Mental health during the COVID-19 pandemic in two longitudinal UK population cohorts

  1. Alex S. F. Kwong
  2. Rebecca M. Pearson
  3. Mark J. Adams
  4. Kate Northstone
  5. Kate Tilling
  6. Daniel Smith
  7. Chloe Fawns-Ritchie
  8. Helen Bould
  9. Naomi Warne
  10. Stan Zammit
  11. David Gunnell
  12. Paul Moran
  13. Nadia Micali
  14. Abraham Reichenberg
  15. Matthew Hickman
  16. Dheeraj Rai
  17. Simon Haworth
  18. Archie Campbell
  19. Drew Altschul
  20. Robin Flaig
  21. Andrew M. McIntosh
  22. Deborah A. Lawlor
  23. David Porteous
  24. Nicholas J. Timpson
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Abstract

Background

The impact of COVID-19 on mental health is unclear. Evidence from longitudinal studies with pre pandemic data are needed to address (1) how mental health has changed from pre-pandemic levels to during the COVID-19 pandemic and (2), whether there are groups at greater risk of poorer mental health during the pandemic?

Methods

We used data from COVID-19 surveys (completed through April/May 2020), nested within two large longitudinal population cohorts with harmonised measures of mental health: two generations of the Avon Longitudinal Study of Parents and Children (ALPSAC): the index generation ALSPAC-G1 (n= 2850, mean age 28) and the parent’s generation ALSPAC-G0 (n= 3720, mean age = 59) and Generation Scotland: Scottish Family Health Study (GS, (n= 4233, mean age = 59), both with validated pre-pandemic measures of mental health and baseline factors. To answer question 1, we used ALSPAC-G1, which has identical mental health measures before and during the pandemic. Question 2 was addressed using both studies, using pre-pandemic and COVID-19 specific factors to explore associations with depression and anxiety in COVID-19.

Findings

In ALSPAC-G1 there was evidence that anxiety and lower wellbeing, but not depression, had increased in COVID-19 from pre-pandemic assessments. The percentage of individuals with probable anxiety disorder was almost double during COVID-19: 24% (95% CI 23%, 26%) compared to pre-pandemic levels (13%, 95% CI 12%, 14%), with clinically relevant effect sizes. In both ALSPAC and GS, depression and anxiety were greater in younger populations, women, those with pre-existing mental and physical health conditions, those living alone and in socio-economic adversity. We did not detect evidence for elevated risk in key workers or health care workers.

Interpretation

These results suggest increases in anxiety and lower wellbeing that may be related to the COVID-19 pandemic and/or its management, particularly in young people. This research highlights that specific groups may be disproportionally at risk of elevated levels of depression and anxiety during COVID-19 and supports recent calls for increasing funds for mental health services.

Funding

The UK Medical Research Council (MRC), the Wellcome Trust and University of Bristol.

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