Trajectories of depression and anxiety symptoms during the COVID‐19 pandemic in a representative Australian adult cohort

Abstract

Objectives To estimate initial levels of symptoms of depression and anxiety, and their changes during the early months of the COVID‐19 pandemic in Australia; to identify trajectories of symptoms of depression and anxiety; to identify factors associated with these trajectories. Design, setting, participants Longitudinal cohort study; seven fortnightly online surveys of a representative sample of 1296 Australian adults from the beginning of COVID‐19‐related restrictions in late March 2020 to mid‐June 2020. Main outcome measures Symptoms of depression and anxiety, measured with the Patient Health Questionnaire (PHQ‐9) depression and Generalised Anxiety Disorder (GAD‐7) scales; trajectories of symptom change. Results Younger age, being female, greater COVID‐19‐related work and social impairment, COVID‐19‐related financial distress, having a neurological or mental illness diagnosis, and recent adversity were each significantly associated with higher baseline depression and anxiety scores. Growth mixture models identified three latent trajectories for depression symptoms (low throughout the study, 81% of participants; moderate throughout the study, 10%; initially severe then declining, 9%) and four for anxiety symptoms (low throughout the study, 77%; initially moderate then increasing, 10%; initially moderate then declining, 5%; initially mild then increasing before again declining, 8%). Factors statistically associated with not having a low symptom trajectory included mental disorder diagnoses, COVID‐19‐related financial distress and social and work impairment, and bushfire exposure. Conclusion Our longitudinal data enabled identification of distinct symptom trajectories during the first three months of the COVID‐19 pandemic in Australia. Early intervention to ensure that vulnerable people are clinically and socially supported during a pandemic should be a priority.

Testing the Differential Impact of an Internet-Based Mental Health Intervention on Outcomes of Well-being and Psychological Distress During COVID-19: Uncontrolled Intervention Study

“…Despite this attenuated impact, various studies point to an immediate impact on outcomes of well-being and distress in Australia, particularly in at-risk population groups [ 45 - 48 ]. For instance, Batterham et al [ 49 ] found that participants in Australia who had financial distress, social impairment, and work impairment were most impacted. Similarly, Li et al [ 50 ] found that young people, who due to their age are already at higher risk of mental health problems, showed elevated mental health problems.…”

Increased Risk Perception, Distress Intolerance and Health Anxiety in Stricter Lockdowns: Self-Control as a Key Protective Factor in Early Response to the COVID-19 Pandemic

“…Thus, our results may only be generalized to this group. Since various studies suggest that women in particular suffered from mental health issues during the early lockdown restrictions (Batterham et al, 2021;Fancourt et al, 2021;Saunders et al, 2021), our results may be valid for the most relevant population.…”

“…The PSIW scores proved to be a promising measure for investigating lockdown-dependent effects. Our sample comprised almost exclusively adult women, who were the most negatively affected by lockdown measures in the early stage of the COVID-19 pandemic (Batterham et al, 2021;Fancourt et al, 2021;Saunders et al, 2021).…”

“…In an early stage of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, several countries reacted with strict lockdown and quarantine policies, causing higher levels of mental health symptoms. A higher risk of increased anxiety and depressive symptoms was reported for younger, female, lower-educated, lower-earning persons, or persons living alone (Batterham et al, 2021;Fancourt et al, 2021;Saunders, et al, 2021). Prati and Mancini (2021) in their recent meta-analysis found small average effects of lockdowns on anxiety and depression, with heterogeneous effect sizes that might be ascribable to differences in lockdowns, samples and study designs.…”

“…During the lockdowns between March and May 2020 however, the initially high levels of anxiety and depressive symptoms decreased rapidly (Batterham et al, 2021;Saunders et al, 2021), indicating that protective psychological factors may help with adapting to the circumstances (cf. Prati & Mancini, 2021).…”