Objectives Previous pandemics have resulted in significant consequences for mental health. Here, we report the mental health sequelae of the COVID-19 pandemic in a UK cohort and examine modifiable and non-modifiable explanatory factors associated with mental health outcomes. We focus on the first wave of data collection, which examined short-term consequences for mental health, as reported during the first 4–6 weeks of social distancing measures being introduced.
Design Cross-sectional online survey.
Setting Community cohort study.
Participants N=3097 adults aged ≥18 years were recruited through a mainstream and social media campaign between 3 April 2020 and 30 April 2020. The cohort was predominantly female (n=2618); mean age 44 years; 10% (n=296) from minority ethnic groups; 50% (n=1559) described themselves as key workers and 20% (n=649) identified as having clinical risk factors putting them at increased risk of COVID-19.
Main outcome measures Depression, anxiety and stress scores.
Results Mean scores for depression ( =7.69, SD=6.0), stress ( =6.48, SD=3.3) and anxiety ( = 6.48, SD=3.3) significantly exceeded population norms (all p<0.0001). Analysis of non-modifiable factors hypothesised to be associated with mental health outcomes indicated that being younger, female and in a recognised COVID-19 risk group were associated with increased stress, anxiety and depression, with the final multivariable models accounting for 7%–14% of variance. When adding modifiable factors, significant independent effects emerged for positive mood, perceived loneliness and worry about getting COVID-19 for all outcomes, with the final multivariable models accounting for 54%–57% of total variance.
Conclusions Increased psychological morbidity was evident in this UK sample and found to be more common in younger people, women and in individuals who identified as being in recognised COVID-19 risk groups. Public health and mental health interventions able to ameliorate perceptions of risk of COVID-19, worry about COVID-19 loneliness and boost positive mood may be effective.
- mental health
- public health
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Contributors RJ: study design, coordination and management of recruitment, preparation, analysis and interpretation of data, preparation and review of final manuscript. KA: study design, coordination and management of recruitment, preparation, analysis and interpretation of data preparation and review of final manuscript. TC: study design, analysis and interpretation of data preparation and review of final manuscript. AM: study design, coordination and management of recruitment, preparation, analysis and interpretation of data and review of final manuscript. EB: study design, interpretation of data and review of final manuscript. CC: study design, analysis and interpretation of data, preparation and review of final manuscript. KV: research lead and overall guarantor for the article contributing to study design, coordination and management of recruitment, preparation, analysis and interpretation of data and preparation of manuscript. As corresponding author, KV had access to all the data in the study and had final responsibility for the decision to submit for publication.
Funding KA was supported by funding from the National Institute for Health Research (NIHR) School for Primary Care Research. The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS or the Department of Health. TC acknowledges the financial support of the Department of Health via the NIHR Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry at King’s College London. The views expressed are those of the authors and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethical approval was granted from the University of Nottingham Faculty of Medicine and Health Sciences (ref: 506-2003) and the NHS Health Research Authority (ref: 20/HRA/1858)
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. Data will be deposited in the University of Nottingham data archive. Access to this dataset will be embargoed for a period of 12 months to permit planned analyses of the dataset. After that it may be shared with the consent of the Chief Investigator. Extra data is available by contacting firstname.lastname@example.org.