PONE-D-24-41871Longitudinal association between psychological distress and mask-wearing post COVID-19 among psychiatric outpatients in JapanPLOS ONE

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Bimala Panthee

Academic Editor

PLOS ONE

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Additional Editor Comments:

Please  incorporate all the comments raised by our reviewers. Further, justification of the study in introduction section needs more elaboration and validity and reliability of the study measures needs to be mentioned .Also mention about the management of  biases  in this study that might have impacted in the study findings.. 

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: The Shapiro-Wilk test checks if the data are normally distributed, but it doesn't mention other important values, such as skewness or kurtosis. Non-parametric tests (Wilcoxon) solve this problem, but it would be better to include these indicators.

Residual plots or tests for heteroscedasticity, multicollinearity (VIFs), or outliers were not discussed. These are critical for validating regression assumptions.

The study examined multiple outcomes (mask wear in different settings: outdoors, shopping, hospitals). If you run multiple tests without correcting for them (like using Bonferroni correction), there is a chance that the number of false positives ( Type I errors) will increase.

Subgroup analyses by diagnosis (e.g., mood vs. anxiety disorders) were not performed. It may be due to sample size constraints. So you can include it as recommendation for future studies could explore these.

So,

Clarify normality test results or justify non-parametric choices more explicitly.

Report model diagnostics (e.g., residuals, VIFs) for regression.

Address potential multiple testing issues if secondary analyses were exploratory.

Reviewer #2: Introduction: Your study raises an important discussion about the potential distress associated with mask usage in vulnerable populations. However, one key area that could benefit from further elaboration is the justification for why mask-wearing leads to psychological distress specifically among psychiatric patients.

Line 102-106 appears misplaced.

Results: Line198-200 appears repetitive (data provided in the table)

Discussion: Your findings highlight an important issue, but I believe the discussion could benefit from a stronger emphasis on the clinical and practical implications of your study for psychiatric care.

Currently, while the results are well presented, there is limited exploration of how these findings could inform mental health interventions, policy adjustments, or clinical practices.

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Reviewer #1: No

Reviewer #2: No

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Longitudinal association between psychological distress and mask-wearing post COVID-19 among psychiatric outpatients in Japan

PONE-D-24-41871R1

Dear Dr. Suzuki,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Bimala Panthee

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: