A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic in 2020
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Abstract
Background Increases in mental health problems have been observed during the COVID-19 pandemic. The objectives were to examine the extent to which mental health symptoms changed during the pandemic in 2020, whether changes were persistent or short lived, and if changes were symptom specific. Methods Systematic review and meta-analysis of longitudinal cohort studies examining changes in mental health among the same group of participants before vs. during the pandemic in 2020. Results Sixty-five studies were included. Compared to pre-pandemic outbreak, there was an overall increase in mental health symptoms observed during March-April 2020 (SMC = .102 [95% CI: .026 to .192]) that significantly declined over time and became non-significant (May-July SMC = .067 [95% CI: -.022 to .157]. Compared to measures of anxiety (SMC = 0.13, p = 0.02) and general mental health (SMC = -.03, p = 0.65), increases in depression and mood disorder symptoms tended to be larger and remained significantly elevated in May-July [0.20, 95% CI: .099 to .302]. In primary analyses increases were most pronounced among samples with physical health conditions and there was no evidence of any change in symptoms among samples with a pre-existing mental health condition. Limitations There was a high degree of unexplained heterogeneity observed (I 2 s > 90%), indicating that change in mental health was highly variable across samples. Conclusions There was a small increase in mental health symptoms soon after the outbreak of the COVID-19 pandemic that decreased and was comparable to pre-pandemic levels by mid-2020 among most population sub-groups and symptom types.
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Numerous sources documented increased anxiety and depression in early months, which declined later in some countries but not others.
“Numerous sources documented a clear and consistent pattern of increased anxiety and depression in the early months of the pandemic, which declined during later months in some countries but not in others.”
From The Lancet Commission on lessons for the future from the COVID-19 pandemic (2022) · cites this paper as [272]
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“A key limitation of the current study is related to the retrospective assessment of the first three timepoints, which may have led to a recall bias.”
Background
- Authors
- Robinson, E., Sutin, A. R., Daly, M., & Jones, A.
- Affiliations
- University of Liverpool (GB)
- National University of Ireland, Maynooth (IE)
- Corresponding author
- Robinson, Eric
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2022-01
- Volume
- 296
- Pages
- 567-576
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC8578001
- OpenAlex
- W3203586449
- Cited by
- 1,147
- References
- 18
- Citations by year
- 2026: 94 · 2025: 140 · 2024: 258 · 2023: 363 · 2022: 253 · 2021: 38 · 2020: 1
- FWCI
- 29.53
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- medRxiv (acceptedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Maynooth University ePrints and eTheses Archive (Maynooth University) (acceptedVersion)
- 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, depression, anxiety, mood disorders, psychiatric symptoms, longitudinal changes in mental health, physical health conditions, pre-existing mental health conditions
- MeSH terms
- COVID-19, SARS-CoV-2, Anxiety, Depression, Humans, Longitudinal Studies, Mental Health, Cohort Studies, Pandemics
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