Inverse association of sense of coherence with psychological distress during the coronavirus disease-2019 pandemic: the Toon Health Study

Objective

The coronavirus disease 2019 (COVID-19) pandemic disrupted daily life, including work, leisure, and social interactions, potentially contributing to psychological distress (PD). However, resilience varies across individuals, and protective factors remain unclear. Sense of coherence (SOC), a core concept of salutogenesis, reflects the capacity to perceive life as comprehensible, manageable, and meaningful. This study examined the longitudinal association between pre-pandemic SOC and PD during COVID-19 in a community-based Japanese population. Materials and Methods: We analyzed data from 1,262 participants (436 men and 826 women) aged 30-84 years, excluding individuals with previous depression or poor mental health status. SOC was assessed at baseline (2014-2018) using a 13-item scale, and participants were classified into tertiles (low, middle, and high). PD was defined as a Kessler Psychological Distress Scale (K6) score ≥5 in 2021. Logistic regression analyses estimated adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for PD, after adjusting for age, living status, education, BMI, smoking, alcohol use, physical activity, medical history, and baseline mental health (MCS score).