Depression, anxiety and stress during the COVID-19 pandemic: results from a New Zealand cohort study on mental well-being

Gasteiger, Norina; Vedhara, Kavita; Massey, Adam; Jia, Ruofei; Ayling, Kieran; Chalder, Trudie; Coupland, Carol; Broadbent, Elizabeth

doi:10.1136/bmjopen-2020-045325

Cited by 110 publications

(125 citation statements)

References 46 publications

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“…This aligns with prior research identifying high stress, anxiety and depression in healthcare trainees, pre-pandemic (e.g., health professions: [48], medicine: [49][50][51], nursing: [52,53]. The COVID-19 pandemic is associated with high levels of psychological distress, globally [9,54,55], particularly in healthcare workers [56][57][58][59][60], younger populations [54,61,62] and student groups [4,[6][7][8][9][10]15,63], including healthcare trainees [5,13].…”

Section: Discussionsupporting

confidence: 80%

Psychological Impacts of COVID-19 on Healthcare Trainees and Perceptions towards a Digital Wellbeing Support Package

Blake

Mahmood

Dushi

et al. 2021

IJERPH

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We explore the impact of COVID–19 on the psychological wellbeing of healthcare trainees, and the perceived value of a digital support package to mitigate the psychological impacts of the pandemic (PoWerS Study). This mixed–methods study includes (i) exposure to a digital support package; (ii) participant survey to assess wellbeing, perceptions of work and intervention fidelity; (iii) semi–structured qualitative interviews. Interviews were digitally recorded and transcribed, data were handled and analysed using principles of thematic framework analysis. Participants are 42 health and medical trainees (9M, 33F) from 13 higher education institutions in the UK, studying during the COVID–19 pandemic. Survey findings showed high satisfaction with healthcare training (92.8%), but low wellbeing (61.9%), moderate to high perceived stressfulness of training (83.3%), and high presenteeism (50%). Qualitative interviews generated 3 over–arching themes, and 11 sub–themes. The pandemic has impacted negatively on emotional wellbeing of trainees, yet mental health is not well promoted in some disciplines, and provision of pastoral support is variable. Disruption to academic studies and placements has reduced perceived preparedness for future clinical practice. Regular check–ins, and wellbeing interventions will be essential to support the next generation health and care workforce, both in higher education and clinical settings. The digital support package was perceived to be accessible, comprehensive, and relevant to healthcare trainees, with high intervention fidelity. It is a useful tool to augment longer–term provision of psychological support for healthcare trainees, during and after the COVID–19 pandemic.

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Section: Discussionsupporting

confidence: 80%

Psychological Impacts of COVID-19 on Healthcare Trainees and Perceptions towards a Digital Wellbeing Support Package

Blake

Mahmood

Dushi

et al. 2021

IJERPH

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“…The sense of pessimism surrounding the lockdown may have led some respondents to exaggerate what had been lost since before the pandemic, and others to romanticise life immediately prior to lockdown - although a strength of this timing was that it allowed respondents to reflect back on the longest possible sustained period at Level 1. Our study thus complements existing studies on social attitudes and behaviours in the immediate aftermath of the 2020 lockdown, and shows how many of the trends reported in that research, including an aversion to mixing with strangers, 48 ongoing uncertainty about the trajectory of the pandemic, 49 and worsening mental health, 50 51 appear to have persisted for many months, despite minimal domestic COVID-19 cases. It also goes beyond those studies by offering a more integrated understanding of how respondents are experiencing and evaluating their social life, engaging with respondents’ accounts of the pandemic on their own terms, and identifying age and medical vulnerability to COVID-19 as risk factors for social disconnection.…”

Section: Discussionsupporting

confidence: 74%

Social relationships and activities following elimination of SARS-CoV-2: a qualitative cross-sectional study

Long

Appleton

Davies

et al. 2021

Preprint

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Objectives To investigate how successfully SARS-CoV-2 elimination strategies fulfil their promise of allowing a return to a "normal" social life, and to identify obstacles and challenges that may inhibit the realisation of this goal. Design Qualitative cross-sectional survey. Setting New Zealand community cohort. Participants 1040 respondents entered the study (18-90 years, M = 48.18.11, SD = 15.52, 76% women). 966 completed the questions relevant to this article. Participants were recruited via online advertisement campaigns designed to maximise variation in the sample as far as practicably possible. Main outcome measures Thematic analysis of participants' narratives. Results A majority of participants reported that the elimination of SARS-CoV-2 had allowed their life to go back to being "more or less the same" as before the pandemic. A small number indicated the pandemic had inspired them to become more social following elimination. Nevertheless, a sizeable minority of respondents reported being less social, even many months after SARS-CoV-2 had been eliminated. This was often because of fears that the virus might be circulating undetected, or because the March-May 2020 lockdown had led to changes in relationships and personal habits that were not easily reversed. Becoming less social was associated with having an underlying health condition that heightened one's vulnerability to COVID-19 (p = 0.00005) and older age (p = 0.007). Conclusions Elimination strategies can successfully allow the public to return to a pre-pandemic "normal" - or reinvent and improve their social lives should they wish. However, such outcomes are not inevitable. Re-establishing social connections after elimination can sometimes be a challenging process, with which people may need support. Plans for providing such support should be an integral part of elimination strategies.

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“…Our results highlight the greater negative outcomes on all psychosocial variables in gender diverse individuals, which would have been obscured in an analysis by sex alone and adds to the literature highlighting the value in analyzing data by gender. It is important to underscore that being a woman was a significant factor that determined higher anxiety, depression, stress, and loneliness—a finding mirrored in the literature across all continents [ 38 , 39 ]. The novelty of this study, however, is that this effect of being a woman was not impacted by participants’ age, ethnicity, or other sociodemographic variables.…”

Section: Discussionmentioning

confidence: 95%

The influence of sex, gender, age, and ethnicity on psychosocial factors and substance use throughout phases of the COVID-19 pandemic

et al. 2021

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Objectives The SARS-CoV-2 (COVID-19) pandemic has had profound physical and mental health effects on populations around the world. Limited empirical research has used a gender-based lens to evaluate the mental health impacts of the pandemic, overlooking the impact of public health measures on marginalized groups, such as women, and the gender diverse community. This study used a gender-based analysis to determine the prevalence of psychosocial symptoms and substance use (alcohol and cannabis use in particular) by age, ethnicity, income, rurality, education level, Indigenous status, and sexual orientation. Methods Participants in the study were recruited from previously established cohorts as a part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex (RESPPONSE) study. Those who agreed to participate were asked to self-report symptoms of depression, anxiety, pandemic stress, loneliness, alcohol use, and cannabis use across five phases of the pandemic as well as retrospectively before the pandemic. Results For all psychosocial outcomes, there was a significant effect of time with all five phases of the pandemic being associated with more symptoms of depression, anxiety, stress, and loneliness relative to pre-COVID levels (p < .0001). Gender was significantly associated with all outcomes (p < .0001) with men exhibiting lower scores (i.e., fewer symptoms) than women and gender diverse participants, and women exhibiting lower scores than the gender diverse group. Other significant predictors were age (younger populations experiencing more symptoms, p < .0001), ethnicity (Chinese/Taiwanese individuals experiencing fewer symptoms, p = .005), and Indigenous status (Indigenous individuals experiencing more symptoms, p < .0001). Alcohol use and cannabis use increased relative to pre-pandemic levels, and women reported a greater increase in cannabis use than men (p < .0001). Conclusions Our findings highlight the need for policy makers and leaders to prioritize women, gender-diverse individuals, and young people when tailoring public health measures for future pandemics.

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Depression, anxiety and stress during the COVID-19 pandemic: results from a New Zealand cohort study on mental well-being

Cited by 110 publications

References 46 publications

Psychological Impacts of COVID-19 on Healthcare Trainees and Perceptions towards a Digital Wellbeing Support Package

Psychological Impacts of COVID-19 on Healthcare Trainees and Perceptions towards a Digital Wellbeing Support Package

Social relationships and activities following elimination of SARS-CoV-2: a qualitative cross-sectional study

The influence of sex, gender, age, and ethnicity on psychosocial factors and substance use throughout phases of the COVID-19 pandemic

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