COVID-19 and mental health: A review of the existing literature
Open accessAbstract
The COVID-19 pandemic is a major health crisis affecting several nations, with over 720,000 cases and 33,000 confirmed deaths reported to date. Such widespread outbreaks are associated with adverse mental health consequences. Keeping this in mind, existing literature on the COVID-19 outbreak pertinent to mental health was retrieved via a literature search of the PubMed database. Published articles were classified according to their overall themes and summarized. Preliminary evidence suggests that symptoms of anxiety and depression (16-28%) and self-reported stress (8%) are common psychological reactions to the COVID-19 pandemic, and may be associated with disturbed sleep. A number of individual and structural variables moderate this risk. In planning services for such populations, both the needs of the concerned people and the necessary preventive guidelines must be taken into account. The available literature has emerged from only a few of the affected countries, and may not reflect the experience of persons living in other parts of the world. In conclusion, subsyndromal mental health problems are a common response to the COVID-19 pandemic. There is a need for more representative research from other affected countries, particularly in vulnerable populations.
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The COVID-19 pandemic has been associated with decreases in positive emotions and quality of life and increases in negative emotions, anxiety, fear, stress, depression, and sleep disturbances.
“mental health has been characterized by decreases in positive emotions and quality of life [5,6,7,8] as well as increases in negative emotions, anxiety, fear, stress, depression, and sleep disturbances [8,9,10,11,12,13,14].”
From At the Peak of the Second Wave of COVID-19, Did Millennials Show Different Emotional Responses from Older Adults? (2022) · cites this paper as [12]
The Results section (Observational studies; page not provided) reports anxiety, depressive symptoms, stress, and an association between anxiety and impaired sleep. The discussion of the general population also describes fear as a likely response. The paper does not report decreases in positive emotions or quality of life, or a general increase in negative emotions. (LLM, conf=0.87)
Experimental — accuracy not yet measuredA review of existing literature on COVID-19 and mental health shows an increase in symptoms of depression, anxiety, self-reported stress, fear, and sleep disturbances.
“According to Rajkumar (2020), a review of the existing literature on COVID-19 and mental health shows an increase in symptoms of depression, anxiety, self-reported stress, fear, and sleep disturbances.”
From Knowledge of COVID-19 and Its Influence on Mindfulness, Cognitive Emotion Regulation and Psychological Flexibility in the Indian Community (2020) · cites this paper as Rajkumar (2020)
The Results section’s observational-studies table reports depressive, anxiety, and self-reported stress symptoms, while the accompanying text links anxiety with impaired sleep. The general-population literature section discusses fear as a likely response. These passages do not establish that all five symptoms increased relative to a baseline; the discussion of fear is predictive rather than a measured increase. Page numbers are not provided in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe awareness that the infectious virus is around and can cause ill-health and fatal outcomes is taxing, leading to sadness and feelings of fear and worry.
“This might be due to the fact that the awareness that the infectious virus is around and can cause ill-health and fatal outcomes is taxing, thus leading to sadness and feelings of fear and worry (Cao et al., 2020; Li Z. et al., 2020; Rajkumar, 2020; Wang et al., 2020b; Özdin and Bayrak Özdin, 2020).”
From Knowledge of COVID-19 and Its Influence on Mindfulness, Cognitive Emotion Regulation and Psychological Flexibility in the Indian Community (2020) · cites this paper as Rajkumar, 2020
The Results section on the general population reports that the seriousness and uncertainty of COVID-19 may contribute to stress and mental morbidity, and describes likely fear and panic. The review also reports anxiety and depressive symptoms, but it does not specifically link awareness of possible illness or death to sadness, fear and worry. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe COVID-19 outbreak is associated with a major mental health burden, increased depressive symptoms, decreased sleep quality, and elevated anxiety in the general population.
“initial studies indicated a major mental health burden among the public, increased depressive symptoms, decreased sleep quality, and elevated anxiety during the COVID-19 outbreak [3–5].”
From Efficacy of a web application for stress management among Iranian college students during COVID-19 outbreak: a study protocol for randomized controlled trials (2020) · cites this paper as [5]
The Results table reports moderate-to-severe depressive symptoms in 16.5% and anxiety symptoms in 28.8% of a Chinese general-population sample, supporting a substantial mental health burden during the outbreak. The observational-studies discussion links anxiety with impaired sleep, but the sleep studies concern medical staff and self-isolating individuals, not the general population as a whole. The cited findings also do not establish increases in symptoms or declines in sleep quality relative to before the outbreak (page numbers unavailable in our copy). (LLM, conf=0.86)
Experimental — accuracy not yet measuredCovid-19 has had a drastic impact on the population's mental health, including medical students.
“Moreover, Covid-19 has had a drastic impact on the population’s mental health [40–43], including medical students [44–48].”
From Effectiveness of online mindfulness interventions on medical students’ mental health: a systematic review (2021) · cites this paper as [41]
Pandemic fear may cause more negative psychological feelings such as anxiety and PTSD symptoms.
“This kind of pandemic fear may cause more negative psychological feelings such as anxiety and PTSD symptoms (15, 46).”
From Prevalence and Psychosocial Correlates of Mental Health Outcomes Among Chinese College Students During the Coronavirus Disease (COVID-19) Pandemic (2020) · cites this paper as [46]
Available studies show an important presence of COVID-19 trauma and stress-related symptoms in the general population and in patients.
“Regarding the recent COVID-19 outbreak, the available studies show an important presence of COVID-19 trauma and stress-related symptoms in the general population and in patients (Bo et al., 2020; Rajkumar, 2020; Ren et al., 2020; Wang et al., 2020).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Rajkumar, 2020
Recent reviews highlighted that risk factors such as being female, younger, being a nurse, lack of adequate protective equipment, and exposure to infected people have been found to be associated with trauma-related stress symptoms in previous epidemics.
“In addition, a series of recent reviews highlighted that risk factors, such as being female, younger, being a nurse, lack of adequate protective equipment, and exposure to infected people, have been found to be associated to TRSs in previous epidemics (Brooks S. K. et al., 2020; Kisely et al., 2020; Rajkumar, 2020; Spoorthy, 2020; Walton et al., 2020).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Rajkumar, 2020
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Pandemic as a Challenge to Subjective Well-Being: Anxiety and Coping
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Fear of COVID-19 and Mental Health: The Role of Mindfulness in During Times of Crisis
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Gender Differences in Coping and Psychological Adaptation during the COVID-19 Pandemic
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“Likewise, public health campaigns that normalize anxiety in reaction to highly stressful events, promote self-care resources and strategies, and disseminate useful information on how to access mental health services will also be critical [66,68].”
BackgroundConsidering grief in mental health outcomes of COVID-19.
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Anxiety linked to COVID-19: A systematic review comparing anxiety rates in different populations
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“The scale of infection has been linked to psychological distress, implying something sinister may be emerging, a mental health crisis [8].”
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A review investigating the relationship between cannabis use and adolescent cognitive functioning
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“pandemic, mitigation policies, including social distancing and social isolation led to increased levels of anxiety and depression in the general population [32].”
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“Given the fact that this group is reportedly more vulnerable during COVID-19 (Chen et al., 2020; Deng et al., 2020; Liu W. et al., 2020; Pan et al., 2020; World Health Organization, 2020), the findings are consistent with other similar studies (Rajkumar, 2020; Özdin and Bayrak Özdin, 2020).”
BackgroundMethodResultInfluentialYogeswaran, V., & El Morr, C. (2021) · BMC Public Health · doi:10.1186/s12889-021-12341-z · Cited by 54 · see citing works
Li, Y., Fan, R., Lu, Y., Li, H., Liu, X., Kong, G., Wang, J., Yang, F., Zhou, J., & Wang, J. (2023) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2022.100618 · Cited by 50 · see citing works
Stress Perceived by University Health Sciences Students, 1 Year after COVID-19 Pandemic
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Rapid Review on COVID-19, Work-Related Aspects, and Age Differences
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Accoto, A., Chiarella, S. G., Raffone, A., Montano, A., de Marco, A., Mainiero, F., Rubbino, R., Valzania, A., & Conversi, D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115512 · Cited by 44 · see citing works
“Data from previously published studies that investigated mental health during the COVID19 pandemic clearly showed an increased mental health burden [92,93].”
ResultBeato, A. F., da Costa, L. P., & Nogueira, R. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18042017 · Cited by 41 · see citing works
“The first studies already published help to understand the levels of psychological impact in stress emotional response [17].”
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Self-compassion and the Mitigation of Negative Affect in the Era of Social Distancing
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Mental Health Impacts of Climate Change: Perspectives for the ED Clinician
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“The factors related to increased emotional distress include infringement of personal freedom, social isolation, the severity of the illness, job insecurity and financial loss, misinformation, unpredictability, and uncertainty.(60,62) Protracted social isolation can lead to anxiety, mood, or addictive disorder.”
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The Impact of COVID-19 on Provider Perceptions of Telemental Health
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Online resilience support groups during the COVID-19 pandemic: the Philippine experience
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- Authors
- Rajkumar, R. P.
- Affiliations
- Jawaharlal Institute of Post Graduate Medical Education and Research (IN)
- Corresponding author
- Rajkumar, Ravi Philip
- Venue
- Asian Journal of Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 52
- Pages
- 102066
- ISSN
- 1876-2018 (ISSN-L)
- PMC
- PMC7151415
- OpenAlex
- W3015556068
- Cited by
- 3,574
- References
- 31
- Citations by year
- 2026: 47 · 2025: 112 · 2024: 230 · 2023: 416 · 2022: 754 · 2021: 1229 · 2020: 777 · 2019: 3 · 2018: 1 · 2017: 1 · 2013: 3
- FWCI
- 317.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Asian Journal of Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- COVID-19 pandemic, mental health, anxiety, depression, stress, sleep disorders, psychological distress, vulnerable populations, mental health services
- MeSH terms
- COVID-19, Anxiety, Depression, Humans, Pneumonia, Viral, Sleep Wake Disorders, Stress, Psychological, Coronavirus Infections, Pandemics
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