Mental disorders following COVID-19 and other epidemics: a systematic review and meta-analysis

Abstract

COVID-19 has imposed a very substantial direct threat to the physical health of those infected, although the corollary impact on mental health may be even more burdensome. Here we focus on assessing the mental health impact of COVID-19 and of other epidemics in the community. We searched five electronic databases until December 9, 2020, for all peer-reviewed original studies reporting any prevalence or correlates of mental disorders in the general population following novel epidemics in English, Chinese or Portuguese. We synthesised prevalence estimates from probability samples during COVID-19 and past epidemics. The meta-analytical effect size was the prevalence of relevant outcomes, estimated via random-effects model. I2 statistics, Doi plots and the LFK index were used to examine heterogeneity and publication bias. This study is pre-registered with PROSPERO, CRD42020179105. We identified 255 eligible studies from 50 countries on: COVID-19 (n = 247 studies), severe acute respiratory syndrome (SARS; n = 5), Ebola virus disease (n = 2), and 1918 influenza (n = 1). During COVID-19, we estimated the point prevalence for probable anxiety (20.7%, 95% CI 12.9–29.7), probable depression (18.1%, 13.0–23.9), and psychological distress (13.0%, 0–34.1). Correlates for poorer mental health include female sex, lower income, pre-existing medical conditions, perceived risk of infection, exhibiting COVID-19-like symptoms, social media use, financial stress, and loneliness. Public trust in authorities, availability of accurate information, adoption of preventive measures and social support were associated with less morbidity. The mental health consequences of COVID-19 and other epidemics could be comparable to major disasters and armed conflicts. The considerable heterogeneity in our analysis indicates that more random samples are needed. Health-care professionals should be vigilant of the psychological toll of epidemics, including among those who have not been infected.

Anxiety among Adolescents and Young Adults during COVID-19 Pandemic: A Multi-Country Survey

“…The present study also agrees with a 2022 systematic review that assessed the mental disorders of communities following epidemics, including the COVID-19 pandemic. The authors reported poorer mental health for those with higher risk of infection, those with medical conditions, and those showing COVID-19-like symptoms [ 46 ].…”

Anxiety is more related to inadequate eating habits in inactive than in physically active adults during COVID-19 quarantine

“…Studies have shown that increases in stress, anxiety, depression, sleep disorders, denial, anger and fear have been impacting global health during the COVID-19 pandemic [29,30]. Those with anxiety and depression are more likely to engage in harmful behaviors such as suicide, self-harm, have an eating disorder, and abuse alcohol [11,31,32].…”

Astrocytes and the Psychiatric Sequelae of COVID-19: What We Learned from the Pandemic

“…Evidence that COVID-19 is followed by a significant rate of neuropsychiatric diagnoses over the subsequent six months has been further confirmed by a robust retrospective cohort study [ 117 ]. On the basis of this data, particular interest was drawn from the persistence of neuropsychiatric symptoms in convalescent patients or from their late appearance in subjects completely restored by the viral infection [ 60 , 124 , 125 ]. This should not be surprising, as similar features with significant neurological and mental complains were already reported in acute or post-disease phases during other previous coronavirus outbreaks.…”