Predictors of mental health during the Covid-19 pandemic in the US: Role of economic concerns, health worries and social distancing

  1. Fabrice Kämpfen
  2. Iliana V. Kohler
  3. Alberto Ciancio
  4. Wändi Bruine de Bruin
  5. Jürgen Maurer
  6. Hans-Peter Kohler

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Abstract

Despite the profound health and economic implications of Covid-19, there is only limited knowledge to date about the role of economic concerns, health worries and social distancing for mental health outcomes during the pandemic. We analyze online survey data from the nationally representative “Understanding America Study” (UAS) covering the period of March 10-31st 2020 (sample size: 6,585). Mental health is assessed by the validated PHQ-4 instrument for measuring symptoms of depression and anxiety. About 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms over the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential implications of the virus for respondents’ own health and social distancing also predicted increases in symptoms of depression and anxiety during the early stages of the pandemic in the US, albeit less strongly. Our findings point towards the possibility of a major mental health crisis unfolding simultaneously with the pandemic, with economic concerns being a key driving force of this crisis. These results highlight the likely importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response.

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  1. Version published to 10.1371/journal.pone.0241895
  2. ScreenIT

    SciScore for 10.1101/2020.06.06.20124198: (What is this?)

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

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    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:
    Limitations: Our analysis data did not allow to firmly establish causality. Nevertheless, our findings are robust to adjustments for respondents’ past mental health history that could potentially confound our results. While our sample is representative for the US adult population, our estimates did not include minors below age 18, for whom economic concerns may not be at the forefront, but whose mental well-being maybe as well affected by the disruption of their daily routines, schooling, extra-curriculum activities, exposure to stress in the household and increased domestic abuse and violence. PhQ-4 may capture only probable depression/anxiety or psychological distress in response to the abnormality of the Covid-19 pandemic and its implications as opposed to clinical diagnostic, which does not reduce the importance of our findings for public health policy. Although most adults report only mild to moderate levels of depression and anxiety, these may nonetheless affect many important outcome such as work productivity and savings [37,38]

    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.

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  3. Version published to 10.1101/2020.06.06.20124198v1 on medRxiv