Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts.

Alex S F Kwong ,Daniel Smith ,Mark J Adams ,Stanley Zammit ,Paul Moran ,Debbie A Lawlor ,Matthew Hickman ,Drew Altschul ,David Gunnell ,Kate Northstone ,Kate Tilling ,Abraham Reichenberg ,Helen Bould ,Simon Haworth ,Chloë Fawns-Ritchie ,Archie Campbell ,David J Porteous ,Nadia Micali ,Robin Flaig ,Andrew M Mcintosh ,Dheeraj Rai ,Rebecca Pearson ,Naomi Warne ,Nicholas J Timpson

doi:10.1192/bjp.2020.242

Abstract

The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences. To quantify the prevalence of depression, anxiety and mental well-being before and during the COVID-19 pandemic. Also, to identify groups at risk of depression and/or anxiety during the pandemic. Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC) index generation (n = 2850, mean age 28 years) and parent generation (n = 3720, mean age 59 years), and Generation Scotland (n = 4233, mean age 59 years). Depression was measured with the Short Mood and Feelings Questionnaire in ALSPAC and the Patient Health Questionnaire-9 in Generation Scotland. Anxiety and mental well-being were measured with the Generalised Anxiety Disorder Assessment-7 and the Short Warwick Edinburgh Mental Wellbeing Scale. Depression during the pandemic was similar to pre-pandemic levels in the ALSPAC index generation, but those experiencing anxiety had almost doubled, at 24% (95% CI 23-26%) compared with a pre-pandemic level of 13% (95% CI 12-14%). In both studies, anxiety and depression during the pandemic was greater in younger members, women, those with pre-existing mental/physical health conditions and individuals in socioeconomic adversity, even when controlling for pre-pandemic anxiety and depression. These results provide evidence for increased anxiety in young people that is coincident with the pandemic. Specific groups are at elevated risk of depression and anxiety during the COVID-19 pandemic. This is important for planning current mental health provisions and for long-term impact beyond this pandemic.

Highlights

The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health
Depression during the pandemic was similar to pre-pandemic levels in the Avon Longitudinal Study of Parents and Children (ALSPAC) index generation, but those experiencing anxiety had almost doubled, at 24% compared with a pre-pandemic level of 13%
Data on mental health outcomes during the COVID-19 pandemic were available for 3579 people for the ALSPAC-parents cohort, 2872 people for the ALSPAC-young cohort and 4208 people for the Generation Scotland cohort

Summary

Introduction

The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health. There is a need for longitudinal designs with well-characterised sampling frames and pre-pandemic data.[13] Such studies can more accurately quantify differences in mental health from pre-pandemic levels, and identify groups that are most at risk of adverse mental health in response to the COVID-19 pandemic These results can inform development of interventions for those at heightened risk, and aid policy decisions regarding the immediate and subsequent management of the COVID-19 response. This includes plans for easing restrictions and monitoring at-risk groups as subsequent waves or epidemics occur, and plans for the longer-term care for groups whose mental health may be affected.[1,14] The COVID-19 pandemic is likely to exacerbate existing social and psychological inequalities.[15] Previous studies have identified several groups who Downloaded from https://www.cambridge.org/core.

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Conclusion