Although many studies have been conducted over the past two years, both during and after the implementation of the 2019 coronavirus disease restrictions (COVID-19), the long-term effects of these events are still unclear.
A new study published in the prepress server medRxiv * looks at changes in the prevalence of depressive and anxiety symptoms throughout the COVID-19 pandemic and its association with individual and environmental factors.
Study: Depressive and anxiety symptoms during the COVID-19 pandemic: a two-year follow-up. Image credit: fizkes / Shutterstock.com
Introduction
The onset of the COVID-19 pandemic was quickly followed by major changes in the global economy, social interactions, education, and health care systems. Some of the common stressors that affected people during the pandemic included the fear of becoming seriously ill and dying of COVID-19, the isolation of loved ones and friends due to measures of social distancing, job loss, daycare and school facilities, which later led parents who had previously worked to become full-time caregivers of children at home, increased financial stress and the reorientation of most health services to cope with the crisis posed by COVID-19.
The rapid spread of coronavirus 2 causing severe acute respiratory syndrome (SARS-CoV-2), as well as the high mortality of COVID-19 and overloaded hospital systems, supported global efforts to rapidly develop highly effective vaccines. Subsequent large-scale deployment of COVID-19 vaccines led to a short-term reduction in case rates, which was followed by a gradual relaxation of most pandemic restrictions.
Some researchers have described an inverse relationship between the severity of COVID-19 restrictions and mental health, while others have shown a positive association. These mixed results emphasize the need to better understand the context, which could confuse the results of these association studies. In addition, predictors of poor mental health should also be reviewed as background experiences change.
About the study
The current study looks at long-term changes in public mental health between March 2020 and April 2022. These changes were assessed on the basis of data from COVID-19 social study (CSS) at University College London ( UCL), which included more than 75,000 adults during the study period.
The researchers examined mental health symptoms with the established assessment of generalized anxiety disorder (GAD-7), contextual factors such as the severity index, the number of cases and deaths, and individual predictors such as the level of confidence that people had in their government, health services, and access to essential services, as well as if the person had contracted COVID-19.
Study results
COVID-19 restrictions were stricter both during the first blockade from 21 March 2020 to 23 August 2020, as well as during the second and third blockade from 21 September 2020 until April 11, 2021. The daily count of cases increased after the first. confinement.
Daily COVID-19-related deaths peaked during confinement periods. However, COVID-19-related deaths decreased during the second confinement, which has been attributed to the deployment of vaccines that began in December 2020.
A small increase in symptoms of depression and anxiety was reported during the two periods of confinement compared to intermittent periods of relaxation. Although these symptoms were high at the beginning of the first confinement, they decreased rapidly thereafter. In August 2020, both anxiety and depressive symptoms increased again to the third confinement.
The next slow decline in these symptoms continued until late 2021 when they began to increase again. However, depressive symptoms decreased again between March and April 2022. During the first confinement, the increase in the number of cases was inversely associated with anxiety and depressive symptoms, but not later.
In addition, an increase in deaths due to COVID-19 was initially associated with depressive symptoms that eventually decreased over time. Vaccination was also associated with a moderate increase in depressive symptoms during the second and third blockages.
Depressive symptoms were higher as confidence in government, health care, and the availability of essentials declined, and this effect intensified over time. There was a small increase in depressive symptoms as knowledge of the disease increased; however, this change was only evident during the first confinement.
Pandemic-related stress was associated with more depressive symptoms, especially during the first confinement. The association between COVID-19-related stress and these symptoms remained constant, although weaker over time, indicating that people only partially adapted to the fear of becoming terminally ill with it. infection. This was probably motivated by a greater awareness of the chances of COVID-19 surviving by personal or social acquaintances and becoming more familiar with the infection.
Strict policies had the greatest impact when they affected social interactions. In fact, even an increase in deaths due to infection was not associated with depressive symptoms at the end of the study period, although the opposite effect was observed before the pandemic. This could be due to the deployment of vaccination, after which deaths remained at a lower and more stable level and no longer represented a major source of terror.
The onset of COVID-19 was associated with an increase in depression throughout the study. In fact, as the pandemic progressed, this association grew stronger, perhaps due to the actual inflammatory effects of SARS-CoV-2 in the brain.
However, these symptoms could be alleviated by providing social support. The importance of social support, “probably the most important predictor in general”, cannot be overemphasized.
Implications
The current study tracked the evolution of anxiety and depression-related symptoms over two years since the onset of the pandemic. This is the longest British study to monitor these symptoms during this period.
The study’s findings corroborated the association of uncertainty and early fear that predominated at the onset of blockage with these symptoms, although they decreased thereafter. The next increase in these symptoms was associated with an increase in COVID-19 cases and the consequent implementation of restrictions in late 2020 and early 2021.
When the final confinement ended, depressive and anxiety symptoms decreased again, although the number of new cases of COVID-19 remained high. Other factors that were associated with these symptoms include a lack of confidence in government, health care systems, and commodities or service supplies. In contrast, social support improves mental health.
Interestingly, the repeated call for protection by the National Health Service (NHS) at the beginning of the pandemic was associated with a loss of confidence in its ability to cope with the crisis. Health service disruptions due to many pandemic-related effects, as well as the fear of infection that led many to avoid medical consultations and other health research behaviors, also had negative impacts on mental health.
The perceived lack of support for mental health due to the overall burden on the health service could also explain the relationship to increased anxiety and depressive symptoms. “
The current study highlights the importance of factors such as social support, fear of being infected with SARS-CoV-2, a history of COVID-19, confidence in government, health care and access to goods, and essential services as well as social restrictions. contact and its ability to affect mental health during a crisis like the current pandemic. In addition, these findings show that other factors such as strict policies and case / death counts are less directly associated with mental health impacts and that their influence varies depending on the prevailing situation in the country.
This could provide important implications for policy-making and for a better understanding of the mental health of the general public during a national or global health crisis. “
* Important news
medRxiv publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered conclusive, guided by clinical practice or health-related behavior, or treated as established information.