Abstract
BackgroundGeneral population surveys have shown that some groups, particularly young women, experienced increased distress during nationally mandated restrictions to control the spread of COVID-19. However, there has been limited research on such trends among people with pre-existing mental health conditions, leaving mental health services ill equipped to plan for current and future lockdowns. MethodsMean weekly scores on the GAD-7 and PHQ-9 between 01/01/2020-22/06/2020 (n=9,538 individuals) for all patients of two psychological treatment services (Improving Access to Psychological Therapies) in London, were compared to mean weekly scores from the same time periods in 2017-2019 (n=37,849). The proportion of scores which were above the clinical thresholds for ‘caseness’ each week were compared, and scores between groups based on gender, age group, and ethnicity, were also compared. ResultsConfirmed community transmission in the UK (26/02/2020-03/03/2020) and the announcement of the national ‘lockdown’ (23/03/2020) were associated with significant increases in anxiety symptom scores. ‘Lockdown’ was associated with a decrease in depression scores. These changes were not maintained during lockdown. Significant increases in depression and anxiety were observed at week 23, as restrictions were eased. LimitationsThis was an exploratory analysis in two services only. Residual confounding and selection biases cannot be ruled out. ConclusionsDifferences in the weekly average symptom scores were short-term; they did not continue throughout ‘lockdown’ as might have been expected, except among older people. Replication of this study in other settings and investigating the potential benefits of more regular reviews or more intensive treatments for at-risk groups, are warranted.
Highlights
COVID-19 has had an unprecedented impact on healthcare services worldwide
The current study explored trends in self-reported depression and anxiety symptoms for those attending UK primary care and community-based psychological treatment services each week during the first half of 2020 compared to average weekly scores over the three preceding years to track changes during the
We compared the proportion of scores which were above the clinical thresholds for ‘caseness’ (≥10 on the PHQ-9 and ≥8 on the GAD-7) (NHS Digital, 2017); and compared scores between groups based on gender, age group, and ethnicity
Summary
COVID-19 has had an unprecedented impact on healthcare services worldwide. The need for mental health treatment is anticipated to rise, as is distress in those with existing mental disorders (Luykx et al, 2020). For services and clinicians referring or treating patients with depression or anxiety disorders, understanding the impact of the pandemic on symptom atology is important in treatment planning and the clinical management of their conditions. General population surveys have shown that whilst the majority of people’s mental health appears unaffected in any significant way, some groups, young women experienced increased distress during ‘lockdown’ (Fancourt et al, 2020; Saunders et al, 2021; Shevlin et al, 2020). The current study explored trends in self-reported depression and anxiety symptoms for those attending UK primary care and community-based psychological treatment services each week during the first half of 2020 compared to average weekly scores over the three preceding years to track changes during the COVID-19 pandemic. Replication of this study in other settings and investigating the potential benefits of more regular reviews or more intensive treatments for at-risk groups, are warranted
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