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
Open accessAbstract
Background The impact of the COVID-19 pandemic on mental health in people with pre-existing mental health disorders is unclear. In three psychiatry case-control cohorts, we 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.Methods Between April 1 and May 13, 2020, online questionnaires were distributed among the Netherlands Study of Depression and Anxiety, Netherlands Study of Depression in Older Persons, and Netherlands Obsessive Compulsive Disorder Association cohorts, including people with (n=1181) and without (n=336) depressive, anxiety, or obsessive-compulsive disorders. The questionnaire contained questions on perceived mental health impact, fear of COVID-19, coping, and four validated scales assessing depressive symptoms, anxiety, worry, and loneliness used in previous waves during 2006-16. Number and chronicity of disorders were based on diagnoses in previous waves. Linear regression and mixed models were done.Findings The number and chronicity of disorders showed a positive graded dose-response relation, with greater perceived impact on mental health, fear, and poorer coping. Although people with depressive, anxiety, or obsessive-compulsive disorders scored higher on all four symptom scales than did individuals without these mental health disorders, both before and during the COVID-19 pandemic, they did not report a greater increase in symptoms during the pandemic. In fact, people without depressive, anxiety, or obsessive-compulsive disorders showed a greater increase in symptoms during the COVID-19 pandemic, whereas individuals with the greatest burden on their mental health tended to show a slight symptom decrease.Interpretation People with depressive, anxiety, or obsessive-compulsive disorders are experiencing a detrimental impact on their mental health from the COVID-19 pandemic, which requires close monitoring in clinical practice. Yet, the COVID-19 pandemic does not seem to have further increased symptom severity compared with their prepandemic levels.Funding Dutch Research Council.
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Compared to before the pandemic, feelings of depression, worry, and loneliness increased for most during the pandemic.
“Compared to before the pandemic, feelings of depression, worry, and loneliness increased for most during the pandemic (Pan et al., 2021).”
From Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations (2024) · cites this paper as Pan et al., 2021
The Results report overall increases in depression, worry, and loneliness scores compared with before the pandemic. They do not establish that these feelings increased for most individuals; the Discussion notes minimal or negative changes among people with the most severe and chronic disorders. Page numbers are not available in our copy. (LLM, conf=0.88)
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- Authors
- Pan, K.-Y., Kok, A. A. L., Eikelenboom, M., Horsfall, M., Jörg, F., Luteijn, R. A., Rhebergen, D., Oppen, P. V., Giltay, E. J., & Penninx, B. W. J. H.
- Affiliations
- Amsterdam Public Health (NL)
- University Medical Center Groningen (NL)
- GGz centraal (NL)
- Leiden University Medical Center (NL)
- Corresponding author
- Pan, Kuan-Yu
- ORCID
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2021-02
- Volume
- 8
- Issue
- 2
- Pages
- 121-129
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC7831806
- OpenAlex
- W3110783124
- Cited by
- 585
- References
- 27
- Citations by year
- 2026: 15 · 2025: 22 · 2024: 68 · 2023: 113 · 2022: 185 · 2021: 178 · 2020: 1 · 2018: 1 · 2012: 1
- FWCI
- 47.59
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-03-01)
- Open access
- bronze
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- Leiden Repository (Leiden University) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- 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 › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- COVID-19 pandemic, mental health outcomes, depressive disorders, anxiety disorders, obsessive-compulsive disorder, depressive symptoms, anxiety, worry, loneliness, coping, fear of COVID-19, symptom severity, dose-response relationship
- MeSH terms
- COVID-19, Adaptation, Psychological, Adolescent, Adult, Aged, Anxiety Disorders, Depressive Disorder, Female, Humans, Loneliness, Longitudinal Studies, Male, Mental Health, Middle Aged, Netherlands, Obsessive-Compulsive Disorder, Severity of Illness Index, Cohort Studies, Young Adult
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