The adverse impact of consecutive COVID-19 waves on mental health

  1. Jan Sebastian Novotný
  2. Juan Pablo Gonzalez-Rivas
  3. Šárka Kunzová
  4. Mária Skladaná
  5. Anna Pospíšilová
  6. Anna Polcrová
  7. Maria Vassilaki
  8. Jose Ramon Medina-Inojosa
  9. Francisco Lopez-Jimenez
  10. Yonas Endale Geda
  11. Gorazd Bernard Stokin

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Abstract

Background

Although several studies documented the impact of COVID-19 on mental health, the long-term effects of COVID-19 on mental health remain unclear.

Aims

To examine longitudinal changes in mental health prior to and during the consecutive COVID-19 waves in a well-established probability sample.

Method

An online survey was completed by the participants of the COVID-19 add-on study at 4 timepoints (N 1 =1823, N 2 =788, N 3 =532, N 4 =383): pre-COVID period (2014/2015), 1 st COVID-19 wave (April-May, 2020), 2 nd COVID-19 wave (August-October, 2020) and 3 rd COVID-19 wave (March-April, 2021). Data were collected via a set of validated instruments and analysed using latent growth models.

Results

During the pandemic, we observed a significant increase in stress levels (slope=1.127, P<0.001) and depressive symptoms (slope=1.177, P<0.001). The rate of increase in stress levels (cov=2.167, P=0.002), but not in depressive symptoms (cov=0.558, P=0.10), was associated with the pre-pandemic mental health status of the participants. Further analysis revealed two opposing clusters of factors that influenced mental health: loneliness and COVID-19 showed a negative effect on emotionality, while higher resilience acted protectively. A greater increase in stress was observed in women and younger participants.

Conclusions

The surge in stress levels and depressive symptoms persisted across all three consecutive COVID-19 waves. This surge is attributable to the effect of several risk factors including the status of mental health prior to the COVID-19 pandemic. Our findings have implications for strategies promoting resilience and addressing loneliness to mitigate the mental health impact of COVID-19 pandemic.

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  1. Version published to 10.1101/2021.07.25.21261094v3 on medRxiv
  2. ScreenIT

    SciScore for 10.1101/2021.07.25.21261094: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line AuthenticationAuthentication: E-questionnaire was completed through an online survey module using validated RedCap software (Research Electronic Data Capture) tool16. 330 out of 715 participants who originally enrolled into the Covid-19 add-on study (46%) completed e-questionnaire prior to and during all of the three Covid-19 waves.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    E-questionnaire was completed through an online survey module using validated RedCap software (Research Electronic Data Capture) tool16. 330 out of 715 participants who originally enrolled into the Covid-19 add-on study (46%) completed e-questionnaire prior to and during all of the three Covid-19 waves.
    RedCap
    suggested: (REDCap, RRID:SCR_003445)
    Data analysis and visualization were performed in the R (v.4.1.0) environment with rstatix, sjmisc, ggplot2, and pheatmap packages.
    ggplot2
    suggested: (ggplot2, RRID:SCR_014601)
    pheatmap
    suggested: (pheatmap, RRID:SCR_016418)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.07.25.21261094v2 on medRxiv
  4. Version published to 10.1101/2021.07.25.21261094v1 on medRxiv