A large-scale meta-analytic atlas of mental health problems prevalence during the COVID-19 early pandemic

doi:10.1002/jmv.27549

Meta-Analysis

. 2022 May;94(5):1935-1949.

doi: 10.1002/jmv.27549. Epub 2022 Jan 9.

A large-scale meta-analytic atlas of mental health problems prevalence during the COVID-19 early pandemic

Elena Dragioti¹, Han Li², George Tsitsas³, Keum Hwa Lee⁴, Jiwoo Choi⁵, Jiwon Kim⁵, Young Jo Choi⁵, Konstantinos Tsamakis⁶, Andrés Estradé^{7

8}, Agorastos Agorastos⁹, Davy Vancampfort¹⁰, Dimitrios Tsiptsios¹¹, Trevor Thompson¹², Anna Mosina¹³, Georgios Vakadaris¹⁴, Paolo Fusar-Poli^{8

15

16}, Andre F Carvalho¹⁷, Christoph U Correll^{18

19

20}, Young Joo Han²¹, Seoyeon Park⁵, Jae Il Shin⁴, Marco Solmi^{22

23}

Affiliations

¹ Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
² University of Florida College of Medicine, Gainesville, Florida, USA.
³ Harokopio University, Athens, Greece.
⁴ Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁵ Yonsei University College of Medicine, Seoul, Republic of Korea.
⁶ Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ Department of Psychology, Universidad Católica, Montevideo, Uruguay.
⁸ Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
⁹ II. Department of Psychiatry, School of Medicine, Division of Neurosciences, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁰ Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
¹¹ Department of Neurology, Democritus University of Thrace, Alexandroupolis, Greece.
¹² Centre for Chronic Illness and Ageing, University of Greenwich, Greenwich, UK.
¹³ Integrated Psychiatry Winterthur, Winterthur, Switzerland.
¹⁴ Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁵ UK OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK.
¹⁶ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
¹⁷ Department of Psychiatry, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Ontario, Canada.
¹⁸ Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA.
¹⁹ Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
²⁰ Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
²¹ Hospital Medicine Center, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
²² Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.
²³ Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada.

PMID: 34958144
PMCID: PMC9015528
DOI: 10.1002/jmv.27549

Meta-Analysis

A large-scale meta-analytic atlas of mental health problems prevalence during the COVID-19 early pandemic

Elena Dragioti et al. J Med Virol. 2022 May.

. 2022 May;94(5):1935-1949.

doi: 10.1002/jmv.27549. Epub 2022 Jan 9.

Authors

Affiliations

¹ Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
² University of Florida College of Medicine, Gainesville, Florida, USA.
³ Harokopio University, Athens, Greece.
⁴ Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁵ Yonsei University College of Medicine, Seoul, Republic of Korea.
⁶ Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ Department of Psychology, Universidad Católica, Montevideo, Uruguay.
⁸ Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
⁹ II. Department of Psychiatry, School of Medicine, Division of Neurosciences, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁰ Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
¹¹ Department of Neurology, Democritus University of Thrace, Alexandroupolis, Greece.
¹² Centre for Chronic Illness and Ageing, University of Greenwich, Greenwich, UK.
¹³ Integrated Psychiatry Winterthur, Winterthur, Switzerland.
¹⁴ Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁵ UK OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK.
¹⁶ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
¹⁷ Department of Psychiatry, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Ontario, Canada.
¹⁸ Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA.
¹⁹ Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
²⁰ Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
²¹ Hospital Medicine Center, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
²² Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.
²³ Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada.

PMID: 34958144
PMCID: PMC9015528
DOI: 10.1002/jmv.27549

Abstract

The COVID-19 pandemic and related restrictions can impact mental health. To quantify the mental health burden of COVID-19 pandemic, we conducted a systematic review and meta-analysis, searching World Health Organization COVID-19/PsycInfo/PubMed databases (09/29/2020), including observational studies reporting on mental health outcomes in any population affected by COVID-19. Primary outcomes were the prevalence of anxiety, depression, stress, sleep problems, posttraumatic symptoms. Sensitivity analyses were conducted on severe mental health problems, in high-quality studies, and in representative samples. Subgroup analyses were conducted stratified by age, sex, country income level, and COVID-19 infection status. One-hundred-seventy-three studies from February to July 2020 were included (n = 502,261, median sample = 948, age = 34.4 years, females = 63%). Ninety-one percent were cross-sectional studies, and 18.5%/57.2% were of high/moderate quality. The highest prevalence emerged for posttraumatic symptoms in COVID-19 infected people (94%), followed by behavioral problems in those with prior mental disorders (77%), fear in healthcare workers (71%), anxiety in caregivers/family members of people with COVID-19 (42%), general health/social contact/passive coping style in the general population (38%), depression in those with prior somatic disorders (37%), and fear in other-than-healthcare workers (29%). Females and people with COVID-19 infection had higher rates of almost all outcomes; college students/young adults of anxiety, depression, sleep problems, suicidal ideation; adults of fear and posttraumatic symptoms. Anxiety, depression, and posttraumatic symptoms were more prevalent in low-/middle-income countries, sleep problems in high-income countries. The COVID-19 pandemic adversely impacts mental health in a unique manner across population subgroups. Our results inform tailored preventive strategies and interventions to mitigate current, future, and transgenerational adverse mental health of the COVID-19 pandemic.

Keywords: COVID-19 pandemic; anxiety; depression; mental health.

PubMed Disclaimer

Conflict of interest statement

C. U. C. has been a consultant and/or advisor to or has received honoraria from Acadia, Alkermes, Allergan, Angelini, Axsome, Gedeon Richter, IntraCellular Therapies, Janssen/J&J, Karuna, LB Pharma, Lundbeck, MedAvante‐ProPhase, MedInCell, Medscape, Merck, Mitsubishi Tanabe Pharma, Mylan, Neurocrine, Noven, Otsuka, Pfizer, Recordati, Rovi, Servier, Sumitomo Dainippon, Sunovion, Supernus, Takeda, and Teva. He provided expert testimony for Janssen and Otsuka. He served on a Data Safety Monitoring Board for Lundbeck, Rovi, Supernus, and Teva. He has received grant support from Janssen and Takeda. He is also a stock option holder of LB Pharma. A. A. has received honoraria and travel support from Janssen‐Cilag, Bausch Health, ELPEN, and Lundbeck in the past 2 years. The remaining authors declare that they have no conflict of interests.

Figures

**Figure 1**
Heat map chart of included studies across countries; darker color represents higher number of studies

**Figure 2**
Pooled prevalence of anxiety (A), depression (B), stress (C), sleep problems (D), and posttraumatic stress (E) symptoms before and after COVID‐19 pandemic outbreak

See this image and copyright information in PMC

Cited by

We Have Spent Time, Money, and Effort Making Self-Help Digital Mental Health Interventions: Is Anyone Going to Come to the Party?
Fitzpatrick S, Crenshaw AO, Donkin V, Collins A, Xiang A, Earle EA, Goenka K, Varma S, Bushe J, McFadden T, Librado A, Monson C. Fitzpatrick S, et al. J Med Internet Res. 2024 Sep 19;26:e58198. doi: 10.2196/58198. J Med Internet Res. 2024. PMID: 39298760 Free PMC article. Review.
Associations between social COVID-19 exposure and psychological functioning.
Lewicka M, Hamilton JG, Waters EA, Orom H, Schofield E, Kiviniemi MT, Kanetsky PA, Hay JL. Lewicka M, et al. J Behav Med. 2023 Jun;46(3):472-482. doi: 10.1007/s10865-022-00374-7. Epub 2022 Nov 5. J Behav Med. 2023. PMID: 36334169 Free PMC article.
Prevalence of mental health symptoms and associated risk factors among healthcare workers in specialized COVID-19 hospitals in Anyang, China: A cross-sectional survey.
Xu YH, Wu F, Yu S, Zhang XY, Xu PJ, Sun QM. Xu YH, et al. Heliyon. 2024 Jun 6;10(11):e32593. doi: 10.1016/j.heliyon.2024.e32593. eCollection 2024 Jun 15. Heliyon. 2024. PMID: 38961983 Free PMC article.
Suicide and homicide before and during the COVID-19 pandemic in Milan, Italy.
Calati R, Gentile G, Fornaro M, Madeddu F, Tambuzzi S, Zoja R. Calati R, et al. J Affect Disord Rep. 2023 Apr;12:100510. doi: 10.1016/j.jadr.2023.100510. Epub 2023 Feb 23. J Affect Disord Rep. 2023. PMID: 36852089 Free PMC article.
Designing the Well-Being of Romanians by Achieving Mental Health with Digital Methods and Public Health Promotion.
Brătucu G, Tudor AIM, Litră AV, Nichifor E, Chițu IB, Brătucu TO. Brătucu G, et al. Int J Environ Res Public Health. 2022 Jun 27;19(13):7868. doi: 10.3390/ijerph19137868. Int J Environ Res Public Health. 2022. PMID: 35805527 Free PMC article.

See all "Cited by" articles

References

1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497‐506. - PMC - PubMed
1. Dong E, Du H, Gardner L. An interactive web‐based dashboard to track COVID‐19 in real time. Lancet Infect Dis. 2020;20(5):533‐534. - PMC - PubMed
1. Pan A, Liu L, Wang C, et al. Association of public health interventions with the epidemiology of the COVID‐19 outbreak in Wuhan, China. JAMA. 2020;323(19):1915‐1923. - PMC - PubMed
1. Trippella G, Ciarcià M, Ferrari M, et al. COVID‐19 in pregnant women and neonates: a systematic review of the literature with quality assessment of the studies. Pathogens. 2020;9(6). - PMC - PubMed
1. Tung HoCL, Oligbu P, Ojubolamo O, Pervaiz M, Oligbu G. Clinical characteristics of children with COVID‐19. AIMS Public Health. 2020;7(2):258‐273. - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

[1] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497‐506. - PMC - PubMed

[2] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497‐506. - PMC - PubMed

[3] Dong E, Du H, Gardner L. An interactive web‐based dashboard to track COVID‐19 in real time. Lancet Infect Dis. 2020;20(5):533‐534. - PMC - PubMed

[4] Dong E, Du H, Gardner L. An interactive web‐based dashboard to track COVID‐19 in real time. Lancet Infect Dis. 2020;20(5):533‐534. - PMC - PubMed

[5] Pan A, Liu L, Wang C, et al. Association of public health interventions with the epidemiology of the COVID‐19 outbreak in Wuhan, China. JAMA. 2020;323(19):1915‐1923. - PMC - PubMed

[6] Pan A, Liu L, Wang C, et al. Association of public health interventions with the epidemiology of the COVID‐19 outbreak in Wuhan, China. JAMA. 2020;323(19):1915‐1923. - PMC - PubMed

[7] Trippella G, Ciarcià M, Ferrari M, et al. COVID‐19 in pregnant women and neonates: a systematic review of the literature with quality assessment of the studies. Pathogens. 2020;9(6). - PMC - PubMed

[8] Trippella G, Ciarcià M, Ferrari M, et al. COVID‐19 in pregnant women and neonates: a systematic review of the literature with quality assessment of the studies. Pathogens. 2020;9(6). - PMC - PubMed

[9] Tung HoCL, Oligbu P, Ojubolamo O, Pervaiz M, Oligbu G. Clinical characteristics of children with COVID‐19. AIMS Public Health. 2020;7(2):258‐273. - PMC - PubMed

[10] Tung HoCL, Oligbu P, Ojubolamo O, Pervaiz M, Oligbu G. Clinical characteristics of children with COVID‐19. AIMS Public Health. 2020;7(2):258‐273. - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

A large-scale meta-analytic atlas of mental health problems prevalence during the COVID-19 early pandemic

Affiliations

A large-scale meta-analytic atlas of mental health problems prevalence during the COVID-19 early pandemic

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical