Psychological distress, depression, anxiety and life satisfaction following COVID-19 infection: evidence from 11 UK longitudinal population studies

Thompson, E. J. et al. (2022) Psychological distress, depression, anxiety and life satisfaction following COVID-19 infection: evidence from 11 UK longitudinal population studies. Lancet Psychiatry, 9(11), pp. 894-906. (doi: 10.1016/S2215-0366(22)00307-8) (PMID:36244359) (PMCID:PMC9560745)

Abstract

Background: Evidence on associations between COVID-19 illness and mental health is mixed. We aimed to examine whether COVID-19 is associated with deterioration in mental health while considering pre-pandemic mental health, time since infection, subgroup differences, and confirmation of infection via self-reported test and serology data. Methods: We obtained data from 11 UK longitudinal studies with repeated measures of mental health (psychological distress, depression, anxiety, and life satisfaction; mental health scales were standardised within each study across time) and COVID-19 status between April, 2020, and April, 2021. We included participants with information available on at least one mental health outcome measure and self-reported COVID-19 status (suspected or test-confirmed) during the pandemic, and a subset with serology-confirmed COVID-19. Furthermore, only participants who had available data on a minimum set of covariates, including age, sex, and pre-pandemic mental health were included. We investigated associations between having ever had COVID-19 and mental health outcomes using generalised estimating equations. We examined whether associations varied by age, sex, ethnicity, education, and pre-pandemic mental health, whether the strength of the association varied according to time since infection, and whether associations differed between self-reported versus confirmed (by test or serology) infection. Findings: Between 21 Dec, 2021, and July 11, 2022, we analysed data from 54 442 participants (ranging from a minimum age of 16 years in one study to a maximum category of 90 years and older in another; including 33 200 [61·0%] women and 21 242 [39·0%] men) from 11 longitudinal UK studies. Of 40 819 participants with available ethnicity data, 36 802 (90·2%) were White. Pooled estimates of standardised differences in outcomes suggested associations between COVID-19 and subsequent psychological distress (0·10 [95% CI 0·06 to 0·13], I2=42·8%), depression (0·08 [0·05 to 0·10], I2=20·8%), anxiety (0·08 [0·05 to 0·10], I2=0·0%), and lower life satisfaction (–0·06 [–0·08 to –0·04], I2=29·2%). We found no evidence of interactions between COVID-19 and sex, education, ethnicity, or pre-pandemic mental health. Associations did not vary substantially between time since infection of less than 4 weeks, 4–12 weeks, and more than 12 weeks, and were present in all age groups, with some evidence of stronger effects in those aged 50 years and older. Participants who self-reported COVID-19 but had negative serology had worse mental health outcomes for all measures than those without COVID-19 based on serology and self-report. Participants who had positive serology but did not self-report COVID-19 did not show association with mental health outcomes. Interpretation: Self-reporting COVID-19 was longitudinally associated with deterioration in mental health and life satisfaction. Our findings emphasise the need for greater post-infection mental health service provision, given the substantial prevalence of COVID-19 in the UK and worldwide. Funding: UK Medical Research Council and UK National Institute for Health and Care Research.

• Item Type: Articles
• Additional Information: The COVID-19 Longitudinal Health and Wellbeing National Core Study was funded by the UK Medical Research Council (MC_PC_20059 and MC_PC_20030) and the CONVALESCENCE study was funded by the UK National Institute for Health and Care Research (CONVALESCENCE grant COV-LT-0009).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Green, Dr Michael and Katikireddi, Professor Vittal and Shaw, Dr Richard
• Authors: Thompson, E. J., Stafford, J., Moltrecht, B., Huggins, C. F., Kwong, A. S.F., Shaw, R. J., Zaninotto, P., Patel, K., Silverwood, R. J., McElroy, E., Pierce, M., Green, M. J., Bowyer, R. C.E., Maddock, J., Tilling, K., Katikireddi, S. V., Ploubidis, G. B., Porteous, D. J., Timpson, N., Chaturvedi, N., Steves, C. J., and Patalay, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: Lancet Psychiatry
• Publisher: Elsevier
• ISSN: 2215-0366
• ISSN (Online): 2215-0374
• Published Online: 14 October 2022
• Copyright Holders: Copyright © 2022 The Author(s)
• First Published: First published in Lancet Psychiatry 9(11):894-906
• Publisher Policy: Reproduced under a Creative Commons license