Purpose Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health. Conclusion There is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.

Purpose. Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods. We used qualitative interviews (N=49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results. Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health. Conclusion. There is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.

BackgroundLoneliness is associated poor health including premature mortality. There are cross-sectional associations with depression, anxiety, psychosis and other mental health outcomes. However, the direction of causation is unclear and clarifying the evidence from longitudinal studies is a key step in understanding this relationship.AimsWe synthesized evidence from longitudinal studies investigating the relationship between loneliness and new onset of mental health problems, in the general population.MethodWe systematically searched six electronic databases, unpublished sources and hand-searching of references, up to March 2020. We conducted a meta-analysis of eight independent cohorts, and narrative synthesis of the remaining studies.ResultsWe included 20 studies, of which the majority focused on depression. Our narrative synthesis concluded that loneliness at baseline is associated with subsequent new onset of depression. The few studies on anxiety also showed an association. Our meta-analysis found a pooled adjusted odds ratio of 2.33 (95% C.I. 1.62 – 3.34) for risk of new onset depression in adults who were often lonely compared with people who were not often lonely. This should be interpreted with caution given evidence of heterogeneity. Most of the studies were in older adults.ConclusionLoneliness is a public mental health issue. There is growing evidence it is associated with the onset of depression and other common mental health problems. Future studies should explore its impact across the age range, look beyond depression, and explore the mechanisms involved.

No abstract

Previous experimental work showed that young adults reporting loneliness performed less well on emotion recognition tasks (Diagnostic Analysis of Nonverbal Accuracy [DANVA-2]) if they were framed as indicators of social aptitude, but not when the same tasks were framed as indexing academic aptitude. Such findings suggested that undergraduates reporting loneliness possessed the social monitoring skills necessary to read the emotions underlying others’ facial expressions, but that they choked under social pressure. It has also been found that undergraduates reporting loneliness have better recall for both positive and negative social information than their non-lonely counterparts. Whether those effects are evident across different age groups has not been examined. Using data from the British Broadcasting Corporation (BBC) Loneliness Experiment that included participants aged 16–99 years ( N = 54,060), we (i) test for replication in a larger worldwide sample and (ii) extend those linear model analyses to other age groups. We found only effects for participants aged 25–34 years: In this age group, loneliness was associated with increased recall of negative individual information, and with choking under social pressure during the emotion recognition task; those effects were small. We did not find any such effects among participants in other age groups. Our findings suggest that different cognitive processes may be associated with loneliness in different age groups, highlighting the importance of life-course approaches in this area.