Introduction There are few published empirical data on the effects of COVID‐19 on mental health, and until now, there is no large international study. Material and methods During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. Statistical analysis Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. Results Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. Conclusions The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them.

Crisis usually involves participants who trust and distrust each other, commonly in the same time. COVID-19 infodemic induced confidence crisis and distrust in authorities, science communities, governments and institutions can lead to harmful health behaviors and ill mental health and become a serious threat to public and global mental health as another kind of virus. Distrust mentality, conspiracy thinking and blame games may have detrimental effects not just on the individual level, but on the level of the whole groups, communities and global world. Public distrust and mistrust are related to the crisis in the domain of social and political relations, not only on the same country level, but also between different countries at regional or global level. Dynamics between public trust and mental health is a complex and bidirectional, ill mental health is causing and enhancing the inclination to confidence crisis, distrust, conspiracy theories and blame games and vice versa confidence crisis, distrust, conspiracy thinking and blame games are leading to ill mental health. It is important to have a holistic transdisciplinary integrative understanding of these dynamics and science-based treatment and prevention.

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