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However, there has been a lack of real\u2010world evidence concerning the predictors of severe psychological distress (SPD) among the general population in Japan during the COVID\u201019 pandemic. The aim of this study was to examine predictors of SPD during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We investigated the predictors of new\u2010onset SPD in the general Japanese population using data from a large\u2010scale internet\u2010based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 16\u2009489 study participants (age range\u2009=\u200916\u201381, mean age\u2009=\u200952.7, percentage of male\u2009=\u200950%) in the analysis. Over the course of 1 year from baseline, the estimated proportion of participants who experienced SPD was 5.2% with inverse probability weighting. The predictors of SPD included younger age, being never married, being unemployed, having a higher education background, scoring higher on the Fear of Coronavirus\u201019 Scale, experiencing more adverse childhood experiences, reporting poorer subjective health status, and COVID\u201019 with oxygen therapy. Our internet\u2010based survey of the Japanese population may have selection bias, limiting the generalizability to other countries and cultures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study revealed that being afflicted with COVID\u201019 requiring oxygen therapy is the most significant predictor of SPD. In addition, we found that vulnerability to social isolation, such as never being unmarried, anxiety toward COVID\u201019, and susceptibility to stress, are predictors of the emergence of SPD. Therefore, the implementation of online support systems and ensuring access to accurate information may protect against SPD during the COVID\u201019 pandemic in Japan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/npr2.12495","type":"journal-article","created":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T03:40:16Z","timestamp":1729914016000},"page":"798-808","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010world predictors of severe psychological distress during the\n                    <scp>COVID<\/scp>\n                    \u201019 pandemic in Japan: Insights from a large\u2010scale internet\u2010based cohort study"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6747-4348","authenticated-orcid":false,"given":"Keita","family":"Tokumitsu","sequence":"first","affiliation":[{"name":"Department of Neuropsychiatry Towada City Hospital  Towada Japan"},{"name":"Department of Psychiatry Dokkyo Medical University School of Medicine  Mibu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7058-664X","authenticated-orcid":false,"given":"Norio","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dokkyo Medical University School of Medicine  Mibu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Tabuchi","sequence":"additional","affiliation":[{"name":"Cancer Control Center Osaka International Cancer Institute  Osaka Japan"},{"name":"Division of Epidemiology, School of Public Health Graduate School of Medicine, Tohoku University  Miyagi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4414-3770","authenticated-orcid":false,"given":"Norio","family":"Yasui\u2010Furukori","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dokkyo Medical University School of Medicine  Mibu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2347631120983481"},{"key":"e_1_2_12_3_1","unstructured":"World Health Organization.WHO Coronavirus (COVID\u201019) Dashboard. 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