Mental Health Consequences Of COVID-19 Research Articles

Unmasking the mental health scars of COVID-19: A longitudinal investigation of children and adolescents in post-lockdown China

The long-term mental health consequences of COVID-19 in children and adolescents remain unclear. We investigated the impact of COVID-19 infection on mental health after China's zero-COVID policy relaxation, focusing on symptom-specific and social-family risk factors for mental health issues in children and adolescents. In a longitudinal study, 8348 youths (aged 10–18) were assessed twice (T1: September to October 2022 and T2: April to May 2023). Mental health changes (Δ=T1-T2) were compared between COVID-19-infected (COVID+, n = 4108) and non-infected (COVID-, n = 4240). After balancing social–family confounding factors at T1 with propensity score-based inverse probability weights, multivariable logistic regression was employed to assess associations between COVID-19 infection and the onset/worsening of mental health symptoms. Multivariable logistic regression was conducted to explore specific acute COVID-19 symptoms and social–family risk factors associated with the onset/worsening of mental health symptoms in COVID + group. Compared to COVID- group, COVID + group exhibited lower overall mental health improvement (Δ). COVID + group was associated with increased risks of depression worsening (OR 1.20, 95 % CI 1.04–1.39), anxiety worsening (OR 1.30, 95 % CI 1.15–1.47), stress worsening (OR 1.23, 95 % CI 1.03–1.46), insomnia worsening (OR 1.21, 95 % CI 1.05–1.39), and emotional symptoms worsening (OR 1.72, 95 % CI 1.27–2.33). Moderate-to-severe difficulty thinking, breathlessness, and gastrointestinal symptoms were specific COVID-19 symptoms associated with worsening of various mental health outcomes. Furthermore, academic difficulties, economic disadvantages, family conflicts, food addiction, and alcohol consumption were identified as social-family risk factors for worsening mental health symptoms in COVID + youths. COVID-19 infection leaves lasting mental health scars in youths, extending beyond the acute phase. Specific symptoms, particularly cognitive dysfunction and respiratory/gastrointestinal distress play a significant role in this vulnerability. Social-family factors further modulate these effects, highlighting the need for comprehensive interventions that address both biological and psychosocial aspects. This study provides valuable insights for tailoring mental health support to youths navigating the consequences of the COVID-19 pandemic.

The mental health consequences of COVID-19 on a sample of health professions students: a mixed methods study

Objective: To assess and examine how the COVID-19 pandemic may have impacted the mental health of a sample of health professions students (HPS) using an explanatory sequential mixed-methods design. Participants: Participants included 41 HPS enrolled in a co-curricular interprofessional education (IPE) program. Measurements: Measures included the CES-D scale, PSS scale, and the GAD scale. Qualitative description was used to explore the experiences of these HPS. Results: The HPS explained that fear of acquiring COVID-19, transmitting the virus to loved ones, and dying as a result of the disease negatively influenced their mental health. The HPS revealed that there were some beneficial outcomes resulting from the pandemic, including the strengthening of family bonds and the cultivation of resiliency. Conclusions: The pandemic has had a negative impact on the mental health of these HPS. It is essential that these students receive support for their mental health in order to provide optimal care to the population they serve.

Longer-Term Mental Health Consequences of COVID-19 Infection: Moderation by Race and Socioeconomic Status.

While evidence suggests that the mental health symptoms of COVID-19 can persist for several months following infection, little is known about the longer-term mental health effects and whether certain sociodemographic groups may be particularly impacted. This cross-sectional study aimed to characterize the longer-term mental health consequences of COVID-19 infection and examine whether such consequences are more pronounced in Black people and people with lower socioeconomic status. 277 Black and White adults (age ≥ 30 years) with a history of COVID-19 (tested positive ≥ 6 months prior to participation) or no history of COVID-19 infection completed a 45-minute online questionnaire battery. People with a history of COVID-19 had greater depressive (d = 0.24), anxiety (d = 0.34), post-traumatic stress disorder (PTSD) (d = 0.32), and insomnia (d = 0.31) symptoms than those without a history of COVID-19. These differences remained for anxiety, PTSD, and insomnia symptoms after adjusting for age, sex, race, education, income, employment status, body mass index, and smoking status. No differences were detected for perceived stress and general psychopathology. People with a history of COVID-19 had more than double the odds of clinically significant symptoms of anxiety (OR = 2.22) and PTSD (OR = 2.40). Education, but not race, income, or employment status, moderated relationships of interest such that COVID-19 status was more strongly and positively associated with all the mental health outcomes for those with fewer years of education. The mental health consequences of COVID-19 may be significant, widespread, and persistent for at least 6 months post-infection and may increase as years of education decreases.

Depression and Generalized Anxiety as Long-Term Mental Health Consequences of COVID-19 in Iraqi Kurdistan

Coronavirus disease 2019 (COVID-19) has been associated with a variety of psychiatric symptoms. However, COVID-19’s association with psychiatric symptoms after the acute illness phase is not fully understood. Thus, this study sought to examine symptoms of depression and generalized anxiety and associated factors in the period following COVID-19 infection. A cross-sectional study design was conducted in three governorates of the Iraqi Kurdistan region. Face-to-face interviews were held between the period of 15 September and 20 December 2021 with both those who had been infected with COVID-19 and those who had not. Depression symptomology was assessed using the 9-item Patient Health Questionnaire and levels of anxiety were measured using the 7-item Generalized Anxiety Disorder scale. A total of 727 participants were recruited. The bulk of the respondents (n = 454) reported having a past COVID-19 infection, of whom a considerable proportion (82%) had mild–moderate symptoms. More than half of the infected respondents (53.3%) stated they were treated at home. The mean score of generalized anxiety was higher among the infected group compared to the non-infected group t(725) = 2.538, p = 0.011. Factors such as older age, female gender, unemployment, previous psychological problems, and diabetes mellitus were strongly associated with symptoms of depression and anxiety post-COVID-19 infection. Additionally, anxiety was associated with a longer duration of post-COVID symptoms. The majority of the study population had mild to moderate levels of post-COVID-19 depression and anxiety. Psychological education and interventions are required to reduce the psychological burden of post-COVID-19 symptoms among the general population.

A Neuropsychiatric Assessment of Children with Previous SARS-CoV-2 Infection.

Concerns have been raised about possible neuropsychiatric sequelae of COVID-19. The objective of this study was to examine the plausibility of long-term mental health consequences of COVID-19 by assessing a sample of children after the resolution of the acute SARS-CoV-2 infection. As part of a systematic follow-up assessment of pediatric patients with COVID-19 conducted at two university children's hospitals, 50 children (56% males) aged 8 to 17 years (median 11.5), 26% with previous multisystem inflammatory syndrome in children (MIS-C), without a prior history of neuropsychiatric disorders, received a battery of clinical neuropsychiatric and neuropsychological rating scales that included the Pediatric Migraine Disability Assessment (PedMIDAS), Sleep Disturbance Scale for Children (SDSC), Multidimensional Anxiety Scale for Children (MASC-2), Child Depression Inventory (CDI-2), Child Behavior Checklist (CBCL), and the NEPSY II (Neuropsychological Assessment, Second Edition). The assessments were conducted between 1 and 18 months (median 8 months) after the acute infection. The CBCL internalizing symptoms score was in the clinical range for 40% of the participants (vs. a population expected rate of about 10%, p < 0.001). A sleep disturbance was detected in 28%, clinically significant anxiety in 48%, and depressive symptoms in 16%. The NEPSY II scores showed impairment in attention and other executive functions in 52%, and memory deficits in 40% of the children. These data from direct assessment of a sample of children who had SARS-CoV-2 infection show higher than expected rates of neuropsychiatric symptoms, thus supporting the possibility that COVID-19 may have mental health sequelae long after the resolution of the acute infection.

Sociodemographic, economic, physical, and mental health status of previously hospitalised patients with COVID-19 symptoms in Bangladesh: Protocol for a mixed-method study.

Not much is known about the long-term consequences of COVID-19, popularly known as long COVID. This is particularly so in terms of patterns and clusters of symptoms over time, sociodemographic and economic characteristics of patients, and related clinical history. This is crucial for resource-constrained health systems such as Bangladesh to address long COVID as a forthcoming challenge. This protocol aims to investigate the consequences of COVID-19 over time for physical and mental health and how these are associated with demographic and socio-economic factors. This mixed-method study collected information on all patients with symptoms of COVID-19 admitted to and discharged after recovery from a COVID-19-dedicated hospital in Bangladesh (N = 942), from April to December 2020. The sources of data were admission records and discharge certificates from the hospital for clinical history, cross-sectional survey on physical and mental health (assessed by DASS21 scale)-related symptoms and socioeconomic changes after recovery, and qualitative in-depth interviews on experiences of COVID-19. Interviews were conducted over the phone. Quantitative analysis was done to estimate the prevalence of physical and mental health consequences of COVID-19 after recovery and the association with socio-economic and demographic information. The qualitative analysis was performed using a thematic analysis approach. It is imperative to understand the post-COVID consequences and related health and non-health aspects to inform evidence-based policymaking, especially for resource-poor contexts such as Bangladesh. Given the dearth of evidence in this regard, the proposed study will contribute to bridging this knowledge gap. It is important to note that this study is one of the few which presents information on post-COVID-19 consequences in the context of low- and middle-income countries and the first in Bangladesh.

Impact of COVID-19 on mental health of primary healthcare workers in Pakistan: lessons from a qualitative inquiry

ObjectivesThe existing literature regarding the mental health consequences of COVID-19 among healthcare workers revolves predominantly around specialised hospital settings, while neglecting primary healthcare workers (PHCW) who are the first point...

Social Capital as Protection Against the Mental Health Impact of the COVID-19 Pandemic.

The corona pandemic has a huge impact on the mental wellbeing of the Dutch population. Based on a large-scale panel survey (N = 22,696) on the social impact of COVID-19, this article firstly examines which social groups are most susceptible to the mental health consequences of the pandemic. Secondly, we examine whether social capital provides protection against this impact. We find that the mental health impact of COVID-19 is considerable and that it increased over the course of 2020. Women, young people, respondents with low incomes and/or poor self-perceived health, experience relatively more fear and stress due to the pandemic. We do not find a difference between respondents with or without a migration background. Social capital (received support, trust in people and in institutions) has the expected effect: the more support and trust, the less fear and stress. There is a mediation effect. Older people, respondents with high incomes and/or good health experience less fear and stress, partly because they have more social capital. This is different for females. They would experience even more fear and stress, compared to men, were it not for the fact that they have more social capital. Hence we conclude that social capital indeed provides some protection against the negative mental health consequences of COVID-19.

Mental health consequences of COVID-19 in house staff physicians

Background: A new coronavirus, SARS-CoV-2, was associated with a newly identified respiratory syndrome, COVID-19 in Wuhan, China, in early December 2019. SARS-CoV-2 rapidly spread across the globe, imposing increased working hours and workloads for healthcare workers. We have evaluated the prevalence of mental health outcomes and associated factors in house staff physicians in Panama. Methods: A cross-sectional study was undertaken from July 23, 2020, to August 13, 2020. Snowball sampling was used to recruit participants. Then, an electronic questionnaire with scales to evaluate anxiety disorders (GAD-7), depression (PHQ-9) and post-traumatic stress (IES-R) was administered. In addition, socio-demographic variables, clinical history of mental disorders and COVID-19 exposure were evaluated. Independent analyses for each mental health outcome were undertaken using a logistic regression analysis. Results: A total of 517/1,205 (42.9%) interns and residents were recruited nationwide. The overall prevalence of depression symptoms was 25.3%, 13.7% for anxiety and 12.2% for post-traumatic stress. At least 9.3% participants reported having suicidal ideation. The most parsimonious model showed females had a higher prevalence of mental health disorders across results, and married participants were more likely to present depression (OR, 1.73; 95% CI, 1.03-2.91; P = 0.039) or at least one mental health disorder (OR, 1.66; 95% CI, 1.03-2.68; P = 0.039). Conclusions: A high prevalence of mental health disorders was found, showing the need to mitigate this emotional burden among healthcare workers in the current context of the COVID-19 pandemic.

Marfatia Award Abstracts

Background:Few studies across the globe have evaluated the adverse mental health consequences of COVID-19, in patients who suffered from COVID-19 infection. However, a comparative study of persons who suffered from COVID-19 and those who witnessed the COVID-19 infection in their 1 st degree relative/s is lacking.Aims & Objectives:This study aims to compare the psychiatric morbidity in persons who suffered from COVID-19 infections, and those who witnessed the illness in one of their first degree relative/s.Methods:In this cross-sectional online survey, 2964 adult participants completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Fear of COVID-19 Scale (FCS-19), Brief Resilient Coping Scale (BRCS), The Brief Resilience Scale (BRS) and a self-designed questionnaire to evaluate Neuropsychiatric issues.Results-Mean PHQ-9, GAD-7 and FCS-19 were significantly higher in those who themselves suffered from COVID-19 as compared to those who witnessed the infection in their 1 st degree relative (7.41 ± 7.09 vs 6.56 ± 6.15; p<0.0001; 5.58 ± 6.59 vs 5.10 ± 5.97;p=0.001;11.32±6.45 vs 10.48±6.12; p=0.001 respectively). However, BRS coping score was not significantly different between both the groups. Overall, about 1/3 rd of the participants who developed COVID-19 infection had depression and one-third had anxiety disorders. One-fifth of the participants reported high fear, PTSD and OCD symptoms, while 1/6 th reported other neuropsychiatric manifestations.Conclusion:Patients who suffered from COVID-19 had higher prevalence of PHQ-9, GAD-7 and FCS-19 as compared to those to witnessed COVID-19 in relatives but with similar BRCS.

Psychiatric and neuropsychiatric issues in persons with COVID-19 infection: A case-control online study from India-Neorealist study.

Many studies across the globe have evaluated the adverse mental health consequences of COVID-19 in patients who suffered from COVID-19 infection. However, a comparative study of persons who suffered from COVID-19 infection and those who witnessed the COVID-19 infection in their close relatives is lacking. This study aims to compare the psychiatric morbidity in persons who suffered from COVID-19 infections, and those who witnessed the illness in one of their close relatives. In this cross-sectional online survey, 2,964 adult participants completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) Scale, Fear of COVID-19 Scale (FCS-19), Brief Resilient Coping Scale (BRCS), The Brief Resilience Scale (BRS) and a self-designed questionnaire to evaluate other neuropsychiatric complications. Compared to the close relatives who had witnessed COVID-19 infection, participants who developed COVID-19 infection had a significantly higher prevalence of depression (34.6%), anxiety disorder (32.3%), and fear of COVID-19 infection (18.8%), which was significantly higher than that noted in close relatives. However, BRS coping score was not significantly different between the two groups. Overall, about one-third of the participants who developed COVID-19 infection had depression and one-third had anxiety disorders. One-fifth of the participants reported high fear, post-traumatic symptoms, and obsessive-compulsive symptoms, whereas one-sixth reported other neuropsychiatric manifestations. Patients who suffered from COVID-19 have a higher prevalence of depression, anxiety, and fear as compared to those to witnessed COVID-19 in relatives.

Mental health consequences of COVID-19: a nationally representative cross-sectional study of pandemic-related stressors and anxiety disorders in the USA

ObjectiveTo document the prevalence of anxiety disorders in the USA during the COVID-19 pandemic.DesignA cross-sectional analysis.SettingA nationally representative sample in the USA between 31 March and 13 April 2020.Participants1450 English-speaking...

The changes of suicidal ideation status among young people in Hong Kong during COVID-19: A longitudinal survey

Background: Pandemics affect the physical and mental well-being of all potentially at-risk young people globally. This longitudinal study examines changes of suicidal ideation status among adolescents during COVID-19. Method: A follow-up after nine-months of a school-based survey among 1,491 secondary school students was conducted during COVID-19. Psychological well-being, psychological factors, family support, and COVID-19-related experiences were examined. Results: The prevalence of suicidal ideation were 24% and 21% among the participants before and during COVID-19, respectively. In particular, 897 (65.0%) remained non-suicidal, 193 (14.0%) recovered from being suicidal, 148 (10.7%) newly reported being suicidal, and 143 (10.4%) remained suicidal. Respondents who remained suicidal were found to have significantly higher depression, anxiety, stress, loneliness, and social anxiety, fixed mind-set, lower meaning of life and self-control; and lower parental support and supervision than the other three groups. Participants with suicidal ideation reported more negative perceptions about COVID-19 than non-suicidal participants. Multinomial logistic regression showed that anxiety, trait anxiety and life satisfactory in baseline were associated with suicidal ideation at follow-up. Limitation: This study was limited by the small number of protective variables being included in the baseline survey to examine the potential reasons for the recovery of suicidal ideation at follow-up. Conclusion: Poor psychological well-being, lower level of family support, and negative impacts of the pandemic were consistently associated with students’ presence of suicidal ideation during the pandemic. Further intervention studies are needed to examine effects of mental health consequences of COVID-19 on youth mental health and to promote positive youth well-being.

Coping strategies mediate the associations between COVID-19 experiences and mental health outcomes in pregnancy.

The COVID-19 pandemic has resulted in elevated mental health problems for pregnant women. Effective coping strategies likely reduce the impact of COVID-19 on mental health. This study aimed to (1) understand how COVID-19 stressors are related to different coping strategies and (2) identify whether coping strategies act as mechanisms accounting for the associations between COVID-19 stressful experiences and mental health problems in pregnancy. Participants were 304 pregnant women from Ontario, Canada. Depression, anxiety, insomnia, and perceived stress were assessed using validated measures. COVID-related stressors (i.e., financial difficulties, social isolation), subjective negative impact of COVID-19, and coping strategies used in response to COVID-19 were assessed by questionnaires. Results indicated that the subjective negative impact of COVID-19 was associated with more dysfunctional coping and less emotion-focused coping, whereas specific COVID-19 stressors, namely financial difficulties and social isolation, were associated with more dysfunctional coping and problem-focused coping. Dysfunctional coping was linked to elevated mental health problems and emotion-focused coping was linked to less mental health problems. Dysfunctional coping and emotion-focused coping partially mediated the effects of specific COVID-19 stressors on mental health outcomes. Findings indicate that coping is one pathway through which the COVID-19 pandemic impacts mental health in pregnancy. Supports and interventions for pregnant women during the pandemic should focus on bolstering coping skills, in order to minimize the mental health consequences of COVID-19.

Can Big Data Be Used to Monitor the Mental Health Consequences of COVID-19?

COMMENTARY Int J Public Health, 08 April 2021 https://doi.org/10.3389/ijph.2021.633451

Association of job loss, income loss, and financial burden with adverse mental health outcomes during coronavirus disease 2019 pandemic in Thailand: A nationwide cross-sectional study.

BackgroundEconomic crises during the coronavirus disease (COVID‐19) pandemic severely impacted mental health outcomes. However, there is limited evidence on this issue in Thailand. We aimed to evaluate the association of economic burden during the first phase of the pandemic and the risk of adverse mental health outcomes in the Thai population.MethodsWe recruited 2,303 participants aged 18 years or above with employment/full‐time jobs before the national lockdown in April–May 2020. The measures of economic burden were job loss, income loss, and financial problems related to the outbreak. The outcomes included depressive symptoms, anxiety, and perceived stress. The association between economic burden and adverse mental health outcomes was evaluated using multivariable logistic regression models.ResultsIndividuals who lost their jobs during the COVID‐19 pandemic had a higher risk of perceived stress compared to those who maintained their job (adjusted odds ratio [OR], 2.40; 95% confidence interval [CI], 1.28–4.51; p = .006). A higher risk of anxiety was observed in individuals with a monthly income loss of 50% (adjusted OR, 1.42; 95% CI, 1.03–1.99; p = .035; individuals without income loss, reference group) or over. Self‐reported financial problems were significantly associated with adverse mental health outcomes (nonexperienced financial problems, reference group): Adjusted ORs of 1.84 (95% CI, 1.34–2.51; p < .001) for depressive symptoms, 2.00 (95% CI, 1.48–2.71; p < .001) for anxiety, and 2.12 (95% CI, 1.51–2.95; p < .001) for perceived stress.ConclusionsEconomic burden, especially self‐reported financial problems, was associated with adverse mental health outcomes. However, long‐term studies are needed to address the mental health consequences of COVID‐19 and economic downturns.

The Loneliness-Life Satisfaction Relationship: The Parallel and Serial Mediating Role of Hopelessness, Depression and Ego-Resilience among Young Adults in South Africa during COVID-19.

Recently, with the onset of the COVID-19 pandemic, several lockdown and stay-at-home regulations have been implemented worldwide. In this regard, loneliness has been identified as the signature mental health consequence of this pandemic. The aim of this study is to explore the associations among loneliness, hopelessness, depression, ego-resilience and life satisfaction in a random sample of young adults (N = 337) at a university in the Western Cape of South Africa. Parallel and serial mediation analysis supported the hypothesis that loneliness is associated with hopelessness, which in turn is associated with depression, and that ego-resilience mediates the association between all the negative indices of psychological well-being and life satisfaction. These findings suggest that mental health interventions that boost ego-resilience and target loneliness may help in dealing with the mental health consequences of COVID-19.

The Covid-19 pandemic and mental health of first-year college students: Examining the effect of Covid-19 stressors using longitudinal data.

The Covid-19 pandemic has brought unprecedented stress to students and educational institutions across the world. We aimed to estimate the effect of the pandemic on the mental health of college students. We used data on 419 first-year students (ages 18-20) at a large public university in North Carolina both before (October 2019-February 2020) and after (June/July 2020) the start of the Covid-19 pandemic. After evaluating descriptive data on mental health and stressors by students' demographic characteristics, we estimated the associations between Covid-19 stressors (including work reductions, health, distanced learning difficulties and social isolation) and mental health symptoms and severity controlling for students' pre-pandemic mental health, psychosocial resources, and demographic characteristics. We found that the prevalence of moderate-severe anxiety increased from 18.1% before the pandemic to 25.3% within four months after the pandemic began; and the prevalence of moderate-severe depression increased from 21.5% to 31.7%. White, female and sexual/gender minority (SGM) students were at highest risk of increases in anxiety symptoms. Non-Hispanic (NH) Black, female, and SGM students were at highest risk of increases in depression symptoms. General difficulties associated with distanced learning and social isolation contributed to the increases in both depression and anxiety symptoms. However, work reductions as well as Covid-19 diagnosis and hospitalization of oneself, family members or friends were not associated with increases in depression or anxiety symptoms. Colleges may be able to reduce the mental health consequences of Covid-19 by investing in resources to reduce difficulties with distance learning and reduce social isolation during the pandemic.

Addressing the Consequences of the COVID-19 Lockdown for Children's Mental Health: Investing in School Mental Health Programs.

Children are likely to struggle with mental health consequences relating to the COVID-19 pandemic. School closures and home confinement increase the risk for emotional distress, domestic violence and abuse, and social isolation, as well as for disruption of sleep-wake and meal cycles, physical exercise routines, and health care access. As schools reopen, school mental health programs (SMHPs) incorporating universal approaches will be important for all children, and targeted approaches will be necessary for those more severely affected. Using their experience in Pakistan, the authors provide a roadmap for extending the World Health Organization's eastern Mediterranean region's SMHP to address the mental health consequences of COVID-19 among children globally.

Anticipated mental health consequences of COVID-19 in a nationally-representative sample: Context, coverage, and economic consequences

The COVID-19 pandemic will have long-term consequences due to social and economic disruption. This study aimed to understand the contextual, media, and economic factors associated with anticipated mental health consequences from the COVID-19 pandemic among Americans. A nationally representative survey of 1001 respondents was conducted in April 2020. Chi-square tests and logistic regressions examined anticipated emotional or psychological effects on respondents or members of their households should social distancing measures continue. Specific analyses focused on: 1) COVID-19 experience - knowing someone or being infected; living in a state with a high death rate; or state social distancing policies; 2) media exposure - source of coronavirus information and time spent on coronavirus news; and 3) economics - current economic effects; and anticipated long-term financial effects. 41% of respondents anticipated mental health consequences. Living in a state with a greater COVID-19 death rate (OR 1.73; 95% CI 1.10, 2.72) and anticipating long-term financial difficulties (OR 2.98; 95% CI 1.93, 4.60) were both associated with greater likelihood of anticipated mental health consequences. Those whose primary news source was television, as opposed to print or online, were almost 50% less likely to anticipate mental health challenges (OR 0.52 CI 0.33, 0.81), while those who reported spending two or more hours daily on COVID-19 news were 90% more likely (OR 1.90; 95% CI 1.27, 2.85). Aspects of community health, media consumption, and economic impacts influence anticipated poor mental health from the COVID-19 pandemic, suggesting each domain is relevant to interventions to address the consequences.