The prevalence, incidence and risk factors of mental health problems and mental health services use before and 9 months after the COVID-19 outbreak among the general Dutch population. A 3-wave prospective study

Abstract

Objectives. Gain insight in the effects of the COVID-19 pandemic on the prevalence, the incidence and risk factors of mental health problems among the Dutch general population and different age groups in November-December 2020, compared to the prevalence, incidence, and risk factors in the same period in 2018 and 2019. More specifically, the prevalence, incidence and risk factors of anxiety and depression symptoms, sleep problems, fatigue, disabilities due to health problems, use of medicines for sleep problems, medicines for anxiety and depression, and mental health services use. Methods. We extracted data from the LISS (Longitudinal Internet studies for the Social Sciences) panel that is based a probability sample of the Dutch population of 16 years and older by Statistics Netherlands. We used three waves of the longitudinal Health module held in November-December 2018 (T1), November-December 2019 (T2) and November-December 2020 (T3), and selected respondents who were 18 years and older at T1. Data were weighted using 16 demographics profiles of the Dutch adult population (Nstudy sample=4,064). The course of mental health problems was examined with repeated measures multivariate logistic regression analyses, and the differences in incidence with multivariate logistic regression analyses. In both types of analyses, we controlled for sex, age, marital status, employment status, education level and physical disease. Results. The repeated measures multivariate logistic regression analyses among the total study sample did not reveal a significant increase in the prevalence of anxiety and depression symptoms, sleep problems, fatigue, disabilities due to health problems, use of medicines for sleep problems, medicines for anxiety and depression, and mental health services use in November-December 2020, compared to November-December 2018 and 2019 (that is, T3 did not differ from T1 and T2). Among the four different age categories (18-34, 35-49, 50-64, and 65 years old and older respondents), 50-64 years respondents had a significantly lower prevalence of anxiety and depression symptoms at T3 than at T1 and T2, while T1 and T2 did not differ. A similar pattern among 65+ respondents was found for mental health services use. We found no indications that the incidence of examined health problems at T2 (no problem at T1, problem at T2) and T3 (no problem at T2, problem at T3) differed. Risk factors for mental health problems at T2 were mostly similar to risk factors at T3; sex and age were less associated with sleep problems at T3, compared to T2. Conclusions. The prevalence, incidence and risk factors of examined mental health problems examined nine months after the COVID-19 outbreak appear to be very stable across the end of 2018, 2019 and 2020 among the Dutch adult population and different age categories, suggesting that the Dutch adult population (20 years and older) in general is rather resilient given all disruptions due to this pandemic.

Comparison of Mental Health Symptoms Prior to and During COVID-19: Evidence from a Systematic Review and Meta-analysis of 134 Cohorts

“…All cohorts reported COVID-19 outcome data collected between March and June 2020. Two large national probability-based cohorts from the United Kingdom 30, 34 and the Netherlands 36, 37, 41 and a cohort of people with a pre-existing medical condition 61 also included data collected between September and November 2020.…”

“…There were 7 studies 30, 32–37 that reported on 5 different general population cohorts, including large national probability-based samples from the United Kingdom (N = 10,918 to 15,376) 30, 34 and the Netherlands (N = 3,983 to 4,064) 36, 37 and 3 convenience samples with 102 to 218 participants per study from Germany, 32 Italy 33 and from multiple countries via an online crowdsourcing platform. 35…”

“…There were 5 studies of older adults, including one (N = 1,679) 41 that reported subgroup data from the large Dutch national probability sample. 36, 37 There were also large nationally sampled studies from the United Kingdom (N = 3,281), 38 Sweden (N = 1,071), 39 and China (N = 6,467) 42 plus a small study from Scotland (N = 137). 40…”

“…Ratings of adequacy of methods and reporting are shown in Table 2. The two large national probability-based cohorts from the United Kingdom 30, 34 and the Netherlands 36, 37 were rated “Yes” on all items 36, 37, 41 or all but one item. 30, 34 Another large national study from China 42 had access to pre-COVID-19 data from over 188,000 nationally representative older results, but the COVID-19 follow-up (rated “No”) was essentially a convenience sample, as participants (N = 6,467) were recruited via a publicity campaign.…”

Black Americans demonstrate comparatively low levels of depression and anxiety during the COVID-19 pandemic

“…On the other hand, a longitudinal study in the UK found that racial and ethnic minorities experienced a greater increase in mental distress after the onset of the pandemic as measured by the General Health Questionnaire-12, possibly due in part to lockdowns and physical distancing [ 35 ]. A separate study in the Netherlands found no increase in anxiety or depression at all in the general population after the pandemic began and noted a stable employment situation relative to the U.S. which may play a large role [ 36 ]; the Netherlands’ universal healthcare system and better social safety net (relative to the US) may also explain this difference. With further investigation, these differences may shed some light on the factors contributing to the racial and ethnic disparities in mental health in the US.…”