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A longitudinal study of psychological distress in the United States before and during the COVID-19 pandemic

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Breslau, Joshua, Finucane, Melissa L., Locker, Alicia R., Baird, Matthew D., Roth, Elizabeth A., Collins, Rebecca L.·2021·Preventive Medicine

DOI 10.1016/j.ypmed.2020.106362PMC PMC9753596

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Abstract

The COVID-19 pandemic has caused financial stress and disrupted daily life more quickly than any prior economic downturn and on a scale beyond any prior natural disaster. This study aimed to assess the impact of the pandemic on psychological distress and identify vulnerable groups using longitudinal data to account for pre-pandemic mental health status. Clinically significant psychological distress was assessed with the Kessler-6 in a national probability sample of adults in the United States at two time points, February 2019 (T1) and May 2020 (T2). To identify increases in distress, psychological distress during the worst month of the past year at T1 was compared with psychological distress over the past 30-days at T2. Survey adjusted logistic regression was used to estimate associations of demographic characteristics at T1 (gender, age, race, and income) and census region at T2 with within-person increases in psychological distress. The past-month prevalence of serious psychological distress at T2 was as high as the past-year prevalence at T1 (10.9% vs. 10.2%). Psychological distress was strongly associated across assessments (X 2(4) = 174.6, p < .0001). Increase in psychological distress above T1 was associated with gender, age, household income, and census region. Equal numbers of people experienced serious psychological distress in 30-days during the pandemic as did over an entire year prior to the pandemic. Mental health services and research efforts should be targeted to those with a history of mental health conditions and groups identified as at high risk for increases in distress above pre-pandemic levels.

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Authors: Breslau, J., Finucane, M. L., Locker, A. R., Baird, M. D., Roth, E. A., & Collins, R. L.
Affiliations: RAND Corporation (US)
Corresponding author: Breslau, Joshua
ORCID: Breslau, Joshua
Finucane, Melissa L.
Locker, Alicia R.
Baird, Matthew D.
Collins, Rebecca L.
Venue: Preventive Medicine
Publisher: Elsevier BV
Published: 2021-02
Volume: 143
Pages: 106362
ISSN: 0091-7435 (ISSN-L)
DOI: 10.1016/j.ypmed.2020.106362
PMC: PMC9753596
OpenAlex: W3117022650
Cited by: 251
References: 19
Citations by year: 2026: 18 · 2025: 35 · 2024: 32 · 2023: 55 · 2022: 55 · 2021: 55
FWCI: 16.58
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Preventive Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Minority Health and Health Disparities (R01 MD010274)
National Institute of Mental Health (R01 MH104381)
Topics: Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords: COVID-19 pandemic, psychological distress, serious psychological distress, mental health, vulnerable populations, financial stress, household income, gender differences, age differences, race, census regions, within-person change, Kessler-6, mental health services
MeSH terms: Psychological Distress, COVID-19, SARS-CoV-2, Adult, Aged, Aged, 80 and over, Mental Disorders, Female, Humans, Longitudinal Studies, Male, Middle Aged, Surveys and Questionnaires, Stress, Psychological, Time Factors, United States, Young Adult, Pandemics

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A longitudinal study of psychological distress in the United States before and during the COVID-19 pandemic

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