3,097 adults joined the COVID-19 Stress and Health Study in the first six weeks of social restriction measures being introduced in the UK. It was designed to look at the effects of the pandemic on the mental health of people living in the UK and examine whether experiences like increased stress, anxiety and depression might be affecting physical health.
Results from the first stage of the study, published in the BMJ Open, have focused on three specific questions:
- Are people in the UK experiencing more stress, anxiety and depression during the first six weeks of social restriction measures being introduced that we normally see in the UK?
- Are certain groups of people more distressed than others?
- Which factors are most strongly associated with mental health and could these be the focus of future interventions?
The results show that stress, anxiety and depression were all significantly higher in participants compared with previous published norms, with 64% of participants reporting symptoms of depression and 57% reporting symptoms of anxiety. When considering the thresholds at which someone would qualify for high intensity psychological support in the NHS, the team observed that 31.6% reported moderate to severe depression and 26% moderate to severe anxiety.
Although these results are from a cross sectional study, they highlight some important messages. The emotional toll early on in the pandemic appears to have been significant in the UK. This is perhaps not surprising as people were required to rapidly and unexpectedly respond to a range of challenges. What is crucial now is to examine if these very high levels of distress are persisting over time.– Study lead Kavita Vedhara, Professor of Health Psychology, from the School of Medicine at the University of Nottingham
The researchers also found that being younger and female was associated with significantly greater levels of stress, anxiety and depression.
However, the strongest associations with mental health were not with age and gender, but with psychological measures which captured how lonely people felt, their worry about getting COVID-19 and also their experience of positive mood. These ‘modifiable’ factors accounted for 54-57% of the variability in mental health.
This study found that worry about getting COVID-19 as well as loneliness were associated with anxiety, depression and stress. More support at a community level and targeted work with individuals particularly affected by the pandemic could help people access ways of coping during these difficult times and alleviate these ‘modifiable’ factors that our study has shown to be so important for our mental health during the pandemic.– Co-investigator on the study, Professor Trudie Chalder from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) King’s College London
Professor Vedhara added: ‘The people hit hardest appear to be younger people and women, but the strongest associations with mental health were with worry about COVID-19, feelings of loneliness and limited positive emotional experiences. This suggests that for some people, the emotional consequences of the pandemic may require psychological intervention. However, it also highlights a potential role for public health interventions too.
‘Robust contact tracing, wearing of face masks etc, are designed to reduce the risk of infection in the community. But if done well, they could also assuage people’s worries about getting COVID-19, increase their opportunities for safe social interaction and improve positive mood. In this way, effective public health interventions could help mental health too.’
Part of the study has also been to collect samples of hair from participants to measure the stress hormone cortisol. This hormone plays a key role in determining how emotional well-being affects physical health and the team will be exploring whether the emotional effects of the pandemic have changed levels of this hormone and how cortisol is related to the risk of COVID-19 and the severity of the infection.
Reference: Jia, R. et al. (2020) Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study. BMJ Open DOI: 10.1136/bmjopen-2020-040620
Based on a press release issued by the University of Nottingham.