A cut-off score can accurately identify individuals with high levels of fear about COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has had profound effects, both globally and on a highly personal level. Now, researchers from Japan have developed an accurate way of assessing the effects of the pandemic on our emotional health and wellbeing.

In a study published in December in the International Journal of Environmental Research and Public Health, researchers from the University of Tsukuba have revealed that a statistically determined cut-off value for a commonly used scoring system can accurately identify individuals with high levels of fear about the COVID-19 pandemic.

Fear of COVID-19 can be associated with severe psychological distress, and several tools for measuring fear and anxiety about the disease have been developed. One of the most commonly used is the Fear of COVID-19 Scale (FCV-19S), a self-administered questionnaire that has been translated into a variety of languages.

While the FCV-19S is easy to use, only the Greek version of this scale has an established cut-off value that determines whether an individual's fear and anxiety are clinically significant. Moreover, the FCV-19S assesses two separate factors: interference with individuals' daily lives caused by fear of COVID-19, and the level of general psychological distress, which is affected by various factors other than fear of COVID-19."

Professor Hirokazu Tachikawa, second author of the study

To determine cut-off values for the FCV-19S regarding both factors, the researchers analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS) which was launched in 2020 to investigate how social issues have changed during the COVID-19 pandemic in Japan. The survey assessed mental status and asked participants how the fear of COVID-19 has affected their work, care of their home, or interaction with other people.

"The results showed that approximately one third of participants were in moderate or severe psychological distress," states Dr Haruhiko Midorikawa, lead author. "Furthermore, one out of every six to seven individuals had problems in daily life due to the fear of COVID-19."

The mean total FCV-19S score for the entire cohort was 18.3, and statistical analysis identified 21 points as the optimal cut-off value for identifying participants with problems in daily life due to the fear of COVID-19. Sex, age, education, marital status, cohabitation, occupation, and income were all associated with the FCV-19S score, but only had a minor impact.

"Our results show that this cut-off value is moderately accurate in identifying individuals with daily life disturbances due to the fear of COVID-19," says Professor Midorikawa. The authors also pointed out that individuals in situations where fear of COVID-19 is an issue, such as healthcare workers, should be monitored even if they score below the cut-off value, as otherwise they may not receive appropriate support despite their fear of COVID-19.

Given the accuracy of this proposed cut-off value, FCV-19S screening could be used in Japan to narrow the population targeted for measures designed to reduce fear of COVID-19.