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Meta-Analysis
. 2024 Jun 13;27(1):e301018.
doi: 10.1136/bmjment-2024-301018.

Changes in the prevalence of mental health problems during the first year of the pandemic: a systematic review and dose-response meta-analysis

Georgia Salanti  1 , Natalie Luise Peter  2 , Thomy Tonia  3 , Alexander Holloway  3 , Leila Darwish  2 , Ronald C Kessler  4 , Ian White  5 , Simone N Vigod  6 , Matthias Egger  3   7 , Andreas D Haas  3 , Seena Fazel  8 , Helen Herrman  9 , Christian Kieling  10   11 , Vikram Patel  12 , Tianjing Li  13 , Pim Cuijpers  14   15 , Andrea Cipriani  8   16   17 , Toshi A Furukawa  18 , Stefan Leucht  2 ; MHCOVID Crowd Investigators
Collaborators, Affiliations
Meta-Analysis

Changes in the prevalence of mental health problems during the first year of the pandemic: a systematic review and dose-response meta-analysis

Georgia Salanti et al. BMJ Ment Health. .

Abstract

Aim: To describe the pattern of the prevalence of mental health problems during the first year of the COVID-19 pandemic and examine the impact of containment measures on these trends.

Methods: We identified articles published until 30 August 2021 that reported the prevalence of mental health problems in the general population at two or more time points. A crowd of 114 reviewers extracted data on prevalence, study and participant characteristics. We collected information on the number of days since the first SARS-CoV-2 infection in the study country, the stringency of containment measures and the number of cases and deaths. We synthesised changes in prevalence during the pandemic using a random-effects model. We used dose-response meta-analysis to evaluate the trajectory of the changes in mental health problems.

Results: We included 41 studies for 7 mental health conditions. The average odds of symptoms increased during the pandemic (mean OR ranging from 1.23 to 2.08). Heterogeneity was very large and could not be explained by differences in participants or study characteristics. Average odds of psychological distress, depression and anxiety increased during the first 2 months of the pandemic, with increased stringency of the measures, reported infections and deaths. The confidence in the evidence was low to very low.

Conclusions: We observed an initial increase in the average risk of psychological distress, depression-related and anxiety-related problems during the first 2 months of the pandemic. However, large heterogeneity suggests that different populations had different responses to the challenges imposed by the pandemic.

Keywords: COVID-19; Data Interpretation, Statistical; Depression.

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Conflict of interest statement

Competing interests: AC has received research, educational and consultancy fees from INCiPiT (Italian Network for Paediatric Trials), CARIPLO Foundation, Lundbeck and Angelini Pharma. VP received consulting fees from Google Modern Health. CK is a cofounder of Wida, a digital mental health platform. TAF reports personal fees from Boehringer-Ingelheim, Daiichi Sankyo, DT Axis, Kyoto University Original, Shionogi, SONY and UpToDate, and a grant from DT Axis and Shionogi, outside the submitted work; In addition, TAF has a patent 7448125, and a pending patent 2022-082495, and intellectual properties for Kokoro-app licensed to Mitsubishi-Tanabe. SL received consulting fees from Alkermes, Angelini, Karuna, Kynexis, Lundbeck, Neurotorium, Novo Nordisk, Otsuka, Roche, ROVI, TEVA and honoraria for lectures and presentations from Angelini, Apsen, Eisai, Ekademia, Gedeon Richter, Janssen, Lundbeck, Medichem, Medscape, Merck, Mitshubishi, Recordati, ROVI, Sanofi Aventis. SNV receives royalties from UpToDate Inc for authorship of materials on depression and pregnancy. From The MHCOVID Crowd Investigators: EO has received consulting fees Angelini Pharma. AS received 30 days of complimentary access from Elsevier to Science Direct, Scopus, Reaxys and Geofacets after reviewing a manuscript for CHEST.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic review and Meta-Analysis flowchart of eligible studies.
Figure 2
Figure 2
Meta-analysis of ORs for people above a threshold on a symptom scale during the pandemic compared with before the pandemic. OR>1 means that the odds of people above the threshold are larger during the pandemic and hence the average mental health of the population deteriorated.
Figure 3
Figure 3
Dose-response meta-analysis plots of the ORs for depression, anxiety and psychological distress as a function of the days since the days of the first case in the study country, the stringency index, the cumulative number of cases and the cumulative number of deaths. CIs are shown as dashed lines. Larger values of OR mean more people above the threshold.
See this image and copyright information in PMC

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