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Abstract
Background: The COVID-19 crisis poses global mental health and global economy challenges. However, there is a lack of longitudinal research investigating whether financial instability and social disruption may increase the risk of developing mental health problems over time that may potentially outlast the pandemic. Methods: We conducted an online survey for members of the general population (n = 2703) in Germany during the twelve months spanning from April 2020 to March 2021. We investigated the development of COVID-19 related psychological distress, the number of unemployed people, federal government debt, income distribution, and loneliness over the time period. Results: Over a period of twelve months, 53.6% of respondents in Germany reported experiencing psychological distress, varying from mild levels, 34.2%, to severe levels, 19.4%, of distress. High federal government debt, high incident COVID-19 cases, low incomes, and the prevalence of loneliness were found to be associated with increased long-term mental health problems. Psychological distress scores were most strongly increased in female and young respondents as well as those who reported fewer years of education, low income, and higher loneliness. Conclusions: Our study highlights factors that have a long-term impact on mental health amid the COVID-19 pandemic. We suggest that specific mental-health services could be offered to support high-risk groups experiencing financial fragility and loneliness. For purposes of safeguarding their mental health there is a need to monitor and track such risk factors in real time.
Highlights
The COVID-19 pandemic poses a great challenge for global mental health [1,2,3] and calls for systemic responses to address mental health needs [4]
We found that psychological distress was significantly predicted by “federal government debt” as well as “the number of unemployed people” in both males and females
In line with our hypothesis, we found that increased federal government debt, a high incident of COVID-19 cases, low income, and high levels of selfreported loneliness were associated with increased psychological distress over 12 months of the pandemic in Germany
Summary
The COVID-19 pandemic poses a great challenge for global mental health [1,2,3] and calls for systemic responses to address mental health needs [4] Public health strategies such as quarantine, social distancing, and isolation, limit the transmission of COVID-19. A meta-analysis of 50 studies amid COVID-19 showed that the pooled prevalence of psychological problems included poor sleep quality (40%), stress (34%), psychological distress (34%), insomnia (30%), post-traumatic stress symptoms (27%), anxiety (26%) and depression (26%) [10] The burden of these psychological problems was highest among COVID-19 patients followed by healthcare workers and the general population [10]. High incident COVID-19 cases, low incomes, and the prevalence of loneliness were found to be associated with increased long-term mental health problems
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