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. 2023 Feb:165:111138.
doi: 10.1016/j.jpsychores.2022.111138. Epub 2022 Dec 26.

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  1 , Brenda W J H Penninx  2 , Nathaly Rius Ottenheim  3 , Erik J Giltay  3 , Didi Rhebergen  4 , Almar A L Kok  2
Affiliations

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 et al. J Psychosom Res. 2023 Feb.

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.

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Conflict of interest statement

Declaration of Competing Interest BWJHP reports grants from Janssen Research and Boehringer Ingelheim, outside of the submitted work. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Change trajectory profiles of depressive and anxiety symptoms and loneliness compared to pre-Covid-19 levels. Upper left panel: Average and standard error of the number of depressive symptoms per class across 16 COVID-19 measurements (n = 1682). Upper right panel: Average and standard error of anxiety symptoms per class across 16 COVID-19 measurements (n = 1668). Lower right panel: Average and standard error of loneliness per class across 16 COVID-19 measurements (n = 1723). Lower right panel: daily number of COVID-19 deaths during the pandemic in the Netherlands, with a sliding mean in dark blue. Key dates with regard to COVID-19 and its Dutch (lockdown) measures are given. Source: https://data.rivm.nl/meta/srv/dut/catalog.search#/metadata/2c4357c8-76e4-4662-9574-1deb8a73f724
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