Abstract
BackgroundWe assessed the moderating effect of pre-pandemic mental disorders on the association of COVID-related perceived stress and social support with mental health.MethodsA nationally representative sample of 3500 Spanish adults was interviewed in June 2020 (mean age 49.25 years, ± 15.64; 51.50% females). Mental health included Generalized Anxiety Disorders (GAD; GAD-7, cut-off point of ≥ 10), Major Depressive Disorders (MDD; PHQ-8, cut-off point of ≥ 10) and the comorbid form (those screening positive for GAD and MDD). COVID-related stress was assessed using an adapted version of the Peri Life Events Scale, and social support using the Oslo Social Support Scale. Logistic regression models were used to assess if COVID-related stress and social support were related to mental health outcomes and interactions were conducted to examine whether these relationships differed according to the presence of pre-pandemic mental disorders.ResultsHigher COVID-related stress was associated with a higher risk of lower mental health. The association between COVID-related stress with GAD and MDD was significantly moderated by pre-pandemic mental disorders, except for comorbid GAD + MDD. Higher levels of social support were linked to better mental health. Only the association between social support and GAD was significantly moderated by pre-pandemic mental disorders. That is, for those without pre-pandemic mental disorders, higher levels of social support decreased the odds of GAD, while minor decreases were observed in those with pre-pandemic mental disorders.ConclusionsThe impact of COVID-related stress and social support on specific indicators of mental health may vary depending on the existence of a previous mental disorder.
Highlights
We assessed the moderating effect of pre-pandemic mental disorders on the association of COVIDrelated perceived stress and social support with mental health
Our study provides an extension of previous evidence by examining the link between COVID-19-related stress and social support with the risk of Generalized Anxiety Disorders (GAD), Major Depressive Disorders (MDD) and comorbid GAD + MDD
These findings are consistent with previous studies demonstrating that people with a pre-pandemic mental health disorder are more negatively impacted by COVIDrelated stress [15,16,17], which is correlated with an increased likelihood to be concurrently depressed or anxious [15]
Summary
We assessed the moderating effect of pre-pandemic mental disorders on the association of COVIDrelated perceived stress and social support with mental health. Examining the impact of the pandemic on anxiety and depression is crucial since these disorders are accompanied by substantial disability and high recurrence rates [9,10,11]. They often co-occur [12], and compared to having one disorder alone, this co-occurrence is associated with more severe psychopathology and a poorer clinical course [13, 14]
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