Depression and anxiety symptoms in young adults before and during the COVID-19 pandemic: evidence from a Canadian population-based cohort

  1. Kia Watkins-Martin
  2. Massimiliano Orri
  3. Marie-Hélène Pennestri
  4. Natalie Castellanos-Ryan
  5. Simon Larose
  6. Jean-Philippe Gouin
  7. Isabelle Ouellet-Morin
  8. Nicholas Chadi
  9. Frederick Philippe
  10. Michel Boivin
  11. Richard E. Tremblay
  12. Sylvana Côté
  13. Marie-Claude Geoffroy

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Abstract

Background

Concerns have been raised that the COVID-19 pandemic could increase risk for adverse mental health outcomes, especially in young adults, a vulnerable age group. We investigated changes in depression and anxiety symptoms (overall and severe) from before to during the pandemic, as well as whether these changes are linked to COVID-19-related stressors and pre-existing vulnerabilities in young adults followed in the context of a population-based cohort.

Method

Participants (n = 1039) from the Quebec Longitudinal Study of Child Development reported on their depression (Centre for Epidemiological Studies Depression Scale, short form) and anxiety (General Anxiety Disorder-7 Scale) symptoms and completed a COVID-19 questionnaire during the first wave of the COVID-19 pandemic in the summer of 2020 (age 22 years). Assessments at age 20 (2018) were used to estimate pre-pandemic depression and anxiety symptom severity.

Results

While mean levels of depression and anxiety symptoms did not change from before to during the first wave of the COVID-19 pandemic (e.g., the mean of depressive symptoms was 9.30 in 2018 and 9.59 in 2020), we observed a slight increase in rates of severe depression (scores ≥ 21) from before (6.1%) to during (8.2%) the pandemic. Most COVID-19-related variables (e.g., loss of education/occupation, frequent news-seeking) – except living alone – and most pre-existing vulnerabilities (e.g., low SES, low social support) were not associated with changes in depression or anxiety symptoms. However, results varied as a function of pre-pandemic levels of depression and anxiety: depression and anxiety symptoms increased among adults with the lowest levels of symptoms before the pandemic, while they decreased among those with the highest levels of symptoms, possibly reflecting a regression to the mean.

Conclusions

Depression and anxiety symptoms in young adults from Québec in Summer 2020 were mostly comparable to symptoms reported in 2018. Most COVID-19-related stressors and pre-existing vulnerabilities were not associated with changes in symptoms, except living alone and pre-existing symptoms of depression and anxiety. However, the increased rate of severe depression warrants further investigation.

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  1. Version published to 10.1186/s12991-021-00362-2
  2. Version published to 10.1101/2021.04.23.21255994v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.04.23.21255994: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: The QLSCD, conducted by the Institut de la Statistique du Québec (ISQ; 17), was approved by ethical committees of the ISQ and the CHU Sainte-Justine Hospital Research Centre and written informed consent was obtained.
    Consent: The QLSCD, conducted by the Institut de la Statistique du Québec (ISQ; 17), was approved by ethical committees of the ISQ and the CHU Sainte-Justine Hospital Research Centre and written informed consent was obtained.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Measures: Statistical analyses: All statistical analyses were conducted in IBM SPSS, version 26, using cohort weights to ensure representativeness of the sample.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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: We detected the following sentences addressing limitations in the study:
    We acknowledge the following limitations. As in all longitudinal surveys, attrition occurred over the years and the most vulnerable individuals were underrepresented. Although all analyses were weighted, such differential attrition could potentially result in underestimation of the rates of anxiety and depression and consequently of the mental impact of Covid-19. Mental health outcomes were measured by self-report questionnaires, which do not provide clinical diagnoses. While we were able to use longitudinal data with mental health assessments before and during the Covid-19 pandemic, it is difficult to differentiate between mental health changes attributable to the pandemic versus developmental changes that are typical for this age group. Conclusion: On average, depressive and anxiety symptoms did not significantly change during the first wave of the COVID-19 pandemic among young adults, although the prevalence of severe depression did increase. While the majority of the young adults showed a pattern of symptoms consistent with adaptation to the pandemic, these findings underscore the need for facilitating access to treatment for the subgroup of individuals who may be newly struggling with severe symptoms of depression. Future studies should track the mental health of young adults throughout the subsequent waves of the Covid-19 pandemic after Summer 2020.

    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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  4. Version published to 10.1101/2021.04.23.21255994v1 on medRxiv