Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population

Matthias Pierce; Holly Hope; Tamsin Ford; Stephani Hatch; Matthew Hotopf; Ann John; Evangelos Kontopantelis; Roger Webb; Simon Wessely; Sally McManus; Kathryn M Abel

doi:10.1016/S2215-0366(20)30308-4

Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population

Lancet Psychiatry. 2020 Oct;7(10):883-892. doi: 10.1016/S2215-0366(20)30308-4. Epub 2020 Jul 21.

Authors

Matthias Pierce¹, Holly Hope², Tamsin Ford³, Stephani Hatch⁴, Matthew Hotopf⁵, Ann John⁶, Evangelos Kontopantelis⁷, Roger Webb⁸, Simon Wessely⁹, Sally McManus¹⁰, Kathryn M Abel¹¹

Affiliations

¹ Centre for Women's Mental Health, University of Manchester, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK. Electronic address: matthias.pierce@manchester.ac.uk.
² Centre for Women's Mental Health, University of Manchester, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
³ Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁴ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; ESRC Centre for Society and Mental Health, King's College London, London, UK.
⁵ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London.
⁶ Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK.
⁷ Division of Informatics, University of Manchester, Manchester, UK.
⁸ Division of Psychology and Mental Health, University of Manchester, Manchester, UK; Faculty of Biology, Medicine and Health Sciences, and National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK.
⁹ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁰ National Centre for Social Research, London, UK; School of Health Sciences, City, University of London, London, UK.
¹¹ Centre for Women's Mental Health, University of Manchester, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK; Greater Manchester Mental Health Trust, Manchester, UK.

Abstract

Background: The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown.

Methods: In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23-30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends.

Findings: Waves 6-9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8-20·0) in 2018-19 to 27·3% (26·3-28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3-11·6) in 2018-19, to 12·6 (12·5-12·8) in April, 2020. This was 0·48 (95% CI 0·07-0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18-24-year-olds (2·69 points, 95% CI 1·89-3·48), 25-34-year-olds (1·57, 0·96-2·18), women (0·92, 0·50-1·35), and people living with young children (1·45, 0·79-2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20-1·06).

Interpretation: By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness.

Funding: None.

MeSH terms

Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
COVID-19
Coronavirus Infections / psychology*
Cross-Sectional Studies
Female
Humans
Longitudinal Studies
Male
Mental Disorders / epidemiology*
Middle Aged
Pandemics
Pneumonia, Viral / psychology*
Prevalence
Regression Analysis
Sampling Studies
Sex Distribution
Surveys and Questionnaires
United Kingdom / epidemiology
Young Adult

Grants and funding

MR/V027751/1/MRC_/Medical Research Council/United Kingdom