The prevalence, incidence, prognosis and risk factors for symptoms of depression and anxiety in a UK cohort during the COVID-19 pandemic

  1. Ru Jia
  2. Kieran Ayling
  3. Trudie Chalder
  4. Adam Massey
  5. Norina Gasteiger
  6. Elizabeth Broadbent
  7. Carol Coupland
  8. Kavita Vedhara

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Abstract

The COVID-19 pandemic has had profound consequences for population mental health. However, it is less clear for whom these effects are sustained.

Aims

To investigate the prevalence, incidence, prognosis and risk factors for symptoms of depression and anxiety in a UK cohort over three distinct periods in the pandemic in 2020.

Method

An online survey was completed by a UK community cohort at three points ( n = 3097 at baseline, n = 878 completed all surveys): April (baseline), July to September (time point 2) and November to December (time point 3). Participants completed validated measures of depression and anxiety on each occasion, and we prospectively explored the role of sociodemographic and psychological factors (loneliness, positive mood and perceived risk of and worry about COVID-19) as risk factors.

Results

Depression (Patient Health Questionnaire-9 means: baseline, 7.69; time point 2, 5.53; time point 3, 6.06) and anxiety scores (Generalised Anxiety Disorder-7 means: baseline, 6.59; time point 2, 4.60; time point 3, 4.98) were considerably greater than pre-pandemic population norms at all time points. Women reported greater depression and anxiety symptoms than men. Younger age, history of mental health disorder, more COVID-19-related negative life events, greater loneliness and lower positive mood at baseline were all significant predictors of poorer mental health at time point 3.

Conclusions

The negative impact of the COVID-19 pandemic on mental health has persisted to some degree. Younger people and individuals with prior mental health disorders are at greatest risk. Easing of restrictions and resumption of social interaction could mitigate the risk factors of loneliness and positive mood.

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  1. Version published to 10.1192/bjo.2022.34
  2. ScreenIT

    SciScore for 10.1101/2021.06.11.21258750: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: Recruitment and eligibility: The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
    Consent: Potential participants were directed to the study website (www.covidstressstudy.co.uk) through which they accessed the information sheet, consent form and online survey.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    BlindingThe University of Nottingham (Deleted for blind review) Faculty of Medicine and Health Sciences (ref: 506-2003) and the NHS Health Research Authority (ref: 20/HRA/1858) approved all study procedures.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were performed using STATA (version 16).
    STATA
    suggested: (Stata, RRID:SCR_012763)

    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:
    Positive psychological interventions, featuring elements such as mindfulness, gratitude, and ‘best possible self’ could be among the armoury of approaches we take to address both loneliness and positive mood.(30, 31) However, a range of other approaches are available, such as enhancing social skills and social support, relaxations, and creative activities, all of which have been shown to improve these outcomes.(30, 31) Some limitations of this work are worthy of note. First, a significant number of participants (72%) dropped out throughout the survey period. This is comparable to other cohorts established early in the pandemic.(22, 32) Those who dropped out were also significantly different compared with those who completed all three surveys, both in demographic characteristics and baseline mental health. The high proportion of drop-outs is likely to have led to an under-estimation of depression and anxiety in our cohort. This was supported by the higher estimated means and prevalence of depression and anxiety from multiple imputations. Indeed, reaching and retaining individuals most in need of mental health support is not uncommon in such research.(22) The high proportion of keyworkers in our cohort (50% at baseline) may have also contributed to the high drop-out rate. These individuals were, by definition, providing essential services throughout the pandemic and will, therefore, have had less capacity to remain engaged in the research. However, it is unlikely that the socio...

    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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  3. Version published to 10.1101/2021.06.11.21258750v1 on medRxiv