Psychological distress, depression, anxiety and life satisfaction following COVID-19 infection: Evidence from 11 UK longitudinal population studies

Ellen J. Thompson , Jean Stafford , Bettina Moltrecht , Charlotte F. Huggins , Alex S. F. Kwong , Richard J. Shaw , Paola Zaninotto , Kishan Patel, Richard J. Silverwood, Eoin Mc Elroy, Matthias Pierce, Michael J Green, Ruth C. E. Bowyer , Jane Maddock , Kate Tilling, S. Vittal Katikireddi, George B. Ploubidis, David J. Porteous, Nic Timpson, Nish ChaturvediClaire J. Steves, Praveetha Patalay

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Background: Evidence on associations between COVID-19 illness and mental health is mixed. We aimed to examine whether COVID-19 is associated with deterioration in mental health while considering: 1) pre-pandemic mental health, 2) time since infection; 3) subgroup differences; and 4) confirmation of infection via self-reported test, and serology data.
Methods: Using data from 11 UK longitudinal studies, with 2 to 8 repeated measures of mental health (psychological distress, depression, anxiety and life satisfaction) and COVID-19 between April 2020 and April 2021, we standardised continuous mental health scales within each study across time. We investigated associations between COVID-19 (self-report, test-confirmed, serology-confirmed) and mental health using generalized estimating equations. We examined whether associations varied by age, sex, ethnicity, education and pre-pandemic mental health.
Findings: Participants were 54,442 individuals (aged 18-90+, 39% men, 90.2% White). Pooled estimates of standardized differences in outcomes suggested associations between COVID-19 and subsequent psychological distress (0.10 [95%CI: 0.06; 0.13], I2=42.8%), depression (0.08 [0.05; 0.10], I2=20.8%), anxiety (0.08 [0.05; 0.10], I2=0%), and lower life satisfaction (-0.06 [-0.08; -0.04], I2=29.2%). Associations did not vary by time since infection until 3+ months and were present in all age groups, with some evidence of stronger effects in those aged 50+. Self-reported COVID-19, whether suspected or test-confirmed and irrespective of serology status, was associated with poorer mental health.
Interpretation: Self-reporting COVID-19 was longitudinally associated with deterioration in mental health and life satisfaction. Our findings highlight the need for greater post-infection mental health service provision, given the substantial prevalence of COVID-19 in the UK and worldwide.
Original languageEnglish
Pages (from-to)894-906
Number of pages13
JournalLancet Psychiatry
Issue number11
Early online date30 Nov 2022
Publication statusPublished (in print/issue) - 30 Nov 2022

Bibliographical note

Funding Information:
The COVID-19 Longitudinal Health and Wellbeing National Core Study was funded by the UK Medical Research Council (MC_PC_20059 and MC_PC_20030) and the CONVALESCENCE study was funded by the UK National Institute for Health and Care Research (CONVALESCENCE grant COV-LT-0009). Full funding acknowledgements for each individual study can be found in the appendix (pp 62–63).

Publisher Copyright:
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.


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