Background: Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to the lives of people. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health. Methods: We used data from four national longitudinal British cohort studies (N=10,666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity, and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis. Results: Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest, were 21.2% (95% CI: 16.2, 26.2) before lockdown, 25.5% (20.0, 30.3) in May, and 28.2% (21.2, 35.2) in September. Conclusions: Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.

中文翻译：

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与COVID-19大流行期间的睡眠，运动，酒精和饮食变化有关的心理健康：对四项英国队列研究的检查

背景：针对COVID-19大流行的应对措施包括封锁和社会疏远，严重破坏了人们的生活。这些变化可能对患有精神健康问题的人产生了特别的影响，导致影响健康的行为不平等加剧。方法：我们使用了来自四项英国国家纵向队列研究的数据（N = 10,666）。受访者在大流行之前和期间报告了心理健康（心理困扰和焦虑/抑郁症状）和健康行为（酒精，饮食，体育锻炼和睡眠）。使用Logistic回归分析了大流行前精神疾病与大流行性精神疾病与健康行为之间的关联。使用荟萃分析评估合并效应。结果：不良的心理健康与不良的健康行为有关。睡眠，运动和饮食的效果最大，而酒精则更弱。在5月的封锁期间，不良的心理健康与不良的健康行为之间的关联比大流行前更大。9月，当限制放宽时，不平等现象已大致恢复到大流行前的水平。一个明显的例外是睡眠，其精神健康状况的差异仍然很大。与之前的精神疾病水平最高的患者相比，先前精神疾病水平最高的患者不良睡眠的风险差异是锁定前的21.2％（95％CI：16.2，26.2），5月的25.5％（20.0，30.3）和9月为28.2％（21.2，35.2）。结论：综上所述，我们的发现表明，心理健康已成为COVID时代健康行为不平等日益重要的因素。