Depression, anxiety and PTSD symptoms before and during the COVID-19 pandemic in the UK

K S Young; K L Purves; C Hübel; M R Davies; K N Thompson; S Bristow; G Krebs; A Danese; C Hirsch; C E Parsons; E Vassos; B N Adey; S Bright; L Hegemann; Y T Lee; G Kalsi; D Monssen; J Mundy; A J Peel; C Rayner; H C Rogers; A Ter Kuile; C Ward; K York; Y Lin; A B Palmos; U Schmidt; D Veale; T R Nicholson; T A Pollak; S A M Stevelink; T Moukhtarian; A R Martineau; H Holt; B Maughan; A Al-Chalabi; K Ray Chaudhuri; M P Richardson; J R Bradley; P F Chinnery; N Kingston; S Papadia; K E Stirrups; R Linger; M Hotopf; T C Eley; G Breen

doi:10.1017/S0033291722002501

Depression, anxiety and PTSD symptoms before and during the COVID-19 pandemic in the UK

Psychol Med. 2023 Sep;53(12):5428-5441. doi: 10.1017/S0033291722002501. Epub 2022 Jul 26.

Authors

K S Young^{1

2}, K L Purves^{1

2}, C Hübel^{1

2

3}, M R Davies^{1

2}, K N Thompson¹, S Bristow¹, G Krebs¹, A Danese^{1

4

5}, C Hirsch⁶, C E Parsons⁷, E Vassos¹, B N Adey¹, S Bright¹, L Hegemann¹, Y T Lee¹, G Kalsi^{1

2}, D Monssen^{1

2}, J Mundy^{1

2}, A J Peel¹, C Rayner¹, H C Rogers^{1

2}, A Ter Kuile^{1

2}, C Ward¹, K York¹, Y Lin¹, A B Palmos¹, U Schmidt^{2

8}, D Veale^{6

9}, T R Nicholson^{9

10}, T A Pollak^{9

10}, S A M Stevelink⁸, T Moukhtarian¹, A R Martineau¹¹, H Holt¹¹, B Maughan¹, A Al-Chalabi¹², K Ray Chaudhuri^{12

13}, M P Richardson^{2

12}, J R Bradley¹⁴, P F Chinnery^{14

15}, N Kingston^{14

16}, S Papadia^{14

17}, K E Stirrups^{14

16}, R Linger^{14

17}, M Hotopf^{2

8}, T C Eley^{1

2}, G Breen^{1

2}

Affiliations

¹ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
² NIHR Maudsley Biomedical Research Centre, King's College London, London, UK.
³ Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
⁴ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
⁵ National and Specialist CAMHS Trauma, Anxiety, and Depression Clinic, South London and Maudsley NHS Foundation Trust, London, UK.
⁶ Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ Interacting Minds Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
⁸ Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
⁹ South London and Maudsley NHS Foundation Trust, London, UK.
¹⁰ Section of Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹¹ Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK.
¹² Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹³ Parkinson Foundation Centre of Excellence, King's College and King's College Hospital, London, UK.
¹⁴ NIHR BioResource and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
¹⁵ Department of Clinical Neurosciences and MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
¹⁶ Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
¹⁷ Department of Public Health and Primary Care, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.

Abstract

Background: The impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health is still being unravelled. It is important to identify which individuals are at greatest risk of worsening symptoms. This study aimed to examine changes in depression, anxiety and post-traumatic stress disorder (PTSD) symptoms using prospective and retrospective symptom change assessments, and to find and examine the effect of key risk factors.

Method: Online questionnaires were administered to 34 465 individuals (aged 16 years or above) in April/May 2020 in the UK, recruited from existing cohorts or via social media. Around one-third (n = 12 718) of included participants had prior diagnoses of depression or anxiety and had completed pre-pandemic mental health assessments (between September 2018 and February 2020), allowing prospective investigation of symptom change.

Results: Prospective symptom analyses showed small decreases in depression (PHQ-9: -0.43 points) and anxiety [generalised anxiety disorder scale - 7 items (GAD)-7: -0.33 points] and increases in PTSD (PCL-6: 0.22 points). Conversely, retrospective symptom analyses demonstrated significant large increases (PHQ-9: 2.40; GAD-7 = 1.97), with 55% reported worsening mental health since the beginning of the pandemic on a global change rating. Across both prospective and retrospective measures of symptom change, worsening depression, anxiety and PTSD symptoms were associated with prior mental health diagnoses, female gender, young age and unemployed/student status.

Conclusions: We highlight the effect of prior mental health diagnoses on worsening mental health during the pandemic and confirm previously reported sociodemographic risk factors. Discrepancies between prospective and retrospective measures of changes in mental health may be related to recall bias-related underestimation of prior symptom severity.

Keywords: Anxiety; COVID-19; PTSD; depression.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety / psychology
COVID-19* / epidemiology
Depression / psychology
Female
Humans
Pandemics
Prospective Studies
Retrospective Studies
SARS-CoV-2
Stress Disorders, Post-Traumatic* / epidemiology
Stress Disorders, Post-Traumatic* / psychology
United Kingdom / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding