Abstract
BACKGROUND The effects of the Covid-19 pandemic on mental health remain unclear. To mitigate the risks and capitalise on opportunities for positive change, we must understand how the impact has been mediated by sociodemographics, mental disorders, personality traits, life circumstances and the coping measures people choose to take.
METHODS Data were collected from 376,987 members of the general public, predominantly in the UK, between late December 2019 and May 2020. Interaction models examined differences in sociodemographic distributions of mood and anxiety for 233,268 people in January vs. 109,749 in May. Factor analysis of a comprehensive instrument determined the dimensionality of self-perceived pandemic-driven change in wellbeing, outlook and behaviour for 74,830 participants in May. Linear modelling identified demographic, contextual, clinical, and trait predictors of pandemic impact. Topic modelling distilled prevalent advice from free-text responses.
RESULTS Anxiety, depression and insomnia changed markedly in demographically-mediated ways. Untoward changes were larger for older adults. Benefits were greater for younger adults. Social connectedness was negatively affected across most mental and neurological conditions. There were disorder-specific changes in other domains, e.g., heightened conflict at home for attention-deficit hyperactivity disorder and heightened anxiety for obsessive-compulsive disorder. Psychiatric symptoms, personality traits, occupational variables and living conditions were amongst the strongest predictors of pandemic impact. Frontline health workers, carers of vulnerable older adults, and disabled or sheltered adults were disproportionately affected. Fifty advice topics were identified from free-text, the prevalence of which covaried with subpopulation, context and traits.
CONCLUSIONS The general public report positive and negative consequences of the pandemic. Particular subsets of people have heightened risk of untoward effects whereas other groups appear resilient. To be valid and effective, studies seeking to quantify, predict or mitigate the impact of pandemics on mental health should apply holistic approaches, combining multiple psycho-socio-economic factors.
Competing Interest Statement
Disclosures: Dr. Chamberlain consults for Promentis, and receives stipends for journal editorial work from Elsevier. Dr. Grant has received research grants from the TLC Foundation for Body-Focused Repetitive Behaviors, Biohaven, Promentis, and Avanir Pharmaceuticals. Prof. Mehta has received grant income from Takeda Pharmaceuticals, Johnson & Johnson and Lundbeck.
Clinical Trial
This was a large scale observational study run in collaboration with BBC2 Horizon. It was not a clinical trial.
Funding Statement
Dr Hampshire is supported by the UK Dementia Research Institute and Biomedical Research Centre at Imperial College London with technology development supported by EU-CIG EC Marie‐Curie CIG and NIHR grant II-LB-0715-20006. Dr Soreq's role was supported by MRC grant MR/R005370/1. William Trender is supported by the EPSRC Center for Doctoral Training in Neurotechnology. Dr Chamberlain's role in this study was funded by a Wellcome Trust Clinical Fellowship (Reference 110049/Z/15/Z). Mitul Mehta is in part supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. We would like to acknowledge COST Action CA16207 'European Network for Problematic Usage of the Internet', supported by COST (European Cooperation in Science and Technology); and the support of the National UK Research Network for Behavioural Addictions (NUK-BA).
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Imperial College Research Ethics Committee. 17IC4009 ICREC
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Data Availability
Summary data for this cohort are provided in the supplementary appendices.