• Vicent Balanzá-Martínez, Flavio Kapczinski, Taiane de Azevedo Cardoso, Beatriz Atienza-Carbonell, Adriane R Rosa, Jurema C Mota, and Raquel B De Boni.
• Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Electronic address: vicente.balanza@uv.es.
• Rev Psiquiatr Salud Ment (Engl Ed). 2021 Jan 1; 14 (1): 16-26.

IntroductionHealthy lifestyles are relevant to several diseases and to maintain individuals' mental health. Exposure to epidemics and confinement have been consistently associated with psychological consequences, but changes on lifestyle behaviours remain under-researched.Materials And MethodsAn online survey was conducted among the general population living in Spain during the COVID-19 home-isolation. In addition to demographic and clinical data, participants self-reported changes in seven lifestyle domains. The Short Multidimensional Inventory Lifestyle Evaluation was developed specifically to evaluate changes during the confinement (SMILE-C).ResultsA total of 1254 individuals completed the survey over the first week of data collection. The internal consistency of the SMILE-C to assess lifestyles during confinement was shown (Cronbach's Alpha=0.747). Most participants reported substantial changes on outdoor time (93.6%) and physical activity (70.2%). Moreover, about one third of subjects reported significant changes on stress management, social support, and restorative sleep. Several demographic and clinical factors were associated to lifestyle scores. In the multivariate model, those independently associated with a healthier lifestyle included substantial changes on stress management (p<0.001), social support (p=0.001) and outdoor time (p<0.001), amongst others. In contrast, being an essential worker (p=0.001), worse self-rated health (p<0.001), a positive screening for depression/anxiety (p<0.001), and substantial changes on diet/nutrition (p<0.001) and sleep (p<0.001) were all associated with poorer lifestyles.ConclusionsIn this study, sizable proportions of participants reported meaningful changes in lifestyle behaviours during the COVID-19 pandemic in Spain. Moreover, the SMILE-C was sensitive to detect these changes and presented good initial psychometric properties. Further follow-up studies should collect relevant data to promote healthy lifestyles in pandemic times.Copyright © 2020 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

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