Mental health in Europe during the COVID-19 pandemic: a systematic review

Ahmed, Nafiso; Barnett, Phoebe; Greenburgh, Anna; Pemovska, Tamara; Stefanidou, Theodora; Lyons, Natasha; Ikhtabi, Sarah; Talwar, Shivangi; Francis, Emma R; Harris, Samantha M; Shah, Prisha; Machin, Karen; Jeffreys, Stephen; Mitchell, Lizzie; Lynch, Chris; Foye, Una; Schlief, Merle; Appleton, Rebecca; Saunders, Katherine R K; Baldwin, Helen; Allan, Sophie M; Sheridan-Rains, Luke; Kharboutly, Omaya; Kular, Ariana; Goldblatt, Peter; Stewart, Robert; Kirkbride, James B; Lloyd-Evans, Brynmor; Johnson, Sonia

doi:10.1016/s2215-0366(23)00113-x

Cited by 45 publications

(18 citation statements)

References 179 publications

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“…The outcomes of our in-depth qualitative approach align well with quantitative findings as reviewed by Ahmed et al 23 ; they observed a lack of a clear exacerbation in symptoms of various psychiatric disorders. Participants in our study reported a fairly stable mental health situation, but also a negative impact of the COVID-19 pandemic and associated restrictions on their overall well-being.…”

Section: Discussionsupporting

confidence: 86%

“…[17][18][19][20][21][22] In contrast to these negative effects of the COVID-19 pandemic, a recent quantitative review found no clear pattern of change in mental health symptom severity and associated outcomes in adults with pre-existing mental health conditions. 23 This systematic review included 37 quantitative studies reporting on one or more of the following outcome measurements: symptom severity, social functioning (assessed through self-administered questionnaires on social participation and loneliness), quality of life, suicide behaviours and self-harm in people with pre-existing mental health conditions. Symptoms of various psychiatric disorders (e.g., depression, anxiety, eating disorders, schizophrenia, bipolar disorder and posttraumatic stress disorder were compared before and during the pandemic, with heterogeneous results.…”

Section: Introductionmentioning

confidence: 99%

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‘I am proud of how I handled it’. Exploring the impact of the COVID‐19 pandemic and related restrictions on well‐being of adults with severe mental illness using qualitative methods

van Rijn,

Metz,

van der Velden

et al. 2024

Health Expectations

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BackgroundThe coronavirus disease 2019 (COVID‐19) pandemic and related restrictions globally impacted mental health, particularly for those with pre‐existing severe mental illness (SMI). This qualitative study examined how adults with SMI perceived the effects of the COVID‐19 pandemic and related restrictions in the Netherlands, focusing on their personal recovery, well‐being and daily life, including an exploration of factors influencing these effects.MethodsSemi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Reflexive thematic analysis was applied. Purposive sampling was used to ensure diversity of individuals with SMI (i.e., age, gender, diagnosis, cultural background and mental healthcare institution).ResultsTwenty participants (median age: 45 years [SD: 12, 8]; 11 females) were interviewed between May and July 2023. Findings revealed a wide range of experiences: while some individuals reported a negative impact on their existing psychiatric symptoms, others described adaptability, resilience and even positive effects of COVID‐19 restrictions on their mental health and well‐being. Factors influencing the heterogeneic perceptions of the COVID‐19 pandemic and related restrictions include the availability of trusted social relationships and enduring interactions with health professionals.ConclusionPersonalised support, both socially and professionally, is crucial for addressing fears, building resilience, reducing isolation and encouraging positive coping strategies for individuals with SMI during external crises. In this project, a participatory research approach that integrated the lived experience perspective helped uncover the unique perceptions of people with SMI with regard to the pandemic and related restrictions.Patient or Public ContributionThe study used a participatory action research approach, with experts‐by‐experience involved in every stage of the project as part of the research team. This included engagement with the funding application process, recruitment strategies for interviews, developing the interview guide, piloting the interview, interpreting findings, and knowledge dissemination activities.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

‘I am proud of how I handled it’. Exploring the impact of the COVID‐19 pandemic and related restrictions on well‐being of adults with severe mental illness using qualitative methods

van Rijn,

Metz,

van der Velden

et al. 2024

Health Expectations

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“…Although several systematic reviews and meta-analyses have reported that the prevalence of people experiencing symptoms of mental health conditions has increased during the pandemic (Ahmed et al , 2023; Cénat et al , 2021; Troglio da Silva and Neto, 2021; Wu et al , 2021; Xiong et al , 2020), we found substantial reductions in the incident diagnoses of mental health conditions. This might indicate that many people experiencing mental health problems, who would have expected to benefit from receiving mental healthcare, did not access health services during the pandemic.…”

Section: Discussioncontrasting

confidence: 67%

“…As of the end of 2022, there were approximately 0.73 billion confirmed cases of COVID-19, resulting in more than 6 million deaths worldwide (World Health Organization, 2022). The unpredictability and uncertainty of the pandemic itself, along with the policy restrictions and economic recession, may have caused great mental health consequences amongst the global population (Ahmed et al , 2023; Aknin et al , 2022; Moreno et al , 2020). Estimates from a Global Burden of Diseases study showed that the COVID-19 pandemic led to a 27.6% increase in major depressive disorders and a 25.6% increase in anxiety disorders globally (Santomauro et al , 2021).…”

Section: Introductionmentioning

confidence: 99%

Incidence of mental health diagnoses during the COVID-19 pandemic: a multinational network study

Chai,

Man,

Luo

et al. 2024

Epidemiol Psychiatr Sci

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Aims Population-wide restrictions during the COVID-19 pandemic may create barriers to mental health diagnosis. This study aims to examine changes in the number of incident cases and the incidence rates of mental health diagnoses during the COVID-19 pandemic. Methods By using electronic health records from France, Germany, Italy, South Korea and the UK and claims data from the US, this study conducted interrupted time-series analyses to compare the monthly incident cases and the incidence of depressive disorders, anxiety disorders, alcohol misuse or dependence, substance misuse or dependence, bipolar disorders, personality disorders and psychoses diagnoses before (January 2017 to February 2020) and after (April 2020 to the latest available date of each database [up to November 2021]) the introduction of COVID-related restrictions. Results A total of 629,712,954 individuals were enrolled across nine databases. Following the introduction of restrictions, an immediate decline was observed in the number of incident cases of all mental health diagnoses in the US (rate ratios (RRs) ranged from 0.005 to 0.677) and in the incidence of all conditions in France, Germany, Italy and the US (RRs ranged from 0.002 to 0.422). In the UK, significant reductions were only observed in common mental illnesses. The number of incident cases and the incidence began to return to or exceed pre-pandemic levels in most countries from mid-2020 through 2021. Conclusions Healthcare providers should be prepared to deliver service adaptations to mitigate burdens directly or indirectly caused by delays in the diagnosis and treatment of mental health conditions.

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“…A recent review of longitudinal studies, investigating the sub-population of individuals with a psychiatric diagnosis before the pandemic, identi ed con icting ndings. Some studies reported improvements while others showed deteriorations of mental health compared to the pre-pandemic period (Ahmed et al, 2023;Kunzler et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Resilience of people with a history of mental disorder during the COVID-19 pandemic: an international 2-years longitudinal prospective study

Pinucci,

Tedeschi,

Serra

et al. 2023

Preprint

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Background During the COVID-19 pandemic, the global population was exposed to a significant psychological distress, however, subgroups of vulnerable individuals proved resilient throughout the pandemic. This study aims to identify predictors of long-term, sustained resilience among people with a history of mental disorder during the first two years of the pandemic. Methods In this international 2-year, 5-wave longitudinal online survey, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder Scale, and the PTSD Checklist DSM-5 were used for a proxy measure of psychological distress. As possible predictors of sustained resilience, we investigated socio-demographic characteristics, economic and housing status, pandemic-related issues, chronic diseases, social support, fear of contamination and personal values which were investigated respectively through the Oslo Social Support Scale, the Padua Inventory, and the Portrait Values Questionnaire. Data were analysed with a Mover-Stayer Latent Transition Analysis model. Results Nine-hundred and forty-three participants with a mental disorder were included in the analysis. Variables associated with a higher chance of sustained resilience were older age, maintaining a job, and having more people in the household. In contrast, female gender, losing job, difficulty in meeting basic needs, higher fear of contamination, hedonism, less social support and loneliness resulted in a lower likelihood of being sustained resilient. Conclusion This study identified factors that predict sustained resilience in people with mental disorders. The newly discovered predictors of sustained resilience could prove invaluable in developing strategies to enhance the resilience of people with mental disorders during times of crises, such as pandemics.

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Mental health in Europe during the COVID-19 pandemic: a systematic review

Cited by 45 publications

References 179 publications

‘I am proud of how I handled it’. Exploring the impact of the COVID‐19 pandemic and related restrictions on well‐being of adults with severe mental illness using qualitative methods

‘I am proud of how I handled it’. Exploring the impact of the COVID‐19 pandemic and related restrictions on well‐being of adults with severe mental illness using qualitative methods

Incidence of mental health diagnoses during the COVID-19 pandemic: a multinational network study

Resilience of people with a history of mental disorder during the COVID-19 pandemic: an international 2-years longitudinal prospective study

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