Psychiatric Symptoms Increased During the Pandemic

This study is the first to assess the mental health impact of the COVID-19 pandemic across the lifespan in the United States in adolescents, adults, and healthcare workers.

Increased loneliness during the coronavirus disease 2019 (COVID-19) pandemic may put individuals at risk for psychiatric disorders as rates of psychiatric symptoms have increased during the pandemic. These findings from an online survey were published in Depression and Anxiety.

Researchers at the University of Pittsburgh School of Medicine recruited individuals (N=4909) aged 13 years or older living in the United States. They were recruited through Facebook and Instagram advertisements between April and July 2020. Participants were assessed by the 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalized Anxiety Disorder (GAD-7), for posttraumatic stress disorder (PTSD), for suicidal ideation and nonsuicidal self-injurious behavior, and grief.

Participants had a mean age of 40.3 (±17.6) years, 80% were women or girls, and 82% were White.

Of respondents, 35% suspected they had been exposed to COVID-19, and 11% had tested positive for it. Some participants (7.5%) reported they had needed a test but had no access to one. Most participants (91%) reported complying with social distancing recommendations.

Current clinically significant symptoms of sleep difficulties (58%), grief (55%), PTSD (34%), depression (32%), anxiety (31%), and suicidal ideation or behavior (18%) were reported.

Stratified by age, adults were negatively affected by more aspects of the pandemic.

Among adults, all assessed factors except gender were associated with depression (P £.032). Similarly, most assessed factors (except gender, ethnicity, household conflict, and suicidal ideation) were associated with anxiety (all P £.019).

Adult PTSD was associated with gender, ethnicity, loneliness, social status, sleep difficulties, household conflict, household income, chronic diseases, and stress (all P £.043). Suicidal ideation or behavior was associated with lifetime suicidal ideation, loneliness, and stress (all P £.002), and prolonged grief associated with loneliness (P =.008).

Adolescent depression was significantly associated with 6 factors (loneliness, overall health, sleep difficulties, stress, and time spent on social media use or playing video games; all P £.043) and anxiety with 9 factors (gender, social status, loneliness, stress, previous suicide attempt, expected COVID-19 exposure, health worries about COVID-19, overall health, and internet use; all P £.042).

This study may have been biased by differentially surveying participants by their ages. For instance, adults were not assessed for time spent on social media or the internet, and it remains unclear whether these factors may have contributed to the observed psychiatric symptoms.

These findings suggest that psychiatric symptoms may be increasing among vulnerable populations during the COVID-19 pandemic. Concerted public health strategies are needed to address the consequences of increased psychiatric symptoms.


Murata S, Rezeppa T, Thoma B, et al. The psychiatric sequelae of the COVID‐19 pandemic in adolescents, adults, and health care workers. Published online December 28, 2020. Depress Anxiety. doi:10.1002/da.23120