Background

The COVID-19 pandemic led to social and physical distancing measures that reduced social contact and support. We explored whether people with more frequent and supportive social contact had fewer depressive symptoms during the UK Spring 2020 ‘lockdown’, whether this applied to face-to-face and remote electronic contact, and whether people with higher empathy levels, or more frequent pre-COVID social contact with others were more protected.

Methods

UK dwelling participants aged ≥18 in the internet-based longitudinal COVID-19 Social Study completed up to 22 weekly questionnaires about frequency of face-to-face and phone/video social contact, perceived social support, and depressive symptoms assessed with the patient health questionnaire (PHQ-9). Mixed linear models examined associations between social contact and support, and depressive symptoms. We examined for interaction by empathic concern and perspective taking and pre-COVID social contact frequency.

Results

In 71,117 people with mean age 49 years (standard deviation 15) we found that daily face-to-face or phone/video contact was associated with lower PHQ-9 scores (mean difference 0.258 (95% confidence interval 0.225, 0.290) and 0.117 (0.080, 0.154) respectively) compared to having no contact. Those with high social support scored 1.836 (1.801, 1.871) PHQ-9 points lower than those with low support. The odds ratio for depression for those with daily face-to-face social contact compared to no face-to-face contact was 0.712 (0.678, 0.747). Daily compared to no phone/video contact was associated with odds ratio for depression 0.825 (0.779, 0.873). And reporting high, compared to low, social support was associated with 0.145 (95%CI 0.138, 0.152) odds ratio for depression. The negative association between social relationships and depressive symptoms was stronger for those with high empathic concern, perspective taking and usual sociability.

Conclusions

Those who had more face-to-face contact during lockdown had fewer depressive symptoms. Phone or video communication were beneficial but less so. People who were usually more sociable or had higher empathy were more likely to have depressive symptoms during enforced reduced social contact. Results have implications both for our management of COVID-19 and potential future pandemics, and for our understanding of the relationship between social factors and mental health.