Psychiatric Epidemiology During the COVID-19 Pandemic

Abstract

Purpose of review: Our review critically examines research on trends in mental health among US adults following the COVID-19 pandemic's onset and makes recommendations for research on the topic.

Recent findings: Studies comparing pre-pandemic nationally representative government surveys ("benchmark surveys") with pandemic-era non-benchmark surveys generally estimated 3-4-fold increases in the prevalence of adverse mental-health outcomes following the pandemic's onset. However, studies analyzing trends in repeated waves of a single survey, which may carry a lower risk of bias, generally estimated much smaller increases in adverse outcomes. Likewise in our analysis of benchmark surveys, we estimated <1% increases in the prevalence of adverse outcomes from 2018/2019-2021. Finally, studies analyzing vital-statistics data estimated spiking fatal-overdose rates, but stable suicide rates.

Summary: Although fatal-overdose rates increased substantially following the pandemic's onset, evidence suggests the population prevalence of other adverse mental-health outcomes may have departed minimally from prior years' trends, at least through 2021. Future research on trends through the pandemic's later stages should prioritize leveraging repeated waves of benchmark surveys to minimize risk of bias.

Keywords: COVID-19; epidemiology; mental disorders; mental health; mood disorders; psychiatric.

Figure 1.

Prevalence of adverse mental-health outcomes by year among respondents ≥18 in data from the Behavioral Risk Factor Surveillance System (BRFSS, n=1,046,382), National Health Interview Survey (NHIS, n=52,936), and National Survey on Drug Use and Health (NSDUH, n=112,988). Notes: Analyses incorporated surveys’ sampling weights and design parameters to obtain nationally representative estimates and accurate 95% confidence intervals. Survey administrators caution about directly comparing pre-2019 NHIS data with data from 2019–on and pre-2020 NSDUH data with data from 2020–on due to survey-design changes. ^a ≥15 days of poor mental health in the past 30 days. ^b Major depressive episode in the past year. ^c Nervousness most or all the time in the past 30 days. ^d ≥13 Kessler K6 score, referring to the past 30 days. ^e Suicidal ideation in the past 30 days.