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1. Changes in the prevalence of mental health problems during the first year of the pandemic: a systematic review and dose-response meta-analysis

Author

Toshi A Furukawa, Edoardo G Ostinelli, Andrea Cipriani, Pim Cuijpers, Lin Ma, Akira Onishi, Tianjing Li, Georgia Salanti, Vikram Patel, Christian Kieling, Sanae Kishimoto, Ronald C Kessler, Seena Fazel, Marialena Trivella, Akira Sato, Yikang Zhu, Raman Sharma, Matthias Egger, Simone N. Vigod, Yu-Kang Tu, Tou-Yuan Tsai, Yuan-Pang Wang, Irene Bighelli, Alessandro Rodolico, Stefan Leucht, Michael Ostacher, Ian White, Virginia Chiocchia, Ethan Sahker, Rie Toyomoto, Kazufumi Yoshida, Trevor Thompson, Dongfang Wang, Jing Tian, Katharine A Smith, Gonzalo Arrondo, Meenakshi Sharma, Silviya Ralovska, Andreas D Haas, Michael A Wewege, Bartosz Helfer, Erika Kalocsanyiova, Harrison Nelson, Gandy Dolores-Maldonado, Caroline Zangani, Kenji Omae, Shimeng Dong, Shino Kikuchi, Thomy Tonia, James S W Hong, Natalie Luise Peter, Letao Sun, Aurélie M Lasserre, Alexander Holloway, Leila Darwish, Andrea Zucchetti, Amin Sharifan, Ana Cristina Solis, Antonio Vita, Carmen Concerto, Chinonso Igwesi-Chidobe, Carlos Rios-Gonzalez, Anna Ceraso, Daniel Prates Baldez, Dicle Dilay Demir, Ying-Chun Lin, Elena Invernizzi, Gabriel Henrique Beraldi, Gamze Erzin, Giulia Ottaviano, Graciela J Balbin-Ramón, Chin-Yen Ho, Helio Elkis, Yun Chen Liu, Javier Ballesteros, Johanna Schneckenburger, Jessie Jingxia Lin, Abdulkadir Usman Sambo, Lena Feber, Mattia Marchetti, Mauro Italia, Mengchang Qin, Yi-Chih Lin, Nurul Husna Salahuddin, Rossella Virgillito, Ogulcan Ciray, Sergio A Covarrubias-Castillo, Yun Hsia, Shiue-Shiuan Tu, and Vidya Giri Shankar

Subjects
Psychiatry, RC435-571
Abstract

Aim To describe the pattern of the prevalence of mental health problems during the first year of the COVID-19 pandemic and examine the impact of containment measures on these trends.Methods We identified articles published until 30 August 2021 that reported the prevalence of mental health problems in the general population at two or more time points. A crowd of 114 reviewers extracted data on prevalence, study and participant characteristics. We collected information on the number of days since the first SARS-CoV-2 infection in the study country, the stringency of containment measures and the number of cases and deaths. We synthesised changes in prevalence during the pandemic using a random-effects model. We used dose-response meta-analysis to evaluate the trajectory of the changes in mental health problems.Results We included 41 studies for 7 mental health conditions. The average odds of symptoms increased during the pandemic (mean OR ranging from 1.23 to 2.08). Heterogeneity was very large and could not be explained by differences in participants or study characteristics. Average odds of psychological distress, depression and anxiety increased during the first 2 months of the pandemic, with increased stringency of the measures, reported infections and deaths. The confidence in the evidence was low to very low.Conclusions We observed an initial increase in the average risk of psychological distress, depression-related and anxiety-related problems during the first 2 months of the pandemic. However, large heterogeneity suggests that different populations had different responses to the challenges imposed by the pandemic.

Published
2024
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2. The Impact of the COVID-19 Pandemic and Associated Control Measures on the Mental Health of the General Population

Author

Georgia, Salanti, Natalie, Peter, Thomy, Tonia, Alexander, Holloway, Ian R, White, Leila, Darwish, Nicola, Low, Matthias, Egger, Andreas D, Haas, Seena, Fazel, Ronald C, Kessler, Helen, Herrman, Christian, Kieling, Dominique J F, De Quervain, Simone N, Vigod, Vikram, Patel, Tianjing, Li, Pim, Cuijpers, Andrea, Cipriani, Toshi A, Furukawa, Stefan, Leucht, Abdulkadir Usman, Sambo, Akira, Onishi, Akira, Sato, Alessandro, Rodolico, Ana Cristina de, Oliveira Solis, Anastasia, Antoniou, Angelika, Kapfhammer, Anna, Ceraso, Aoife, O'Mahony, Aurélie M, Lasserre, Aziz Mert, Ipekci, Carmen, Concerto, Caroline, Zangani, Chinonso, Igwesi-Chidobe, Christina, Diehm, Dicle Dilay, Demir, Dongfang, Wang, Edoardo Giuseppe, Ostinelli, Ethan, Sahker, Gabriel Henrique, Beraldi, Gamze, Erzin, Harrison, Nelson, Helio, Elkis, Hissei, Imai, Hui, Wu, Ilias, Kamitsis, Ioannis, Filis, Ioannis, Michopoulos, Irene, Bighelli, James S W, Hong, Javier, Ballesteros, Katharine A, Smith, Kazufumi, Yoshida, Kenji, Omae, Marialena, Trivella, Masafumi, Tada, Matthias A, Reinhard, Michael J, Ostacher, Monika, Müller, Nathalia Gonzalez, Jaramillo, Panagiotis P, Ferentinos, Rie, Toyomoto, Samuele, Cortese, Sanae, Kishimoto, Sergio A, Covarrubias-Castillo, Spyridon, Siafis, Trevor, Thompson, Vasilios, Karageorgiou, Virginia, Chiocchia, Yikang, Zhu, and Yukiko, Honda

Subjects
Mental Health, Depression, SARS-CoV-2, Internal Medicine, Humans, COVID-19, General Medicine, Anxiety, Pandemics
Abstract

To what extent the COVID-19 pandemic and its containment measures influenced mental health in the general population is still unclear.To assess the trajectory of mental health symptoms during the first year of the pandemic and examine dose-response relations with characteristics of the pandemic and its containment.Relevant articles were identified from the living evidence database of the COVID-19 Open Access Project, which indexes COVID-19-related publications from MEDLINE via PubMed, Embase via Ovid, and PsycInfo. Preprint publications were not considered.Longitudinal studies that reported data on the general population's mental health using validated scales and that were published before 31 March 2021 were eligible.An international crowd of 109 trained reviewers screened references and extracted study characteristics, participant characteristics, and symptom scores at each timepoint. Data were also included for the following country-specific variables: days since the first case of SARS-CoV-2 infection, the stringency of governmental containment measures, and the cumulative numbers of cases and deaths.In a total of 43 studies (331 628 participants), changes in symptoms of psychological distress, sleep disturbances, and mental well-being varied substantially across studies. On average, depression and anxiety symptoms worsened in the first 2 months of the pandemic (standardized mean difference at 60 days, -0.39 [95% credible interval, -0.76 to -0.03]); thereafter, the trajectories were heterogeneous. There was a linear association of worsening depression and anxiety with increasing numbers of reported cases of SARS-CoV-2 infection and increasing stringency in governmental measures. Gender, age, country, deprivation, inequalities, risk of bias, and study design did not modify these associations.The certainty of the evidence was low because of the high risk of bias in included studies and the large amount of heterogeneity. Stringency measures and surges in cases were strongly correlated and changed over time. The observed associations should not be interpreted as causal relationships.Although an initial increase in average symptoms of depression and anxiety and an association between higher numbers of reported cases and more stringent measures were found, changes in mental health symptoms varied substantially across studies after the first 2 months of the pandemic. This suggests that different populations responded differently to the psychological stress generated by the pandemic and its containment measures.Swiss National Science Foundation. (PROSPERO: CRD42020180049).

Published
2022

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