Abstract
Despite growing concerns about mental health during the COVID-19 pandemic, particularly in people with pre-existing mental health disorders, research has shown that symptoms of depression and anxiety were generally quite stable, with modest changes in certain subgroups. However, individual differences in cumulative exposure to COVID-19 stressors have not been yet considered.
Aims
We aimed to quantify and investigate the impact of individual-level cumulative exposure to COVID-19-pandemic-related adversity on changes in depressive and anxiety symptoms and loneliness. In addition, we examined whether the impact differed among individuals with various levels of pre-pandemic chronicity of mental health disorders.
Method
Between April 2020 and July 2021, 15 successive online questionnaires were distributed among three psychiatric case–control cohorts that started in the 2000s (N = 1377). Outcomes included depressive and anxiety symptoms and loneliness. We developed a COVID-19 Adversity Index (CAI) summarising up to 15 repeated measures of COVID-19-pandemic-related exposures (e.g. exposure to COVID-19 infection, negative economic impact and quarantine). We used linear mixed linear models to estimate the effects of COVID-19-related adversity on mental health and its interaction with pre-pandemic chronicity of mental health disorders and CAI.
Results
Higher CAI scores were positively associated with higher increases in depressive symptoms, anxiety symptoms and loneliness. Associations were not statistically significantly different between groups with and without (chronic) pre-pandemic mental health disorders.
Conclusions
Individual differences in cumulative exposure to COVID-19-pandemic-related adversity are important predictors of mental health, but we found no evidence for higher vulnerability among people with (chronic) pre-pandemic mental health disorders.
| Original language | English |
|---|---|
| Article number | e181 |
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | BJPsych Open |
| Volume | 9 |
| Issue number | 6 |
| Early online date | 10 Oct 2023 |
| DOIs | |
| Publication status | Published - Nov 2023 |
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 healthcare 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 and Rob Giel Onderzoekscentrum). The infrastructure for the NESDO study is funded through the Fonds NutsOhra (project 0701-065), Stichting tot Steun VCVGZ and NARSAD The Brain and Behaviour Research Fund (grant no. 41080) and by participating universities and mental healthcare 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 healthcare 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 no. 267). The funding body did not have a role in the design, execution, analysis and interpretation of data or the writing of the paper.
| 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 |
| Universiteit Leiden | |
| Rijksuniversiteit Groningen | |
| ZonMw | 10-000-1002 |
| Fonds NutsOhra | 0701-065 |
| Nederlandse Organisatie voor Wetenschappelijk Onderzoek | 440.20.009 |
| Leids Universitair Medisch Centrum | |
| Stichting tot Steun Vereniging tot Christelijke Verzorging van Geestes- en Zenuwzieken |