Abstract
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.
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 language | English |
|---|---|
| Pages (from-to) | 894-906 |
| Number of pages | 13 |
| Journal | Lancet Psychiatry |
| Volume | 9 |
| Issue number | 11 |
| Early online date | 30 Nov 2022 |
| DOIs | |
| Publication status | Published (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.
Funding
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.
