Depressive and anxiety symptoms during the COVID-19 pandemic: A two-year follow-up

Abstract

Background: There has been much research into the mental health impact of the COVID-19 pandemic and how it is related to time-invariant individual characteristics (e.g. age and gender). However, there is still a lack of research showing long-term trajectories of mental health across different stages of the pandemic. And little is known regarding the longitudinal association of time-varying contextual and individual factors (e.g. COVID-19 policy response and pandemic intensity) with mental health outcomes. This study aimed to provide a longitudinal profile of how depressive and anxiety symptoms changed by month between March 2020 and April 2022, and to examine their longitudinal associations with time-varying contextual and individual level factors. Methods and findings: Drawing data from a large panel study of over 58,000 adults living in England, we showed that mental health changes were largely in line with changes in COVID-19 policy response and pandemic intensity. Further, data were analysed using fixed-effects, with models fitted separately across three stages of the COVID-19 pandemic. We found that more stringent policy response was associated with increased mental health symptoms, in particular during lockdown periods. Higher COVID-19 deaths were also associated with poorer mental health, but this association weakened over time. Finally, there was also evidence for the longitudinal association of mental health with individual level factors, including confidence in government/healthcare/essentials, COVID-19 knowledge, COVID-19 stress, COVID-19 infection and social support. Conclusions: Our results provided empirical evidence on how changes in contextual and individual level factors were related to depressive and anxiety symptoms. While some factors clearly acted as consistent predictors of mental health during a pandemic, other factors were dependent on the specific situations occurring within society. This could provide important implications for policy making and for a better understanding of mental health of the general public during a national or global health crisis.

Impact of social isolation caused by the COVID-19 pandemic on the mood profile of active and sedentary older adults: physical activity as a protective factor

“…For the categorization of variables, a likelihood test was used, as proposed by Bu et al ( 37 ), using a proportion of 0.5. Variables were included in the adjusted model regardless of the p -value of the crude analysis.…”

How pharmacy teams can provide health education

“…Indeed, by May 2020 as many as 29% of participants reported experiencing physiological symptoms of anxiety such as sickness and trembles when they thought about COVID-19 (8). Stress levels regarding catching COVID-19 and becoming ill across the pandemic corresponded with depression and anxiety levels, suggesting that fear of the disease itself influenced mental health (6). However, both our qualitative and quantitative work demonstrated that as people became used to the virus being around and began receiving vaccinations, these stress levels decreased and their relationship to depression and anxiety levels became weaker (6) (9).…”

“…This fluctuation in mental health continued over the second year of the pandemic, with higher levels of depression and anxiety corresponding with an increase in COVID-19 cases and more social distancing restrictions, and lower levels corresponding with fewer restrictions and lower virus levels (6).…”

“…After the vaccine roll-out, the virus was perceived as less of a threat and no longer had the same impact on mental health (6).…”

“…We also discovered that the effects of social restrictions on mental health was not proportional. Increases in low level social restrictions had little impact on mental health, while increases in restrictions that infringed more on social freedoms had more damaging effects (6). Nonetheless, some people had to spend more time at home during the pandemic due to issues including clinical vulnerability, local restrictions, or mobility issues.…”