Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022

Silvia S. Klokgieters; Brenda W.J.H. Penninx; Nathaly Rius Ottenheim; Erik J. Giltay; Didi Rhebergen; Almar A.L. Kok

doi:10.1016/j.jpsychores.2022.111138

Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022

Silvia S. Klokgieters^*, Brenda W.J.H. Penninx, Nathaly Rius Ottenheim, Erik J. Giltay, Didi Rhebergen, Almar A.L. Kok

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Objective: While research found heterogeneous changes in mental health during the COVID-19 pandemic, less is known about the long-term changes in mental health in psychiatric groups. Therefore, we applied a data-driven method to detect sub-groups with distinct trajectories across two years into the pandemic in psychiatric groups, and described their differences in socio-demographic and clinical characteristics. Method: We conducted sixteen rounds of questionnaires between April 2020 and February 2022 among participants (n = 1722) of three psychiatric case–control cohorts that started in the 2000's. We used Growth Mixture Modelling and (multinomial) logistic regression to identify characteristics associated with trajectory membership. Results: We found low decreasing (1228 [72%] participants), intermediate (n = 348 [22%] participants) and high stable (106 [6%] participants) trajectories of depressive symptoms; decreasing low/intermediate (1507 [90%] participants) and high stable (161 [10%] participants) trajectories of anxiety symptoms; and stable low (1109 [61%] participants), stable high (315 [17%] participants), temporary lowered (123 [9%]) and temporary heightened (175 [13%] participants) trajectories of loneliness. Chronicity and severity of pre-pandemic mental disorders predicted unfavourable sub-group membership for all outcomes. Being female, having a low education and income level were associated with unfavourable trajectories of depression, being younger with unfavourable trajectories of anxiety and being female and living alone with unfavourable trajectories of loneliness. Conclusion: We found relatively stable trajectories of depression and anxiety symptoms over two years, suggesting low heterogeneity in outcomes during the pandemic. For loneliness, we found two specific sub-groups with temporary increase and decrease in loneliness during the pandemic.

Original language	English
Article number	111138
Journal	Journal of Psychosomatic Research
Volume	165
DOIs	https://doi.org/10.1016/j.jpsychores.2022.111138
Publication status	Published - Feb 2023

Bibliographical note

Funding Information:
COVID online data collection and analyses were partly funded by a ‘fast track grant’ from the Dutch Research Council (grant no 440.20.009 ) and by the RESPOND project which has received funding from the European Union's Horizon 2020 research and innovation programme Societal Challenges under grant agreement No 101016127 . The infrastructure for the NESDA study is funded through the Geestkracht programme of the Netherlands Organisation for Health Research and Development (grant no 10–000-1002 ) and financial contributions by participating universities and mental health-care organisations ( VU University Medical Center , Geestelijke Gezondheidszorg (GGZ) inGeest, Leiden University Medical Center , Leiden University , GGZ Rivierduinen , University Medical Center Groningen , University of Groningen , Lentis , GGZ Friesland , GGZ Drenthe , Dimence , Rob Giel Onderzoekscentrum ). The infrastructure for the NESDO study is funded through the Fonds NutsOhra (project 0701–065 ), Stichting tot Steun VCVGZ , NARSAD The Brain and Behaviour Research Fund (grant id 41080 ), and by participating universities and mental health-care organisations (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen, University Medical Center St Radboud, GGZ inGeest, GGNet, GGZ Nijmegen, GGZ Rivierduinen, Lentis, and Parnassia). The infrastructure for the NOCDA study is funded by participating universities and mental health-care organisations ( Academic Department VU Medical Center , GGZ inGeest , Innova Research Centre , Mental Health Care Institute GGZ Centraal , Marina de Wolf Anxiety Research Centre , Center for Anxiety Disorders Overwaal , Dimence , GGZ Overijssel , Department of Psychiatry at Leiden University Medical Center , Vincent van Gogh Institute Mental Health Care Centre , Academic Anxiety Center , PsyQ Maastricht University , Division Mental Health and Neuroscience , and Stichting tot Steun VCVGZ ). This work was supported by a research grant from Stichting tot Steun VCVGZ [grant number 267 ]. The funding body did not play a role in the design, execution, analysis and interpretation of data, or writing of the study.

Publisher Copyright:
© 2023 The Authors

Funding

COVID online data collection and analyses were partly funded by a ‘fast track grant’ from the Dutch Research Council (grant no 440.20.009 ) and by the RESPOND project which has received funding from the European Union's Horizon 2020 research and innovation programme Societal Challenges under grant agreement No 101016127 . The infrastructure for the NESDA study is funded through the Geestkracht programme of the Netherlands Organisation for Health Research and Development (grant no 10–000-1002 ) and financial contributions by participating universities and mental health-care organisations ( VU University Medical Center , Geestelijke Gezondheidszorg (GGZ) inGeest, Leiden University Medical Center , Leiden University , GGZ Rivierduinen , University Medical Center Groningen , University of Groningen , Lentis , GGZ Friesland , GGZ Drenthe , Dimence , Rob Giel Onderzoekscentrum ). The infrastructure for the NESDO study is funded through the Fonds NutsOhra (project 0701–065 ), Stichting tot Steun VCVGZ , NARSAD The Brain and Behaviour Research Fund (grant id 41080 ), and by participating universities and mental health-care organisations (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen, University Medical Center St Radboud, GGZ inGeest, GGNet, GGZ Nijmegen, GGZ Rivierduinen, Lentis, and Parnassia). The infrastructure for the NOCDA study is funded by participating universities and mental health-care organisations ( Academic Department VU Medical Center , GGZ inGeest , Innova Research Centre , Mental Health Care Institute GGZ Centraal , Marina de Wolf Anxiety Research Centre , Center for Anxiety Disorders Overwaal , Dimence , GGZ Overijssel , Department of Psychiatry at Leiden University Medical Center , Vincent van Gogh Institute Mental Health Care Centre , Academic Anxiety Center , PsyQ Maastricht University , Division Mental Health and Neuroscience , and Stichting tot Steun VCVGZ ). This work was supported by a research grant from Stichting tot Steun VCVGZ [grant number 267 ]. The funding body did not play a role in the design, execution, analysis and interpretation of data, or writing of the study.

Funders	Funder number
Academic Department VU Medical Center
European Union's Horizon 2020 research and innovation programme Societal Challenges	101016127
Innova Research Centre	267
National Alliance for Research on Schizophrenia and Depression	41080
National Alliance for Research on Schizophrenia and Depression
Universiteit Leiden
Rijksuniversiteit Groningen
ZonMw	10–000-1002
ZonMw
Fonds NutsOhra	0701–065
Fonds NutsOhra
Nederlandse Organisatie voor Wetenschappelijk Onderzoek	440.20.009
Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Leids Universitair Medisch Centrum
Stichting tot Steun Vereniging tot Christelijke Verzorging van Geestes- en Zenuwzieken

Keywords

Anxiety symptoms
COVID-19 pandemic
Depressive symptoms
Growth mixture modelling
Loneliness

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jpsychores.2022.111138

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Klokgieters, S. S., Penninx, B. W. J. H., Rius Ottenheim, N., Giltay, E. J., Rhebergen, D., & Kok, A. A. L. (2023). Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022. Journal of Psychosomatic Research, 165, Article 111138. https://doi.org/10.1016/j.jpsychores.2022.111138

@article{c959c30eac1146eab49340ede63dc2b4,

title = "Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022",

abstract = "Objective: While research found heterogeneous changes in mental health during the COVID-19 pandemic, less is known about the long-term changes in mental health in psychiatric groups. Therefore, we applied a data-driven method to detect sub-groups with distinct trajectories across two years into the pandemic in psychiatric groups, and described their differences in socio-demographic and clinical characteristics. Method: We conducted sixteen rounds of questionnaires between April 2020 and February 2022 among participants (n = 1722) of three psychiatric case–control cohorts that started in the 2000's. We used Growth Mixture Modelling and (multinomial) logistic regression to identify characteristics associated with trajectory membership. Results: We found low decreasing (1228 [72%] participants), intermediate (n = 348 [22%] participants) and high stable (106 [6%] participants) trajectories of depressive symptoms; decreasing low/intermediate (1507 [90%] participants) and high stable (161 [10%] participants) trajectories of anxiety symptoms; and stable low (1109 [61%] participants), stable high (315 [17%] participants), temporary lowered (123 [9%]) and temporary heightened (175 [13%] participants) trajectories of loneliness. Chronicity and severity of pre-pandemic mental disorders predicted unfavourable sub-group membership for all outcomes. Being female, having a low education and income level were associated with unfavourable trajectories of depression, being younger with unfavourable trajectories of anxiety and being female and living alone with unfavourable trajectories of loneliness. Conclusion: We found relatively stable trajectories of depression and anxiety symptoms over two years, suggesting low heterogeneity in outcomes during the pandemic. For loneliness, we found two specific sub-groups with temporary increase and decrease in loneliness during the pandemic.",

keywords = "Anxiety symptoms, COVID-19 pandemic, Depressive symptoms, Growth mixture modelling, Loneliness",

author = "Klokgieters, {Silvia S.} and Penninx, {Brenda W.J.H.} and {Rius Ottenheim}, Nathaly and Giltay, {Erik J.} and Didi Rhebergen and Kok, {Almar A.L.}",

note = "Funding Information: COVID online data collection and analyses were partly funded by a {\textquoteleft}fast track grant{\textquoteright} from the Dutch Research Council (grant no 440.20.009 ) and by the RESPOND project which has received funding from the European Union's Horizon 2020 research and innovation programme Societal Challenges under grant agreement No 101016127 . The infrastructure for the NESDA study is funded through the Geestkracht programme of the Netherlands Organisation for Health Research and Development (grant no 10–000-1002 ) and financial contributions by participating universities and mental health-care organisations ( VU University Medical Center , Geestelijke Gezondheidszorg (GGZ) inGeest, Leiden University Medical Center , Leiden University , GGZ Rivierduinen , University Medical Center Groningen , University of Groningen , Lentis , GGZ Friesland , GGZ Drenthe , Dimence , Rob Giel Onderzoekscentrum ). The infrastructure for the NESDO study is funded through the Fonds NutsOhra (project 0701–065 ), Stichting tot Steun VCVGZ , NARSAD The Brain and Behaviour Research Fund (grant id 41080 ), and by participating universities and mental health-care organisations (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen, University Medical Center St Radboud, GGZ inGeest, GGNet, GGZ Nijmegen, GGZ Rivierduinen, Lentis, and Parnassia). The infrastructure for the NOCDA study is funded by participating universities and mental health-care organisations ( Academic Department VU Medical Center , GGZ inGeest , Innova Research Centre , Mental Health Care Institute GGZ Centraal , Marina de Wolf Anxiety Research Centre , Center for Anxiety Disorders Overwaal , Dimence , GGZ Overijssel , Department of Psychiatry at Leiden University Medical Center , Vincent van Gogh Institute Mental Health Care Centre , Academic Anxiety Center , PsyQ Maastricht University , Division Mental Health and Neuroscience , and Stichting tot Steun VCVGZ ). This work was supported by a research grant from Stichting tot Steun VCVGZ [grant number 267 ]. The funding body did not play a role in the design, execution, analysis and interpretation of data, or writing of the study. Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = feb,

doi = "10.1016/j.jpsychores.2022.111138",

language = "English",

volume = "165",

journal = "Journal of Psychosomatic Research",

issn = "0022-3999",

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Klokgieters, SS, Penninx, BWJH, Rius Ottenheim, N, Giltay, EJ, Rhebergen, D & Kok, AAL 2023, 'Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022', Journal of Psychosomatic Research, vol. 165, 111138. https://doi.org/10.1016/j.jpsychores.2022.111138

Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022. / Klokgieters, Silvia S.; Penninx, Brenda W.J.H.; Rius Ottenheim, Nathaly et al.
In: Journal of Psychosomatic Research, Vol. 165, 111138, 02.2023.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic

T2 - Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022

AU - Klokgieters, Silvia S.

AU - Penninx, Brenda W.J.H.

AU - Rius Ottenheim, Nathaly

AU - Giltay, Erik J.

AU - Rhebergen, Didi

AU - Kok, Almar A.L.

N1 - Funding Information: COVID online data collection and analyses were partly funded by a ‘fast track grant’ from the Dutch Research Council (grant no 440.20.009 ) and by the RESPOND project which has received funding from the European Union's Horizon 2020 research and innovation programme Societal Challenges under grant agreement No 101016127 . The infrastructure for the NESDA study is funded through the Geestkracht programme of the Netherlands Organisation for Health Research and Development (grant no 10–000-1002 ) and financial contributions by participating universities and mental health-care organisations ( VU University Medical Center , Geestelijke Gezondheidszorg (GGZ) inGeest, Leiden University Medical Center , Leiden University , GGZ Rivierduinen , University Medical Center Groningen , University of Groningen , Lentis , GGZ Friesland , GGZ Drenthe , Dimence , Rob Giel Onderzoekscentrum ). The infrastructure for the NESDO study is funded through the Fonds NutsOhra (project 0701–065 ), Stichting tot Steun VCVGZ , NARSAD The Brain and Behaviour Research Fund (grant id 41080 ), and by participating universities and mental health-care organisations (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen, University Medical Center St Radboud, GGZ inGeest, GGNet, GGZ Nijmegen, GGZ Rivierduinen, Lentis, and Parnassia). The infrastructure for the NOCDA study is funded by participating universities and mental health-care organisations ( Academic Department VU Medical Center , GGZ inGeest , Innova Research Centre , Mental Health Care Institute GGZ Centraal , Marina de Wolf Anxiety Research Centre , Center for Anxiety Disorders Overwaal , Dimence , GGZ Overijssel , Department of Psychiatry at Leiden University Medical Center , Vincent van Gogh Institute Mental Health Care Centre , Academic Anxiety Center , PsyQ Maastricht University , Division Mental Health and Neuroscience , and Stichting tot Steun VCVGZ ). This work was supported by a research grant from Stichting tot Steun VCVGZ [grant number 267 ]. The funding body did not play a role in the design, execution, analysis and interpretation of data, or writing of the study. Publisher Copyright: © 2023 The Authors

PY - 2023/2

Y1 - 2023/2

N2 - Objective: While research found heterogeneous changes in mental health during the COVID-19 pandemic, less is known about the long-term changes in mental health in psychiatric groups. Therefore, we applied a data-driven method to detect sub-groups with distinct trajectories across two years into the pandemic in psychiatric groups, and described their differences in socio-demographic and clinical characteristics. Method: We conducted sixteen rounds of questionnaires between April 2020 and February 2022 among participants (n = 1722) of three psychiatric case–control cohorts that started in the 2000's. We used Growth Mixture Modelling and (multinomial) logistic regression to identify characteristics associated with trajectory membership. Results: We found low decreasing (1228 [72%] participants), intermediate (n = 348 [22%] participants) and high stable (106 [6%] participants) trajectories of depressive symptoms; decreasing low/intermediate (1507 [90%] participants) and high stable (161 [10%] participants) trajectories of anxiety symptoms; and stable low (1109 [61%] participants), stable high (315 [17%] participants), temporary lowered (123 [9%]) and temporary heightened (175 [13%] participants) trajectories of loneliness. Chronicity and severity of pre-pandemic mental disorders predicted unfavourable sub-group membership for all outcomes. Being female, having a low education and income level were associated with unfavourable trajectories of depression, being younger with unfavourable trajectories of anxiety and being female and living alone with unfavourable trajectories of loneliness. Conclusion: We found relatively stable trajectories of depression and anxiety symptoms over two years, suggesting low heterogeneity in outcomes during the pandemic. For loneliness, we found two specific sub-groups with temporary increase and decrease in loneliness during the pandemic.

AB - Objective: While research found heterogeneous changes in mental health during the COVID-19 pandemic, less is known about the long-term changes in mental health in psychiatric groups. Therefore, we applied a data-driven method to detect sub-groups with distinct trajectories across two years into the pandemic in psychiatric groups, and described their differences in socio-demographic and clinical characteristics. Method: We conducted sixteen rounds of questionnaires between April 2020 and February 2022 among participants (n = 1722) of three psychiatric case–control cohorts that started in the 2000's. We used Growth Mixture Modelling and (multinomial) logistic regression to identify characteristics associated with trajectory membership. Results: We found low decreasing (1228 [72%] participants), intermediate (n = 348 [22%] participants) and high stable (106 [6%] participants) trajectories of depressive symptoms; decreasing low/intermediate (1507 [90%] participants) and high stable (161 [10%] participants) trajectories of anxiety symptoms; and stable low (1109 [61%] participants), stable high (315 [17%] participants), temporary lowered (123 [9%]) and temporary heightened (175 [13%] participants) trajectories of loneliness. Chronicity and severity of pre-pandemic mental disorders predicted unfavourable sub-group membership for all outcomes. Being female, having a low education and income level were associated with unfavourable trajectories of depression, being younger with unfavourable trajectories of anxiety and being female and living alone with unfavourable trajectories of loneliness. Conclusion: We found relatively stable trajectories of depression and anxiety symptoms over two years, suggesting low heterogeneity in outcomes during the pandemic. For loneliness, we found two specific sub-groups with temporary increase and decrease in loneliness during the pandemic.

KW - Anxiety symptoms

KW - COVID-19 pandemic

KW - Depressive symptoms

KW - Growth mixture modelling

KW - Loneliness

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DO - 10.1016/j.jpsychores.2022.111138

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Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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