Anxiety and depression symptoms, the recovery from symptoms, and loneliness before and after the COVID-19 outbreak among the general population: Findings from a Dutch population-based longitudinal study

Abstract

Objectives Examine the effects of the COVID-19 pandemic on the mental health and loneliness in the general population. More specifically, the study focused on prevalence of anxiety and depression symptoms, the extent to which individuals with existing symptoms recovered or not, the prevalence of subtypes of loneliness, and the extent to which loneliness before and during this pandemic was associated with anxiety and depression symptoms. Methods Data was extracted from the longitudinal LISS panel, based on a probability sample of the Dutch population, with assessments on loneliness in October 2019 (T1) and June 2020 (T4), and anxiety and depression symptoms in November 2019 (T2), March 2020 (T3) and June 2020 (T4; Ntotal = 4,084). Loneliness was examined with the De Jong Gierveld Loneliness Scale and anxiety and depression symptoms with the Mental Health Inventory (MHI-5). Results Repeated measures multivariate logistic regression analyses (RMMLRA) showed a statistical significant lower prevalence of anxiety and depression symptoms after the outbreak (T4 = 15.3%) than before (T2 = 16.8%) and during the COVID-19 outbreak (T3 = 17.2%). According to the Reliable Change Index, the distribution of recovery categories (remission, improvement, unchanged and worsening symptoms) after the outbreak did not differ significantly from the distribution of these categories before the outbreak. RMMLRA revealed that the prevalence of emotional loneliness increased significantly after the outbreak (T1 = 18.4%, T4 = 24.8%). Among individuals who were not lonely before and after the outbreak the prevalence of symptoms decreased significantly (T2 = 7.0%, T4 = 4.4%) and, likewise, among those who were not lonely anymore after the outbreak (T2 = 21.5%, T4 = 14.5%). However, the prevalence of symptoms increased significantly among those who became lonely during the pandemic (T2 = 17.9%, T4 = 26.3%). Conclusions Findings suggest that this pandemic did not negatively affect the prevalence of anxiety and depression symptoms nor the normal recovery of symptoms among the general population during the first four months, but that emotional loneliness increased.

Changes in depression and suicidal ideation under severe lockdown restrictions during the first wave of the COVID-19 pandemic in Spain: a longitudinal study in the general population

“…The first emotional reactions may represent feelings of fear, anger, or sadness in response to an unprecedented situation rather than a mental disorder. More fine-grained analyses have showed that mental health problems remained stable or declined throughout the initial lockdown period (Chandola et al, 2020;Daly et al, 2020;Somma et al, 2020;van der Velden et al, 2021;Gonzalez-Sanguino et al, 2020;Wang et al, 2020;Bryan et al, 2020;Hyland et al, 2020;McGinty et al, 2020a), which would be consistent with the notion of a progressive adjustment for managing and overcoming stressful events. It is worth noting that these are findings at a very early stage of the COVID-19 outbreak and different conclusions may hold for the comparisons among rate estimates of mental health conditions in the mid-and long-term.…”

“…Among the studies tracking longitudinal changes in mental health from before to during the pandemic, some of them have showed increases in the prevalence rate of depression and suicidal ideation (Daly et al, 2020;Niedzwiedz et al, 2020;McGinty et al, 2020b;Novotny et al, 2020;Pierce et al, 2020;Planchuelo-Gomez et al, 2020;Winkler et al, 2020) while others did not report differences above pre-pandemic levels (Kwong et al, 2020;van der Velden et al, 2020) or even decreased estimates (van der Velden et al, 2021). It is worth noting that all but one of the previous studies measured 12 psychological distress or depressive symptoms.…”

“…The COVID-19 outbreak and the policies to prevent its spread have disrupted the daily living of the population. The evidence regarding the mental health consequences of the confinement due to the COVID-19 pandemic in the general population is inconclusive (Tanaka and Okamoto, 2021;Bueno-Notivol et al, 2021;van der Velden et al, 2021;Prati and Mancini, 2021;Faust et al, 2021;O'Connor et al, 2020).…”

Prevalence and factors associated with psychological burden in COVID-19 patients and their relatives: A prospective observational cohort study

“…Studies evaluating the general population during the current pandemic found considerably high and increased levels of psychological distress [ 18 , 19 , 21 – 23 , 25 , 30 , 31 , 81 – 83 ], potentially related to environmental factors such as quarantine [ 12 , 84 ], socioeconomic effects, and the risk of infection. However, several longitudinal studies did not find an increase in psychological distress in the general population before and during the first months of the pandemic [ 27 – 29 ]. First studies further differentiating between individuals who have a relative with COVID-19 and those who do not, suggest that having a sick relative causes significantly higher levels of distress [46.7 vs. 27.7%; 79 , 84 , 85 ].…”

“…Two prospective studies analyzing the prevalence of anxiety [ 24 ] and depression [ 24 , 25 ] before and after the outbreak in two different samples of the general population each, found an increase in clinically relevant symptoms. Contrary, a Dutch long-term study assessing prevalence of moderate to high levels of anxiety or depression in the general population in November 2019 and March 2020 did not show an increase with rates being 16.9% and 17.0%, respectively [ 26 ] and a later follow-up assessment in June 2020 even revealed a significant decrease to 15.3% [ 27 ]. Findings of a similar Dutch long-term study in older adults and a study comparing serious psychological distress in two samples of the US general population were in line with this [ 28 , 29 ].…”