (SMD=0.53/SMD=0.74), especially initially during the pandemic. We identified 15 modifiable/nine non-modifiable risk and 13 modifiable/three non-modifiable protective factors for WHO-5, 16 modifiable/11 non-modifiable risk and 10 modifiable/six non-modifiable protective factors for P-score. The 12 shared risk/protective factors with highest centrality (network-analysis) were, for non-modifiable factors, country income, ethnicity, age, gender, education, mental disorder history, COVID-19-related restrictions, urbanicity, physical disorder history, household room numbers and green space, and socioeconomic status. For modifiable factors, we identified medications, learning, internet, pet-ownership, working and religion as coping strategies, plus pre-pandemic levels of stress, fear, TV, social media or reading time, and COVID-19 information. In multivariable models, for WHO-5, additional non-modifiable factors with |B|>1 were income loss, COVID-19 deaths. For modifiable factors we identified pre-pandemic levels of social functioning, hobbies, frustration and loneliness, and social interactions as coping strategy. For P-scores, additional non-modifiable/modifiable factors were income loss, pre-pandemic infection fear, and social interactions as coping strategy. COH-FIT identified vulnerable sub-populations and actionable individual/environmental factors to protect well-being/mental health during crisis times. Results inform public health policies, and clinical practice.
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