Impact of the Covid-19 pandemic and lockdown on the mental health of people exposed to the terrorist attacks of 13 November 2015.

Résumé

BACKGROUND: In response to the widespread transmission of coronavirus diseases worldwide, France implemented a strict lockdown from March 17 to May 11, 2020.OBJECTIVES: This study aimed to evaluate the mental health of individuals who have previously been exposed to the same traumatic event—the terrorist attacks of November 13, 2015—during the COVID-19 pandemic, covering the lockdown and post-lockdown periods.METHODS: This longitudinal study included 74 exposed individuals, 27 with PTSD (PTSD+) and 47 without PTSD (PTSD-). An additional control group of 46 non-exposed individuals (Nonexposed) was established. Data were collected through online questionnaires during the initial lockdown period (April 23 - May 16, 2020) and post-lockdown (July 2 - August 3, 2020).RESULTS: The study shows no significant increase in PTSD scores in any group at any time during the pandemic period, whether related to the terrorist attacks or the COVID-19 outbreak. Depression scores also remained unchanged across all groups. However, a decline in well-being was observed. Notably, anxiety scores increased significantly across all groups at all periods, particularly so in the PTSD + group. During the lockdown period, heightened anxiety levels in the PTSD + group were found to be associated with COVD-19 symptoms, lack of concentration, and feelings of boredom. Conversely, coping mechanisms such as acceptance were found to be associated with reduced anxiety levels, while self-blame and behavioural disengagement were associated with heightened anxiety levels. Collectively, these factors accounted for 33% of the variance in anxiety severity. A similar set of risk and protective factors was identified in the post-lockdown period, with the addition of disappointment in career improvement expectations and the use of religion.CONCLUSION: The present study shows a significant increase in anxiety levels in all the studied groups during the pandemic. Numerous instances of elevated anxiety suggesting a pathologival anxiety were observed in all groups during the pandemic compared to the prepandemic period with a much higher prevalence in PTSD+. In contrast, PTSD scores remained stable in the entire population studied. These results underline the importance of monitoring anxiety in people with a history of PTSD+, even years after a traumatic event. They highlight the potential benefits of certain specific coping mechanisms to prevent mental health problems.