Depressive and anxiety symptoms during the COVID-19 pandemic: A two-year follow-up
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Abstract
Background
There has been much research into the mental health impact of the COVID-19 pandemic and how it is related to time-invariant individual characteristics (e.g. age and gender). However, there is still a lack of research showing long-term trajectories of mental health across different stages of the pandemic. And little is known regarding the longitudinal association of time-varying contextual and individual factors (e.g. COVID-19 policy response and pandemic intensity) with mental health outcomes. This study aimed to provide a longitudinal profile of how depressive and anxiety symptoms changed by month between March 2020 and April 2022, and to examine their longitudinal associations with time-varying contextual and individual level factors.
Methods and findings
Drawing data from a large panel study of over 58,000 adults living in England, we showed that mental health changes were largely in line with changes in COVID-19 policy response and pandemic intensity. Further, data were analysed using fixed-effects, with models fitted separately across three stages of the COVID-19 pandemic. We found that more stringent policy response was associated with increased mental health symptoms, in particular during lockdown periods. Higher COVID-19 deaths were also associated with poorer mental health, but this association weakened over time. Finally, there was also evidence for the longitudinal association of mental health with individual level factors, including confidence in government/healthcare/essentials, COVID-19 knowledge, COVID-19 stress, COVID-19 infection and social support.
Conclusions
Our results provided empirical evidence on how changes in contextual and individual level factors were related to depressive and anxiety symptoms. While some factors clearly acted as consistent predictors of mental health during a pandemic, other factors were dependent on the specific situations occurring within society. This could provide important implications for policy making and for a better understanding of mental health of the general public during a national or global health crisis.
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SciScore for 10.1101/2022.05.24.22275529: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Field Sample Permit: Following the monthly data collection, additional follow-ups were carried out in January 2022 and March 2022.
IRB: The study was approved by the UCL Research Ethics Committee [12467/005] and all participants gave informed consent.
Consent: The study was approved by the UCL Research Ethics Committee [12467/005] and all participants gave informed consent.Sex as a biological variable not detected. Randomization When the survey was converted to monthly, participants were randomly assigned into four groups. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your data.
Results from LimitationRecogniz…SciScore for 10.1101/2022.05.24.22275529: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Field Sample Permit: Following the monthly data collection, additional follow-ups were carried out in January 2022 and March 2022.
IRB: The study was approved by the UCL Research Ethics Committee [12467/005] and all participants gave informed consent.
Consent: The study was approved by the UCL Research Ethics Committee [12467/005] and all participants gave informed consent.Sex as a biological variable not detected. Randomization When the survey was converted to monthly, participants were randomly assigned into four groups. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, our study is not without any limitation. First, it is important to acknowledge that our data were from a non-probability sample. Despite the effort to recruit a heterogeneous sample and make our sample representative to the adult population in England by weighting, there is still the possibility of potential biases due to omitting other demographic factors that could be associated with survey participation in the weighting process. We therefore advice caution when generalising these findings to the population. Moreover, the fixed effects approach cannot rule out the possibility of bidirectional associations of depressive/anxiety symptoms with individual level factors. This calls for further research in this area. Since July 2021, England removed most of its legal restrictions, making it one of the countries with the least strict COVID-19 policies (see Figure S4) and highest vaccine coverage (Figure S5) at the time of writing. The United Kingdom is also one of the countries with highest cumulative number of COVID-19 cases and deaths (Figure S6-S7). But there is a lot of variation in COVID-19 situation and policy stringency across countries and over time. Our results provided empirical evidence on how changes in contextual measures, including stringency index, COVID-19 cases, COVID-19 deaths and national vaccination, as well as individual level factors, such as COVID-19 related stress, COVID-19 infection and social support were related to depressive and anxiety symptom...
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.
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