Refuting the myth of a ‘tsunami’ of mental ill-health in populations affected by COVID-19: evidence that response to the pandemic is heterogeneous, not homogeneous

Abstract

Background The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. Methods The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Results Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Conclusions A low-stable profile characterised by little-to-no psychological distress (‘resilient’ class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels.

Psychological responses to the COVID-19 pandemic are heterogeneous but have stabilised over time: 1 year longitudinal follow-up of the COVID-19 Psychological Research Consortium (C19PRC) study

“…The current study extends the findings of Shevlin et al (2021) by identifying trajectory patterns that were consistent with those initially reported from the analysis of the first three waves of C19PRC data 2…”

“…Possible PTSD scores range from 0 to 24. The same baseline predictor variables were used as in Shevlin et al (2021).…”

The weaker sex? What we can learn from sex differences in population mental health during and beyond the COVID-19 pandemic

“…In line with this, more recent longitudinal studies and meta-analyses draw a more differential picture regarding population mental health during COVID-19, indicating that a vast majority of people is resilient [ 7 , 8 ]. Of note, high-quality data from representative surveys modelling longitudinal mental health trajectories do not identify sex differences any longer [ 8 – 10 ] or outlines that females who initially reacted with increased levels of anxiety and depression rapidly adapted to the situation and belonged to the groups with fastest mental health improvements in the first weeks after lockdown [ 9 ]. This outlines the importance to differentiate between acute and long-term reactions to (pandemic-related) stress and their interactions with potential sex differences.…”

Effects of COVID‐19 lockdown on eating disorders and obesity: A systematic review and meta‐analysis

“…There is evidence that increases in mental distress did not affect all groups equally (Pierce et al., 2020 ). History of mental health problems, loneliness, external locus of control, and higher levels of intolerance to uncertainty and death anxiety have been also associated with increased psychological distress (Shevlin et al., 2021 ). In our review, the few studies (19% of the eligible papers) comparing EDs or obesity cases with healthy controls during the confinement showed higher symptomatic behaviours and mental distress, suggesting that individuals with eating or weight disorders can be more at risk.…”