Mental Health Impacts Observed Among the General Population During COVID-19

covid19, stress
The researchers compared the perceived mental health impact and coping and changes in depressive symptoms, anxiety, worry, and loneliness before and during the COVID-19 pandemic between people with and without lifetime depressive, anxiety, or obsessive-compulsive disorders.

Individuals living with obsessive compulsive, anxiety, or depressive disorders during the coronavirus 2019 (COVID-19) pandemic are at increased risk for detrimental impacts to their mental health. These findings, from a questionnaire, were published in Lancet Psychiatry.

This study recruited individuals from 3 cohort studies in the Netherlands which had similar procedures and data collection. The source studies were of longitudinal designs which began in 2006 and had several rounds of follow-up. This analysis included data from 1517 participants who were stratified by the presence of lifetime mental health disorders.

Living participants (N=2748) of the 3 studies were contacted between April 1 and May 13, 2020. The respondents tended to be younger (P <.0001), with a lower educational attainment (P =.0017), and higher prevalence of mental health disorders (P =.029) compared with non-respondents.

Respondents were aged mean 56.1 (standard deviation [SD], 13.2) years and 64% were women. Stratified by presence of a lifetime mental health disorder, those with a disorder tended to be women (P <.0001), had lower educational attainment (P <.0001), lived alone (P =.011), and were younger (P =.013).

Individuals with more mental health burden indicated they were experiencing increased impact on their mental health (P <.0001), increased fear (P <.0001), and decreased positive coping ability (P <.0001) in a dose-response gradient depending on their mental health burden during the pandemic.

Compared with previous responses, overall symptoms of worry (b, 0.66; 95% CI, 0.25-1.07), depression (b, 0.26; 95% CI, 0.07-0.44), and loneliness (b, 0.22; 95% CI, 0.11-0.33) increased after the COVID-19 pandemic began.

The change of symptoms was observed to have a dose-response gradient, in which individuals with a higher number and severity of mental health disorders were experiencing decreased symptoms.

For symptoms of depression, individuals with no lifetime disorders reported a significant increase of symptoms (P <.0001) and those with the highest burden of mental health disorders reported a decrease (P =.0038). A similar pattern for symptoms of worry were observed, in which participants with no mental health burden had a significant increase (P <.0001) and the greatest burden a significant decrease (P =.0088).

A separate pattern for loneliness and anxiety symptoms were observed, in which participants with no burden had a significant increase (P <.0001; P =.032) and the highest burden was a nonsignificant decrease of symptoms (P =.30; P =.071), respectively.

This study may have been limited by the change in the data collection strategy. Previous waves of all the studies were conducted in person and the COVID-19 wave was an online questionnaire.

These data indicated individuals with pre-existing mental health disorders were at an increased risk for detrimental impacts during the COVID-19 pandemic.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Pan KY, Kok AAL, Eikelenboom M, et al. The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: A longitudinal study of three Dutch case-control cohorts. Lancet Psychiatry. Published online December 8, 2020. doi:10.1016/S2215-0366(20)30491-0