Change in mental health during the COVID-19 pandemic: a longitudinal study of residents of Indian metropolitan cities

Husain, Zakir; Datta, Soumitra Shankar; Ghosh, Saswata; Dutta, Mousumi

doi:10.1080/09638237.2023.2182417

Cited by 6 publications

(3 citation statements)

References 63 publications

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“…Our results on mental health during the lockdown period align with a large number of studies that have reported high mental health symptom burden in the initial lockdown stage of the pandemic in India [30,31]. The literature on mental health outcomes in later stages of the pandemic in India is more scarce and somewhat mixed; studies have reported both increasing and decreasing symptom burden over time [24,32,33]. Our findings suggest that such inconsistent evidence could be due to differences in the timing of survey waves and longitudinal follow-ups; we found both increasing and decreasing symptom burden during different time periods.…”

Section: Discussionsupporting

confidence: 84%

Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nation-wide survey

Nichols,

Petrosyan,

Khobragade

et al. 2023

Preprint

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Introduction: The COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over two years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context. Methods: We used data from the Real-Time Insights of COVID-19 in India (RTI COVID-India) cohort study (N=3,662). We used covariate-adjusted linear regression models with generalized estimating equations to assess associations between mental health (PHQ-4 score) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender, and rural/urban residence. Results: Mental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly and independently associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.041 SD units; 95% Confidence Interval 0.030 - 0.053), government stringency index (0.060 SD units; 0.048 - 0.072), self-reported major financial impacts (0.45 SD units; 0.41-0.49), and COVID-19 infection in the household (0.11 SD units; 0.07-0.16). Conclusion: While the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-age and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics.

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Section: Discussionsupporting

confidence: 84%

Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nation-wide survey

Nichols,

Petrosyan,

Khobragade

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Our results on mental health during the lockdown period align with a large number of studies that have reported high mental health symptom burden in the initial lockdown stage of the pandemic in India 33 34. The literature on mental health outcomes in later stages of the pandemic in India is more scarce and somewhat mixed; studies have reported both increasing and decreasing symptom burden over time 26 35 36. Our findings suggest that such inconsistent evidence could be due to differences in the timing of survey waves and longitudinal follow-ups; we found both increasing and decreasing symptom burden during different time periods.…”

Section: Discussionsupporting

confidence: 66%

Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nationwide survey

Nichols,

Petrosyan,

Khobragade

et al. 2024

BMJ Glob Health

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IntroductionThe COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over 2 years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context.MethodsWe used data from the Real-Time Insights of COVID-19 in India cohort study (N=3709). We used covariate-adjusted linear regression models with generalised estimating equations to assess associations between mental health (Patient Health Questionnaire (PHQ-4) score; range 0–12) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender and rural/urban residence.ResultsMental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.10 units; 95% CI 0.06 to 0.13), government stringency index (0.14 units; 95% CI 0.11 to 0.18), self-reported major financial impacts (1.20 units; 95% CI 1.09 to 1.32) and COVID-19 infection in the household (0.36 units; 95% CI 0.23 to 0.50).ConclusionWhile the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-aged and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics.

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“…Females are slightly over-represented in the sample (51.96% females vis-à-vis 48.04% males). Given the absence of conclusive evidence on whether COVID-19 affected women more or less,[ 15 , 29 ] it is not easy to determine how this will affect the results. On the other hand, men are more likely to be employed, and in patriarchal South Asian societies, the stigma of failing to provide for their family is more on men.…”

Section: Resultsmentioning

confidence: 99%

Impact of economic shocks on mental health during COVID-19: A longitudinal study of adult residents of Indian metropolitan cities

Husain

Dutta

Ghosh

et al. 2023

Indian Journal of Psychiatry

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Background: The causal impact of income shocks on mental well-being in developing countries is an under-researched area. The COVID-19 pandemic, along with the economic recession caused by the lockdowns to reduce transmission, provides a natural experimental setting to examine the causal impact of a decline in monthly per capita expenditure (MPCE) on mental health of the general population in India during the pandemic. Aim: To evaluate the impact of income shocks on mental health of adults in metro cities during the COVID-19 pandemic. Materials and Methods: The data were collected using the abridged version of the Depression Anxiety Stress Schedule administered through a telephonic survey on adult residents of six metropolitan cities in September–August 2020 and July–August 2021. Results: In the present study, 994 adults participated from six metropolitan cities. Average treatment effects were estimated using Propensity Score Matching. The mean normalized scores are significantly higher for respondents whose MPCE had fallen (treated) vis-à-vis respondents whose MPCE had remained same or increased (control): anxiety (0.21 for treated vs –0.19 for control), stress (0.16 vs –0.14), and depression (0.04 vs –0.19). Propensity score matching reveals that the normalized scores for anxiety, stress, and depression were 33 (95% confidence intervals, CI: 20.0–46.7), 25 (95% CI: 12.9–36.9), and 36 (95% CI: 18.6–53.1) higher among the treated group vis-a-vis control group. The ATET was 34 (95% CI: 18.9–48.9), 26 (95% CI: 10.1–42.9), and 32 (955 CI: 12.3–50.7) for these three outcomes, respectively. The post-estimation tests indicated that the results are valid. Conclusions: The study advocates that policies to ensure income security should be made an integral part of the response packages to tackle pandemics like COVID-19.

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Change in mental health during the COVID-19 pandemic: a longitudinal study of residents of Indian metropolitan cities

Cited by 6 publications

References 63 publications

Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nation-wide survey

Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nation-wide survey

Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nationwide survey

Impact of economic shocks on mental health during COVID-19: A longitudinal study of adult residents of Indian metropolitan cities

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