Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study

Abstract

ObjectivesPrevious pandemics have resulted in significant consequences for mental health. Here, we report the mental health sequelae of the COVID-19 pandemic in a UK cohort and examine modifiable and non-modifiable explanatory factors associated with mental health outcomes. We focus on the first wave of data collection, which examined short-term consequences for mental health, as reported during the first 4–6 weeks of social distancing measures being introduced.DesignCross-sectional online survey.SettingCommunity cohort study.ParticipantsN=3097 adults aged ≥18 years were recruited through a mainstream and social media campaign between 3 April 2020 and 30 April 2020. The cohort was predominantly female (n=2618); mean age 44 years; 10% (n=296) from minority ethnic groups; 50% (n=1559) described themselves as key workers and 20% (n=649) identified as having clinical risk factors putting them at increased risk of COVID-19.Main outcome measuresDepression, anxiety and stress scores.ResultsMean scores for depression (x- =7.69, SD=6.0), stress (x- =6.48, SD=3.3) and anxiety (x- = 6.48, SD=3.3) significantly exceeded population norms (all p<0.0001). Analysis of non-modifiable factors hypothesised to be associated with mental health outcomes indicated that being younger, female and in a recognised COVID-19 risk group were associated with increased stress, anxiety and depression, with the final multivariable models accounting for 7%–14% of variance. When adding modifiable factors, significant independent effects emerged for positive mood, perceived loneliness and worry about getting COVID-19 for all outcomes, with the final multivariable models accounting for 54%–57% of total variance.ConclusionsIncreased psychological morbidity was evident in this UK sample and found to be more common in younger people, women and in individuals who identified as being in recognised COVID-19 risk groups. Public health and mental health interventions able to ameliorate perceptions of risk of COVID-19, worry about COVID-19 loneliness and boost positive mood may be effective.

The Influence of the COVID-19 Pandemic on Mental Well-Being and Psychological Distress: Impact Upon a Single Country

“…Psychological distress is also higher in women and those from deprived areas. These findings are broadly in line with previous studies (6,8,11,12) but represent a more extreme effect.…”

“…There have also been reports of far greater anxiety due to COVID-19 in older adults in the UK (46). However, similar findings that the mental health of young adults has been most affected have been reported in previous studies published on this topic to date (6,8,11,12). Any stressor that affects the whole population will produce more people entering the "severe" category for those groups that already have lower well-being scores before the stressor, via a simple "additive" model.…”

“…These increases were greater in the younger age groups, and for women. This pattern of results has been replicated by other studies that occurred in the early phase of the pandemic [e.g., (10)(11)(12)] and have been extended to show high levels of thoughts of self-harm and suicide in the first month of the lockdown in the UK (13) with, again, a higher incidence rate for women.…”

“…We hypothesized that psychological well-being would be reduced due to COVID-19 and that this effect would be greater in women than in men, in those of a younger age, and in those people living in areas of high deprivation (8). In line with this reduction in psychological wellbeing, we hypothesized that levels of mental distress would be high, with the same demographic factors aggravating these levels of distress (6,8,(10)(11)(12).…”

“…Second, the present study examined a period deeper into the pandemic. For instance, most studies (4,6,8,(10)(11)(12) gathered data within the first few weeks of the pandemic, whereas the data for the present study were gathered 11-16 weeks into the lockdown period. It is possible that psychological well-being will be more severely impacted after a prolonged exposure to pandemic related stressors.…”