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

backgroundIn response to the widespread transmission of coronavirus diseases worldwide, France implemented a strict lockdown from March 17 to May 11, 2020.

objectivesThis 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.

methodsThis 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).

resultsThe 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.

conclusionThe 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.