Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences. Aims: To quantify the prevalence of depression, anxiety and mental wellbeing before and during the COVID-19 pandemic. To identify groups at risk of depression and/or anxiety during the pandemic. Methods: Data were from two generations of the Avon Longitudinal Study of Parents and Children (ALSPAC): the index generation (ALSPAC-young, n=2850, mean age=28), parent's generation (ALSPAC-parents, n=3720, mean age=59), and Generation Scotland (GS, n=4233, mean age=59). Depression was measured using the Short Mood and Feelings Questionnaire (SMFQ) in ALSPAC and the Patient Health Questionnaire (PHQ-9) in GS. Anxiety and mental wellbeing were measured using the Generalised Anxiety Disorder Assessment (GAD-7) and the Short Warwick Edinburgh Mental Wellbeing Scale. Results: Depression during COVID-19 was similar to pre-pandemic levels in ALSPAC-young, but those experiencing anxiety almost doubled during COVID-19: 24% (95% CI: 23%, 26%) compared to pre-pandemic levels of 13% (95% CI: 12%, 14%). In both ALSPAC and Generation Scotland, anxiety and depression during COVID-19 was greater in younger members, in women, in those with preexisting mental/physical health conditions, and in individuals in socioeconomic adversity, even when controlling for pre-pandemic anxiety and depression. Conclusions: These results provide evidence for increased anxiety in young people that is coincident with the pandemic. Specific groups are at elevated risk of depression and anxiety during COVID-19. This is important for planning mental health provisions now and for long-term impact beyond this pandemic.

Effects of the COVID-19 pandemic on primary care-recorded mental illness and self-harm episodes in the UK: a population-based cohort study

“…Using survey data, one study found that socioeconomic deprivation was associated with higher risks of depression and anxiety disorders in adults and young people during the COVID-19 pandemic compared with pre-pandemic levels. 11 The inverse care law, which describes the combination of greater health care need among people living in deprived areas and the lack of additional availability of health services in these areas to meet increased demand, 28 has previously been demonstrated in relation to primary care management of self-harm, with lower referral rates associated with higher incidence and higher levels of deprivation. 29 Our findings suggest that COVID-19 has widened such inequalities, and have implications for general practices in deprived areas managing potential demand.…”

“…Evidence from self-report surveys indicates that short-term increases in the prevalence of mental illness, self-harm, and suicidal ideation might have occurred after implementation of the UK lockdown in March, 2020. 8 , 9 , 10 , 11 Such increases are concerning because non-fatal self-harm is a strong risk factor for suicide. 4 , 12 Direct comparison of prevalence of mental health disorders before and after the COVID-19 pandemic is challenging; however, available evidence indicates that, to date, the prevalence of anxiety and depression during the pandemic has been higher than would be expected for the general population.…”

“… 1 Usual clinical care and social support for people with pre-existing mental illnesses are likely to have been disrupted, which could exacerbate symptoms. 1 Young adults are also at risk from deterioration in their mental health, 9 , 11 , 15 although some studies have reported improved mental health during lockdown among this age group. 16 Increased unemployment and financial insecurity are likely to have more severe ramifications for socially disadvantaged groups than less disadvantaged groups, 2 leading to concerns that the pandemic could widen pre-existing inequalities.…”

“… 15 , 17 To date, most evidence regarding the mental health impact of COVID-19 at the national level is from self-report surveys. 11 , 18 However, individuals with pre-existing mental illnesses and older adults are less likely to complete such surveys, which could potentially mask the effects of COVID-19 on these groups. 18 …”

Face covering adherence is positively associated with better mental health and wellbeing: a longitudinal analysis of the CovidLife surveys

“…The outcomes can also categorize individuals as having either poor mental health in a particular domain or not (Kwong et al, 2020). We fit logistic regression models with these outcomes, which give the odds of having poor mental health or wellbeing depending on degree of adherence.…”