Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-30T07:15:23.931Z Has data issue: false hasContentIssue false

A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic

Published online by Cambridge University Press:  24 August 2023

Mary Blendermann
Affiliation:
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
Tracie I Ebalu
Affiliation:
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
Immanuela C Obisie-Orlu
Affiliation:
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
Eiko I Fried
Affiliation:
Department of Psychology, Leiden University, Leiden, The Netherlands
Lauren S Hallion*
Affiliation:
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
*
Corresponding author: Lauren S Hallion; Email: hallion@pitt.edu
Rights & Permissions [Opens in a new window]

Abstract

The onset of the COVID-19 pandemic raised concerns regarding population-wide impacts on mental health. Existing work on the psychological impacts of disaster has identified the potential for multiple response trajectories, with resilience as likely as the development of chronic psychopathology. Early reviews of mental health during the pandemic suggested elevated prevalence rates of multiple forms of psychopathology, but were limited by largely cross-sectional approaches. We conducted a systematic review of studies that prospectively assessed pre- to peri-pandemic changes in symptoms of psychopathology to investigate potential mental health changes associated with the onset of the pandemic (PROSPERO #CRD42021255042). A total of 97 studies were included, covering symptom clusters including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), fear, anxiety, depression, and general distress. Changes in psychopathology symptoms varied by symptom dimension and sample characteristics. OCD, anxiety, depression, and general distress symptoms tended to increase from pre- to peri-pandemic. An increase in fear was limited to medically vulnerable participants, and findings for PTSD were mixed. Pre-existing mental health diagnoses unexpectedly were not associated with symptom exacerbation, except in the case of OCD. Young people generally showed the most marked symptom increases, although this pattern was reversed in some samples. Women in middle adulthood in particular demonstrated a considerable increase in anxiety and depression. We conclude that mental health responding during the pandemic varied as a function of both symptom cluster and sample characteristics. Variability in responding should therefore be a key consideration guiding future research and intervention.

Type
Invited Review
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press

As the financial, occupational, and social impacts of the COVID-19 pandemic became apparent, voices across clinical psychological science and medicine raised concerns regarding potential consequences for population-wide mental health (Fiorillo & Gorwood, Reference Fiorillo and Gorwood2020; Gruber et al., Reference Gruber, Prinstein, Clark, Rottenberg, Abramowitz, Albano and Weinstock2021; Pfefferbaum & North, Reference Pfefferbaum and North2020). Some early predictions anticipated a broad decline in mental health, including development of psychopathology in previously healthy individuals and exacerbated symptoms in clinical populations (Fiorillo & Gorwood, Reference Fiorillo and Gorwood2020; Gruber et al., Reference Gruber, Prinstein, Clark, Rottenberg, Abramowitz, Albano and Weinstock2021). Stress is a well-established risk factor for the development and worsening of psychopathology (Liu & Miller, Reference Liu and Miller2014; McLaughlin, Reference McLaughlin, Harkness and Hayden2020), particularly internalizing symptoms such as anxiety and depression (Faravelli et al., Reference Faravelli, Lo Sauro, Lelli, Pietrini, Lazzeretti, Godini and Ricca2012; Kendler & Gardner, Reference Kendler and Gardner2016), and these predictions largely followed from conceptualizations of the COVID-19 pandemic as both an acute and chronic stressor (Bridgland et al., Reference Bridgland, Moeck, Green, Swain, Nayda, Matson and Takarangi2021; Waugh, Leslie-Miller, & Cole, Reference Waugh, Leslie-Miller and Cole2022).

Other perspectives argued that mental health impacts of the COVID-19 pandemic would be more nuanced than population-level decline (Koushik, Reference Koushik2020; Mancini, Reference Mancini2020). For example, decreased work and social obligations might provide temporary relief from anxiety symptoms, while mandated social isolation might exacerbate depression (Koushik, Reference Koushik2020). An increased sense of togetherness, previously observed in communities experiencing mass trauma, could even benefit mental health (Lau et al., Reference Lau, Chi, Cummins, Lee, Chou and Chung2008; Mancini, Reference Mancini2020). Inter-individual differences may also play a role, with vulnerable populations shouldering the burden of worsening symptoms (Mancini, Reference Mancini2020). Such predictions are in line with prospective studies of the psychological impacts of disaster, with only a minority of participants (typically 30% or less) developing severe, chronic psychopathology (Bonanno, Brewin, Kaniasty, & Greca, Reference Bonanno, Brewin, Kaniasty and Greca2010).

Early systematic reviews of general population mental health during the first few months of the COVID-19 pandemic reported startling rates of clinically significant anxiety (ranging from 26% to 38%), depression (26–34%), and psychological distress (30–38%; Deng et al. Reference Deng, Zhou, Hou, Silver, Wong, Chang and Huang2021; Krishnamoorthy, Nagarajan, Saya, & Menon, Reference Krishnamoorthy, Nagarajan, Saya and Menon2020; Luo, Guo, Yu, Jiang, & Wang, Reference Luo, Guo, Yu, Jiang and Wang2020; Necho, Tsehay, Birkie, Biset, & Tadesse, Reference Necho, Tsehay, Birkie, Biset and Tadesse2021; Salari et al. Reference Salari, Hosseinian-Far, Jalali, Vaisi-Raygani, Rasoulpoor, Mohammadi and Khaledi-Paveh2020). However, the studies covered by these reviews are largely epidemiological and cross-sectional, often with single item or unvalidated assessments. The absence of pre-pandemic timepoints in particular limits inferences about change over time that is potentially attributable to the pandemic. To our knowledge, only one meta-analysis has synthesized studies with a pre-pandemic timepoint (Robinson, Sutin, Daly, & Jones, Reference Robinson, Sutin, Daly and Jones2022). Across 65 longitudinal cohort studies, there was a small overall increase in symptoms of psychopathology, with the largest symptom increases observed in studies that sampled participants early in the pandemic (March–April 2020). Although this meta-analysis focused on longitudinal cohort studies, samples were largely European and North American, and did not include symptom clusters beyond the broad categories of anxiety, depression, and psychological distress.

Important questions also remain regarding variability in trajectories across symptom types and populations. For example, OCD symptoms related to contamination and health behaviors (e.g. handwashing, disinfecting surfaces) may have been impacted differently than other kinds of internalizing symptoms (Guzick et al., Reference Guzick, Candelari, Wiese, Schneider, Goodman and Storch2021). PTSD symptoms might emerge in populations such as healthcare workers (Bridgland et al., Reference Bridgland, Moeck, Green, Swain, Nayda, Matson and Takarangi2021). Finally, theoretical and empirical frameworks distinguish between acute autonomic reactions to imminent threat (fear) v. prolonged apprehension involving chronic or distal threat (anxiety; Kotov et al., Reference Kotov, Krueger, Watson, Achenbach, Althoff, Bagby and Zimmerman2017; Öhman, Reference Öhman, Lewis, Haviland-Jones and Barrett2008). Whereas fear might be expected to show a sharp increase relative to pre-pandemic followed by a steady decline, the evolving and prolonged nature of the pandemic suggests a potentially different course for anxiety. The present systematic review gives in-depth consideration to these and other internalizing-related symptom clusters. We adopt a global, lifespan, and transdiagnostic perspective, with findings reported separately for unselected samples, samples with diagnosed psychopathology, and selected samples such as patients with preexisting medical conditions or other special characteristics (e.g. veterans).

Method

Search strategy

A systematic review was conducted in accordance with PRISMA guidelines (Moher, Liberati, Tetzlaff, & Altman, Reference Moher, Liberati, Tetzlaff and Altman2009) and preregistered on PROSPERO (#CRD42021255042). We searched PubMed and PsycINFO for studies that assessed mental health symptoms both before and during the COVID-19 pandemic. Keywords included (COVID-19 OR coronavirus OR COVID OR pandemic OR SARS-CoV-2 OR social distancing OR quarantine OR lockdown) AND (anxi* OR obsess* OR trauma* OR fear OR panic OR agoraphobi* OR social anxiety OR separation anxiety OR acute stress* OR depress*). A database search was conducted from 29 January 2020 (the day before the World Health Organization designated the COVID-19 pandemic a Public Health Emergency of International Concern) to 24 June 2021. Complete search strategies for each database and deviations from the preregistration can be found in online Supplementary Materials.

Study selection

Titles and abstracts were screened according to eligibility criteria (outlined below). Full-text screening was conducted by four authors (M. B., T. I. E., I. C. O., and L. S. H.). Where eligibility was uncertain, a consensus decision was made following discussion. Study selection process and reasons for exclusion are described in Fig. 1.

Figure 1. PRISMA diagram showing study selection process.

Inclusion criteria. Studies were included if they met all of the following criteria: (a) published or in press on or after 29 January 2020; (b) published in English; (c) participants and/or studies based in a country or region with confirmed COVID-19 cases, lockdown measures, and/or quarantine; and (d) assessed symptoms of mental health both prior to (no later than 29 January 2020) and during the COVID-19 pandemic, either in the same sample at both timepoints or in two nationally or regionally representative samples.

Exclusion criteria. Studies were excluded if they met any of the following criteria: (a) cross-sectional design, or repeated measures in different, non-representative samples; (b) administered mental health treatment between the pre-pandemic and peri-pandemic assessments (healthy and no-treatment control groups remained eligible); (c) did not present original empirical work (e.g. commentaries, reviews).

Methodological quality. Included studies were assessed for methodological quality by the first author across four domains: sample size, sampling methodology, response rate, and measurement (see online Supplementary Materials).

Results

The search terms yielded 981 results from PsycINFO and 8666 results from PubMed, for a total of 9647 potentially eligible items. Following the removal of 672 duplicate items, 8646 items were excluded during title and abstract screening, and 232 items were excluded during full-text screening, yielding 97 studies which were included in the final review (see Figs 2–3 and Table 1 for included studies). Symptom changes described below were statistically significant unless otherwise specified.

Figure 2. Distribution of studies in each symptom cluster reporting either an increase, decrease, or no change in symptoms. Colors reflect the reported statistical significance of each symptom change.

Figure 3. Spread of effect sizes for studies where Cohen's d was reported or could be calculated (k = 55). Effect sizes <0 indicate symptom decrease; effect sizes >0 indicate symptom increase. See Supplementary Table S4 for studies corresponding to point labels.

Table 1. Summary of included studies, sample characteristics, and symptom change results

OCD, obsessive-compulsive disorder; MDD, major depressive disorder; HIV, human immunodeficiency virus; Y-BOCS, Yale-Brown Obsessive Compulsive Scale; CIS-R, Clinical Interview Schedule-Revised; CBCL, Child Behaviour Check List; OCI-R, Obsessive-Compulsive Inventory-Revised; PCL-5, PTSD Checklist for DSM-5; SCL-90-R, Symptom Checklist 90 Revised; CY-BOCS, Children's Yale-Brown Obsessive Compulsive Scale; DASS, Depression Anxiety Stress Scale (42 or 21 item version specified); BAI, Beck Anxiety Subscale; PHQ, Patient Health Questionnaire (2, 4, 8, or 9-item version specified); PSWQ, Penn State Worry Questionnaire; RCADS, Revised Child Anxiety and Depression Scales; HADS, Hospital Anxiety and Depression Scales; GAD, Generalized Anxiety Disorder (2 or 7-item version specified); MASC, Multidimensional Anxiety Inventory for Children; PSS, Perceived Stress Scale (4-item version specified); GAI, Geriatric Anxiety Inventory (Short Form [SF] specified); HAM-A, Hamilton Anxiety Scale; PROMIS, Patient-Reported Outcomes Measurement Information System; SCA-S, Spence Children's Anxiety Scale; MINI, Mini International Neuropsychiatric Interview; IDS-30, Inventory of Depressive Symptomology 30; CIDI, Composite International Diagnostic Interview; CDI, Children's Depression Inventory (Short Form [S] specified); CES-D, Center for Epidemiologic Studies Depression Scale; EPDS, Edinburgh Postnatal Depression Scale; HAM-D, Hamilton Depression Scale; SMFQ-C, Short Mood and Feelings Questionnaire – Child Version; GDS, Geriatric Depression Scale; QIDS, Quick Inventory of Depressive Symptoms; NVDDI-E, Neurological Disorders Depression Inventory for Epilepsy; DRS, Depression Rating Scale; BSI, Brief Symptom Inventory; SDQ, Strengths and Difficulties Questionnaire; IDAS-II, Inventory of Depression and Anxiety Symptoms – II; STAI, State-Trait Anxiety Inventory; GHQ-12, General Health Questionnaire; K10 or K6, Kessler Psychological Distress Scale (10 or 6-item version); PSI-SF, Parenting Stress Index – Short Form.

Note. In many cases, authors only reported T1 data (e.g. sample size) for participants for whom T2 data were also available. An equivalent N at T1 and T2 may be indicative of participants with available data at both timepoints, rather than the total sample being the same size at both timpoints. Response rate is reported as the percentage of participants with available data at T1 who responded to an invitation to participate in T2 follow-up data collection. Many studies invited only a subset of participants from T1 to participate at T2; hence, response rate is not always obtained by diving N at T2 by N at T1.

Obsessive-compulsive disorder (k = 11)

Three of four studies in unselected (including undergraduate student) samples reported increases in overall OCD symptoms, particularly washing and contamination symptoms (Cox & Olatunji, Reference Cox and Olatunji2021; Jelinek, Göritz, Miegel, Moritz, & Kriston, Reference Jelinek, Göritz, Miegel, Moritz and Kriston2021; Knowles & Olatunji, Reference Knowles and Olatunji2021). The fourth, a longitudinal cohort study of 2117 Brazilian university employees, found no change in the prevalence of OCD diagnoses from pre- to peri-pandemic (Brunoni et al., Reference Brunoni, Suen, Bacchi, Razza, Klein, Dos Santos and Benseñor2021). Of five studies including participants with pre-existing OCD diagnoses (N = 60 to N = 270), four found that OCD severity increased. In one study of an outpatient clinic sample, pre-existing contamination symptoms predicted increases in overall OCD severity (Davide et al., Reference Davide, Andrea, Martina, Andrea, Davide and Mario2020). A study of children and adolescents with OCD treated at a university psychiatry department only found changes in washing and contamination symptoms (Tanir et al., Reference Tanir, Karayagmurlu, Kaya, Kaynar, Türkmen, Dambasan and Coşkun2020). In a Spanish sample of 127 clinic outpatients with OCD, ~31% showed at least a moderate increase in severity (over 25%), with the remaining changes ranging from a small increase to a small decrease (Alonso et al., Reference Alonso, Bertolín, Segalàs, Tubío, Real, Mar-Barrutia and Menchón2021). Similarly, about half of a sample of 84 Indian adults with OCD showed no change, while the other half mostly showed increases in severity of less than 5% (Chakraborty & Karmakar, Reference Chakraborty and Karmakar2020). In samples with psychiatric diagnoses other than OCD, a study of 80 children and adolescents with various neurologic and psychiatric disorders found an increase in OCD symptoms (Conti et al., Reference Conti, Sgandurra, De Nicola, Biagioni, Boldrini, Bonaventura and Battini2020), while a study of 35 Catalán adults with autism found no changes (Lugo-Marín et al., Reference Lugo-Marín, Gisbert-Gustemps, Setien-Ramos, Español-Martín, Ibañez-Jimenez, Forner-Puntonet and Ramos-Quiroga2021).

Across samples, OCD symptoms tended to increase, with few exceptions. Calculable effect sizes (k = 4) were small to moderate (median Cohen's d = 0.59, range = 0.11–0.79). Consistent with predictions, symptom increase was more pronounced for washing-checking domains and in diagnosed samples.

Post-traumatic stress disorder (k = 5)

Findings for PTSD were inconclusive, driven in part by the small total number of studies. The largest study available, in a nationally representative panel survey of 3078 American veterans, did not find significant changes in PTSD probable diagnosis prevalence (Hill et al., Reference Hill, Nichter, Na, Norman, Morland, Krystal and Pietrzak2021). In a sample of 473 Canadian adults, no changes in PTSD symptoms were identified (Minhas et al., Reference Minhas, Belisario, González-Roz, Halladay, Murphy and MacKillop2021). An increase in PTSD symptoms was observed in 80 Italian children and adolescents with a pre-existing neuro-developmental disorder (Conti et al., Reference Conti, Sgandurra, De Nicola, Biagioni, Boldrini, Bonaventura and Battini2020), as well as in 85 German adults with and without psychiatric disorders (Seitz, Bertsch, & Herpertz, Reference Seitz, Bertsch and Herpertz2021). By contrast, there was a decrease in PTSD severity among 76 older adults with a pre-existing PTSD diagnosis compared to trauma-exposed controls in the USA (Rutherford et al., Reference Rutherford, Choi, Chrisanthopolous, Salzman, Zhu, Montes-Garcia and Roose2021).

Fear (k = 10)

Six studies assessed fear/autonomic anxiety in unselected samples, with variable results. A study of 217 Indian undergraduates found a small increase in fear (Saraswathi et al., Reference Saraswathi, Saikarthik, Senthil Kumar, Madhan Srinivasan, Ardhanaari and Gunapriya2020), as did two smaller studies [99 adult women in Poland (Ilgen, Kurt, Aydin, Bilen, & Kula, Reference Ilgen, Kurt, Aydin, Bilen and Kula2021) and 68 Italian undergraduates (Bussone, Pesca, Tambelli, & Carola, Reference Bussone, Pesca, Tambelli and Carola2020)]. By contrast, a study of 2364 Chinese undergraduates found a slight decrease in fear (Yang, Ji, et al., Reference Yang, Ji, Yang, Wang, Zhu and Cai2021), as did a study of 66 Brazilian pharmacy students (Campos, Campos, Bueno, & Martins, Reference Campos, Campos, Bueno and Martins2021). The remaining study, in a crowdsourced sample of 146 American adults, found no change (Haliwa, Wilson, Lee, & Shook, Reference Haliwa, Wilson, Lee and Shook2021).

Both studies including samples with pre-existing psychiatric diagnoses found no change in fear [275 American adults with autism spectrum disorder drawn from an existing research registry (Adams, Zheng, Taylor, & Bishop, Reference Adams, Zheng, Taylor and Bishop2021); 1181 adults with internalizing disorders drawn from a prospective longitudinal study in the Netherlands (Pan et al., Reference Pan, Kok, Eikelenboom, Horsfall, Jörg, Luteijn and Penninx2021)]. The latter study did report a small increase in fear among 336 healthy control participants (recruited through primary care settings; Pan et al., Reference Pan, Kok, Eikelenboom, Horsfall, Jörg, Luteijn and Penninx2021). Two studies of selected samples showed stronger effects, including a clinically significant increase in fear in 595 Turkish cancer patients (Yildirim, Poyraz, & Erdur, Reference Yildirim, Poyraz and Erdur2021), and an increase in the proportion of 63 pregnant participants meeting the threshold for moderate or severe fear (Ayaz et al., Reference Ayaz, Hocaoğlu, Günay, Yardımcı, Turgut and Karateke2020).

Taken together, findings suggest that medically selected samples experienced a clinically significant increase in fear, but this pattern did not apply to unselected samples or those with pre-existing psychiatric vulnerabilities, who tended to experience at most small increases. Although several studies reporting null results had small sample sizes, a few larger studies also showed no change in fear severity, suggesting that null results are unlikely to be due to low statistical power.

Anxiety (k = 47)

Of 21 studies prospectively examining anxiety in unselected samples, 11 found an increase in anxiety and eight found no change, while two studies reported a decrease. One of the largest studies, a randomly sampled cohort study of 113 928 German adults ages 20–74, reported an increase in anxiety for participants under 60 years of age only, with women ages 20–39 showing the largest increase (Peters, Rospleszcz, Greiser, Dallavalle, & Berger, Reference Peters, Rospleszcz, Greiser, Dallavalle and Berger2020). In a prospective cohort study of 1237 French adults (Ramiz et al., Reference Ramiz, Contrand, Rojas Castro, Dupuy, Lu, Sztal-Kutas and Lagarde2021), the proportion of participants with ‘possible anxiety’ (GAD-7 score >4) increased over time, with the most marked increases occurring for women ages 23–49 and ages 70 or above. A study comparing two randomly sampled, nationally representative samples of Czech adults (Winkler et al., Reference Winkler, Mohrova, Mlada, Kuklova, Kagstrom, Mohr and Formanek2021) similarly found that the prevalence of anxiety disorders increased from 8% in November 2017 to 13% in May 2020. Younger adults, women, those who struggled to retain employment, and those without a high school diploma had the highest absolute rates of anxiety disorder during the second wave of the pandemic.

Well-powered studies that did not find changes in anxiety include a representative sample of 1041 Irish adults (Hyland et al., Reference Hyland, Shevlin, Murphy, McBride, Fox, Bondjers and Vallières2021) and a nationally representative study of 944 604 American adults compared to a 2019 propensity-matched sample (Jacobs & Burch, Reference Jacobs and Burch2021). However, interpretability of these large studies may be offset by other methodological constraints (use of a cut-off score and single-item assessment, respectively).

The only two studies reporting a decrease in anxiety were a study of 2364 Chinese undergraduates (assessed October 2019, February 2020, and May 2020; Yang, Ji., et al., Reference Yang, Ji, Yang, Wang, Zhu and Cai2021) and 2117 Brazilian adults (May–July 2020 compared to 2008–2010, with no change compared to 2016–2018; Brunoni et al., Reference Brunoni, Suen, Bacchi, Razza, Klein, Dos Santos and Benseñor2021).

Five studies examined anxiety in psychiatric samples. One study (Pan et al., Reference Pan, Kok, Eikelenboom, Horsfall, Jörg, Luteijn and Penninx2021) found an increase in worry across 1181 adults with psychiatric illness and 336 healthy controls from three longitudinal cohort studies in the Netherlands. Another longitudinal cohort study found an increase in 147 healthy controls, but not 345 adults with bipolar disorder (Yocum, Zhai, McInnis, & Han, Reference Yocum, Zhai, McInnis and Han2021). Two smaller studies also found an increase in anxiety; in 76 Chinese participants receiving methadone maintenance treatment for substance use disorder (Liu et al., Reference Liu, Jin, Zhang, Zhang, Li and Ma2021); and in 46 American older adults with PTSD, but not 30 trauma-exposed controls (Rutherford et al., Reference Rutherford, Choi, Chrisanthopolous, Salzman, Zhu, Montes-Garcia and Roose2021). A third study found no change in a sample of 35 Catalán adults with autism (Lugo-Marín et al., Reference Lugo-Marín, Gisbert-Gustemps, Setien-Ramos, Español-Martín, Ibañez-Jimenez, Forner-Puntonet and Ramos-Quiroga2021).

Seven studies prospectively assessed changes in anxiety in children and adolescents with remarkably consistent findings; all but one found at least a small increase in anxiety coinciding with the onset of the pandemic (Breaux et al., Reference Breaux, Dvorsky, Marsh, Green, Cash, Shroff and Becker2021; Conti et al., Reference Conti, Sgandurra, De Nicola, Biagioni, Boldrini, Bonaventura and Battini2020; Magson et al., Reference Magson, Freeman, Rapee, Richardson, Oar and Fardouly2021; Rogers, Ha, & Ockey, Reference Rogers, Ha and Ockey2021). Studies reporting an increase in anxiety include a sample of 775 children and adolescents assessed via an experience-sampling application in Australia (Arjmand, Seabrook, Bakker, & Rickard, Reference Arjmand, Seabrook, Bakker and Rickard2021); a representative sample of 844 Dutch children and adolescents (compared to a representative sample from 2018; Luijten et al., Reference Luijten, van Muilekom, Teela, Polderman, Terwee, Zijlmans and Haverman2021); and 136 Canadian children and adolescents (De France, Hancock, Stack, Serbin, & Hollenstein, Reference De France, Hancock, Stack, Serbin and Hollenstein2021), who demonstrated a marginal increase in anxiety that was driven by an increase in girls only.

Ten studies prospectively assessed changes in anxiety in older adults and other medically vulnerable samples. Relatively larger studies tended to find an increase in anxiety, including a multinational sample of 435 adults with systemic sclerosis recruited during medical visits (Thombs et al., Reference Thombs, Kwakkenbos, Henry, Carrier, Patten, Harb and Benedetti2020); 538 Chinese older adults with two or more chronic health conditions (Wong et al., Reference Wong, Zhang, Sit, Yip, Chung, Wong and Mercer2020); 721 Chilean older adults from a random community sample (Herrera et al., Reference Herrera, Elgueta, Fernández, Giacoman, Leal, Marshall and Bustamante2021); and 133 American adults with HIV (but not 54 healthy controls; Cooley, Nelson, Doyle, Rosenow, & Ances, Reference Cooley, Nelson, Doyle, Rosenow and Ances2021). Null findings were observed in a prospective observational study of 1051 patients with remitted breast cancer (Mink van der Molen et al., Reference Mink van der Molen, Bargon, Batenburg, Gal, Young-Afat, van Stam and Verkooijen2021); 450 Australian adults with type 2 diabetes (Sacre et al., Reference Sacre, Holmes-Truscott, Salim, Anstey, Drummond, Huxley and Shaw2021); and 411 Chinese older adults (Siew, Mahendran, & Yu, Reference Siew, Mahendran and Yu2021).

Studies of other selected samples also tended to find increases in anxiety. A longitudinal cohort study of 2288 American sexual and gender minority (SGM) adults found an increase in anxiety severity during the early stages of the pandemic (Flentje et al., Reference Flentje, Obedin-Maliver, Lubensky, Dastur, Neilands and Lunn2020). However, this increase was driven by participants who were relatively lower in anxiety, with those who screened positive for GAD prior to the pandemic showing no change. A study of 1028 recent mothers in a hospital-based birth cohort in Brazil found a twofold increase in GAD prevalence from 2019 (during pregnancy) to 2020 (Loret de Mola et al., Reference Loret de Mola, Martins-Silva, Carpena, Del-Ponte, Blumenberg, Martins and Cesar2021). A nationally representative study of 3078 predominantly male American veterans found an increase in the prevalence of positive GAD screenings from 7% to 9%, driven by a marked increase in anxiety severity among middle-aged veterans (Hill et al., Reference Hill, Nichter, Na, Norman, Morland, Krystal and Pietrzak2021).

Collectively, most studies found an increase in anxiety associated with the onset of the pandemic, although calculable effect sizes (k = 14) tended to be small (median Cohen's d = 0.16, range = −0.35 to 0.54). Findings were especially pronounced and consistent in child and adolescent samples and in medically vulnerable participants. Psychiatric samples also showed some vulnerability to an increase in anxiety, but this vulnerability was not more pronounced than that observed in unselected samples.

Depression (k = 74)

Twenty-seven studies prospectively assessed changes in incidence or severity of depression in unselected samples. Only two studies found a decrease in severity, one in 1020 Irish adults (Hyland et al., Reference Hyland, Shevlin, Murphy, McBride, Fox, Bondjers and Vallières2021) and one in 2364 Chinese undergraduate students (Yang, Ji, et al., Reference Yang, Ji, Yang, Wang, Zhu and Cai2021). The remaining studies found either an increase (k = 17) or no change (k = 8) in severity. In the largest study (N = 113 928 German adults; Peters et al., Reference Peters, Rospleszcz, Greiser, Dallavalle and Berger2020), incidence of moderate-to-severe depression symptoms increased from 6.4% 1–5 years before the pandemic to 8.8% in May 2020. Incidence of depression increased by 7.8% (from 4% in November 2017 to 11.8% in May 2020) across two nationally representative samples of over 3000 Czech adults (Winkler et al., Reference Winkler, Mohrova, Mlada, Kuklova, Kagstrom, Mohr and Formanek2021). Incidence doubled across two representative random samples of Chinese adults (from 6.3% of 4054 adults in 2017 to 14.8% of 1501 adults in April 2020; Zhao et al., Reference Zhao, Wong, Luk, Wai, Lam and Wang2020); and increased more than fivefold in a representative random sample of 715 Czech adults (Novotný et al., Reference Novotný, Gonzalez-Rivas, Kunzová, Skladaná, Pospíšilová, Polcrová and Stokin2020).

Studies comparing demographic groups found that younger adults (e.g. under age 60; Peters et al., Reference Peters, Rospleszcz, Greiser, Dallavalle and Berger2020) and women (Fruehwirth, Biswas, & Perreira, Reference Fruehwirth, Biswas and Perreira2021; Minhas et al. Reference Minhas, Belisario, González-Roz, Halladay, Murphy and MacKillop2021; Peters et al. Reference Peters, Rospleszcz, Greiser, Dallavalle and Berger2020) were especially vulnerable to increased depression incidence or severity. Studies of undergraduates had proportionately more non-significant results, which may be due in part to smaller sample sizes (although see findings from Yang, Ji, et al., Reference Yang, Ji, Yang, Wang, Zhu and Cai2021, above).

Of seven studies including psychiatric samples, findings were mixed, with increases in depression severity reported in a sample of 1181 Dutch participants with internalizing disorders and in 336 healthy controls (Pan et al., Reference Pan, Kok, Eikelenboom, Horsfall, Jörg, Luteijn and Penninx2021); 52 German adults with eating disorders (Giel, Schurr, Zipfel, Junne, & Schag, Reference Giel, Schurr, Zipfel, Junne and Schag2021); and 76 Chinese adults with substance use disorder (Liu et al., Reference Liu, Jin, Zhang, Zhang, Li and Ma2021). The remaining studies reported no change in depression in 275 American adults with autism (Adams et al., Reference Adams, Zheng, Taylor and Bishop2021); a decrease in 35 Catalán adults with autism (Lugo-Marín et al., Reference Lugo-Marín, Gisbert-Gustemps, Setien-Ramos, Español-Martín, Ibañez-Jimenez, Forner-Puntonet and Ramos-Quiroga2021); or non-significant changes (Rutherford et al., Reference Rutherford, Choi, Chrisanthopolous, Salzman, Zhu, Montes-Garcia and Roose2021; Yocum et al., Reference Yocum, Zhai, McInnis and Han2021).

Of nine studies with child and adolescent samples, all but two reported an increase in depression severity, with some studies reporting small effect sizes (e.g. Magson et al., Reference Magson, Freeman, Rapee, Richardson, Oar and Fardouly2021; Rogers et al., Reference Rogers, Ha and Ockey2021), and others reporting moderate-to-large effects (e.g. Breaux et al., Reference Breaux, Dvorsky, Marsh, Green, Cash, Shroff and Becker2021; Thorisdottir et al., Reference Thorisdottir, Asgeirsdottir, Kristjansson, Valdimarsdottir, Jonsdottir Tolgyes, Sigfusson and Halldorsdottir2021). Only one large study did not find changes (1778 Chinese children and adolescents recruited through school-based cluster sampling; Teng, Pontes, Nie, Griffiths, & Guo, Reference Teng, Pontes, Nie, Griffiths and Guo2021). Studies that examined demographic predictors tended to find worse outcomes for girls compared to boys (e.g. De France et al., Reference De France, Hancock, Stack, Serbin and Hollenstein2021; Thorisdottir et al., Reference Thorisdottir, Asgeirsdottir, Kristjansson, Valdimarsdottir, Jonsdottir Tolgyes, Sigfusson and Halldorsdottir2021) and for children whose parents experienced employment difficulties (e.g. Luijten et al., Reference Luijten, van Muilekom, Teela, Polderman, Terwee, Zijlmans and Haverman2021).

Of seven studies examining depression in older adults, five reported an increase in incidence or severity. In the largest study, a national opt-in panel survey of 16 644 older American adults (Barcellos, Jacobson, & Stone, Reference Barcellos, Jacobson and Stone2021), this increase was driven by an increase in women only. Of 13 studies examining changes in depression in other medically vulnerable individuals, seven reported increases in severity, though only two studies with sample sizes >100 found this increase. The remainder of larger studies reported no change (k = 4) or a decrease (k = 1). This pattern is potentially suggestive of a true null effect.

Seven studies assessed other selected samples, with all but the smallest reporting an increase in incidence or severity of depression, typically with moderate or large effect sizes. A study of 2288 American SGM individuals found a small increase in self-reported depression severity (Flentje et al., Reference Flentje, Obedin-Maliver, Lubensky, Dastur, Neilands and Lunn2020). In a sample of 419 American undergraduates (Fruehwirth et al., Reference Fruehwirth, Biswas and Perreira2021), increased depression was observed in both SGM and non-SGM students. Four studies assessed participants who were pregnant or newly post-partum, with Ns ranging from 50 (Lorentz et al., Reference Lorentz, Chagas, Perez, da Silva Cassol, Vettorazzi and Lubianca2021) to 1042 (Loret de Mola et al., Reference Loret de Mola, Martins-Silva, Carpena, Del-Ponte, Blumenberg, Martins and Cesar2021).

Across studies, findings for depression did not follow a clear pattern. While the majority of studies reported increased depression incidence or severity, other studies in similar populations found no change or a decrease. Effect sizes (k = 24) tended to be small (median Cohen's d = 0.22, range = −0.2 to 1.4).

General distress (k = 23)

Of 10 studies investigating general psychological distress in unselected samples, seven reported pandemic-related increases. These included the three largest studies, including two nationally representative samples (2032 American adults, Twenge & Joiner, Reference Twenge and Joiner2020; 13 754 adults in the UK, Chandola, Kumari, Booker, & Benzeval, Reference Chandola, Kumari, Booker and Benzeval2020). The magnitude of these increases varied, but tended to be large. Only two studies found a decrease in general distress, in 555 Chinese undergraduate students (Li, Cao, Leung, & Mak, Reference Li, Cao, Leung and Mak2020); and 71 Brazilian undergraduates (da Freitas, de Medeiros, & de Lopes, Reference da Freitas, de Medeiros and de Lopes2021). In both cases, absolute severity was low at both occasions.

Of four studies examining general distress in psychiatric samples, increased severity was observed in 76 Chinese adults undergoing methadone maintenance treatment (Liu et al., Reference Liu, Jin, Zhang, Zhang, Li and Ma2021); 32 children with dyslexia and their mothers (Soriano-Ferrer, Morte-Soriano, Begeny, & Piedra-Martínez, Reference Soriano-Ferrer, Morte-Soriano, Begeny and Piedra-Martínez2021); and 66 adults with psychiatric diagnoses and 22 healthy controls (Seitz et al., Reference Seitz, Bertsch and Herpertz2021). Only one study, of 37 children and 35 adults on the autism spectrum (Lugo-Marín et al., Reference Lugo-Marín, Gisbert-Gustemps, Setien-Ramos, Español-Martín, Ibañez-Jimenez, Forner-Puntonet and Ramos-Quiroga2021), found no change in psychiatric distress.

Results for children and adolescents without psychiatric diagnoses were variable. A study of 1778 Chinese youth who play video games (Teng et al., Reference Teng, Pontes, Nie, Griffiths and Guo2021) found a small increase in distress. However, a study of 127 Canadian youth found a decrease (Gagné, Piché, Clément, & Villatte, Reference Gagné, Piché, Clément and Villatte2021), while a study of 203 Dutch youth found no change (Achterberg, Dobbelaar, Boer, & Crone, Reference Achterberg, Dobbelaar, Boer and Crone2021).

Of six studies in medically vulnerable samples, four found an increase in distress (including both studies in pregnant women; Ayaz et al., Reference Ayaz, Hocaoğlu, Günay, Yardımcı, Turgut and Karateke2020; Perzow et al., Reference Perzow, Hennessey, Hoffman, Grote, Davis and Hankin2021), while the remainder found no change. Small sample size constrains interpretability for these studies, as the largest (177 dialysis patients; Bonenkamp et al., Reference Bonenkamp, Druiventak, van Eck van der Sluijs, van Ittersum, van Jaarsveld and Abrahams2021) found no change in distress, while the next largest (135 pregnant participants; Perzow et al., Reference Perzow, Hennessey, Hoffman, Grote, Davis and Hankin2021) found an increase. The remaining studies had fewer than 70 participants each and were likely underpowered to detect increases of small magnitude. Finally, a longitudinal cohort study of 208 American transgender and gender non-binary individuals found an increase in distress (Kidd et al., Reference Kidd, Jackman, Barucco, Dworkin, Dolezal, Navalta and Bockting2021).

There was a stable tendency for distress to increase in adult samples. Calculable effect sizes (k = 10) tended to be small (median Cohen's d = 0.29; range = −0.24 to 3.8). Undergraduate students and children demonstrated the most consistent exception to this pattern, often showing a decrease in general distress.

General discussion

The present systematic review found that changes in psychopathology from pre- to peri-pandemic varied as a function of symptom cluster and sample characteristics. Contrary to expectations (e.g. Gruber et al., Reference Gruber, Prinstein, Clark, Rottenberg, Abramowitz, Albano and Weinstock2021), adults with pre-existing mental health conditions were not disproportionately affected, excepting adults with pre-existing OCD, whose symptoms tended to worsen. Age also showed unexpected effects. Several large studies (Peters et al., Reference Peters, Rospleszcz, Greiser, Dallavalle and Berger2020; Ramiz et al., Reference Ramiz, Contrand, Rojas Castro, Dupuy, Lu, Sztal-Kutas and Lagarde2021; Winkler et al., Reference Winkler, Mohrova, Mlada, Kuklova, Kagstrom, Mohr and Formanek2021) found more striking increases in anxiety symptoms in children and relatively younger adults, despite those being among the demographics least susceptible to serious COVID-19 infection. Studies of older adults and medically vulnerable individuals tended to have relatively smaller samples and more mixed results, though studies with larger samples found increases in anxiety and fear. Symptom trajectories were similarly variable; OCD and distress-related psychopathology (anxiety; depression) tended to increase, while PTSD and fear-related psychopathology failed to show a consistent pattern.

These patterns are likely multidetermined, but some candidate explanations can be offered. Different trajectories for anxiety (generally increased) v. fear (generally remained stable) may be attributable in part to the time course of the pandemic. Because acute fear reactions unfold on a much shorter timeline compared to anxiety, assessments weeks or months into the pandemic may have captured increased anxiety, but missed an initial uptick in fear. That women in their 20s–40s showed an especially prominent increase in anxiety and depression stands in contrast to their lower medical risk, and aligns with empirical findings that women took on more caregiving work than men when schools and childcare facilities closed during lockdown (OECD, 2021), which may have been especially stressful in light of reduced social support. Samples with pre-existing psychopathology tended to show increases in OCD symptoms, anxiety, and general distress, perhaps due to heightened vulnerability to contamination fears and prolonged uncertainty associated with a viral pandemic. Student samples, individuals with autism, and medical samples were the most likely to demonstrate stable or decreasing symptoms, suggesting that pandemic-related reductions in academic and social demands may have actually reduced overall stress for these populations.

The conclusions of the present review should be interpreted in light of its relative strengths and limitations. The reviewed studies varied in quality, with tradeoffs evident. The largest and most representative studies tended to use briefer assessments, and countries were not evenly represented. Methodological quality coding indicated that most studies used validated measures and reported average to good response rates, but often relied on smaller convenience samples. This suggests that while samples were characterized accurately, they may have failed to include those less likely to participate in voluntary mental health research, such as older individuals or those with existing psychopathology. However, many of the reviewed studies targeted samples with vulnerabilities related to age and psychiatric or medical characteristics, potentially mitigating bias introduced by non-random sampling methods. Although formal meta-analysis or modeling symptom trajectories was not possible due to considerable variability in utilized measures and reporting standards, we placed greater interpretative weight on studies with larger samples and well-validated assessments (and see Table 1, which includes sample nationality and months elapsed between assessments).

Taken together, these findings underscore the importance of specificity in investigating and responding to pandemic-related changes in mental health. Findings are more consistent with theoretical conceptualizations of the pandemic as a chronic stressor, v. an acute trauma. Increased mental health symptoms may have reflected contextual adaptations to a high-risk environment (i.e. ‘true alarms’). Future studies of mental health in disaster contexts should consider the functional context (e.g. potential adaptive value) and impairment associated with symptom changes, while carefully weighing psychometric considerations, such as assuming measurement invariance. Demographic factors such as age, gender, socioeconomic status, and marginalized identity status should also be assessed as possible hidden moderators of disaster impact on mental health. In the present review, although lifespan risk factors such as pregnancy and older age were associated with increased internalizing symptoms, medically vulnerable and most psychiatric populations showed unexpected resilience, which suggests the potential value of a strengths-based perspective.

Anxiety and other forms of internalizing psychopathology have long been conceptualized as evolutionary adaptations that operate in excess in modern, generally safe contexts (Öhman & Mineka, Reference Öhman and Mineka2001). Chronically anxious individuals may have experienced a sense of validation from the societal consensus that the environment was unsafe, or may have been more experienced in navigating day-to-day life while anxious. This resilience was not universal, however. Individuals with contamination-related OCD in particular experienced a worsening of symptoms, perhaps due in part to public health messaging around risks of the virus and responsibility for preventing harm. From a clinical and public health perspective, children and relatively younger adults, and particularly younger women, appear to be shouldering most of the mental health burden. Additional research is needed to identify the major psychological determinants of these vulnerabilities (e.g. caregiving responsibilities; social isolation) to best inform the development of public policy and interventions.

Supplementary material

The supplementary material for this article can be found at https://doi.org/10.1017/S0033291723002295.

Acknowledgements

The authors thank Paige DeGennaro for assistance with data checking.

References

Achterberg, M., Dobbelaar, S., Boer, O. D., & Crone, E. A. (2021). Perceived stress as mediator for longitudinal effects of the COVID-19 lockdown on wellbeing of parents and children. Scientific Reports, 11(1), 114.CrossRefGoogle ScholarPubMed
Adams, R. E., Zheng, S., Taylor, J. L., & Bishop, S. L. (2021). Ten weeks in: COVID-19-related distress in adults with autism spectrum disorder. Autism: The International Journal of Research and Practice, 25(7), 21402145.CrossRefGoogle ScholarPubMed
Algattas, H., Roy, S., Agarwal, N., & Maroon, J. (2021). COVID-19 impact in neurosurgery residency: Grit during pandemic. World Neurosurgery, 151, 395398.CrossRefGoogle ScholarPubMed
Alonso, P., Bertolín, S., Segalàs, J., Tubío, M., Real, E., Mar-Barrutia, L., … Menchón, J. M. (2021). How is COVID-19 affecting patients with obsessive-compulsive disorder? A longitudinal study on the initial phase of the pandemic in a Spanish cohort. European Psychiatry: The Journal of the Association of European Psychiatrists, 64(1), 127.CrossRefGoogle Scholar
Arjmand, H.-A., Seabrook, E., Bakker, D., & Rickard, N. (2021). Mental health consequences of adversity in Australia: National bushfires associated with increased depressive symptoms, while COVID-19 pandemic associated with increased symptoms of anxiety. Frontiers in Psychology, 12, 17.CrossRefGoogle ScholarPubMed
Asquini, G., Bianchi, A. E., Borromeo, G., Locatelli, M., & Falla, D. (2021). The impact of Covid-19-related distress on general health, oral behaviour, psychosocial features, disability and pain intensity in a cohort of Italian patients with temporomandibular disorders. PLoS ONE, 16(2), 113.CrossRefGoogle Scholar
Ayaz, R., Hocaoğlu, M., Günay, T., Yardımcı, O. D., Turgut, A., & Karateke, A. (2020). Anxiety and depression symptoms in the same pregnant women before and during the COVID-19 pandemic. Journal of Perinatal Medicine, 48(9), 965970.CrossRefGoogle ScholarPubMed
Ayuso-Mateos, J. L., Morillo, D., Haro, J. M., Olaya, B., Lara, E., & Miret, M. (2021). Changes in depression and suicidal ideation under severe lockdown restrictions during the first wave of the COVID-19 pandemic in Spain: A longitudinal study in the general population. Epidemiology and Psychiatric Sciences, 30, 19.CrossRefGoogle Scholar
Baiano, C., Zappullo, I., Group, T. L., & Conson, M. (2020). Tendency to worry and fear of mental health during Italy's COVID-19 lockdown. International Journal of Environmental Research and Public Health, 17(16), 18.CrossRefGoogle ScholarPubMed
Barcellos, S., Jacobson, M., & Stone, A. A. (2021). Varied and unexpected changes in the well-being of seniors in the United States amid the COVID-19 pandemic. PLoS ONE, 16(6), 114.CrossRefGoogle ScholarPubMed
Bonanno, G. A., Brewin, C. R., Kaniasty, K., & Greca, A. M. L. (2010). Weighing the costs of disaster: Consequences, risks, and resilience in individuals, families, and communities. Psychological Science in the Public Interest, 11(1), 149. https://doi.org/10.1177/1529100610387086CrossRefGoogle ScholarPubMed
Bonenkamp, A. A., Druiventak, T. A., van Eck van der Sluijs, A., van Ittersum, F. J., van Jaarsveld, B. C., & Abrahams, A. C. (2021). The impact of COVID-19 on the mental health of dialysis patients. Journal of Nephrology, 34(2), 337344.CrossRefGoogle ScholarPubMed
Breaux, R., Dvorsky, M. R., Marsh, N. P., Green, C. D., Cash, A. R., Shroff, D. M., … Becker, S. P. (2021). Prospective impact of COVID-19 on mental health functioning in adolescents with and without ADHD: Protective role of emotion regulation abilities. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 62(9), 11321139.CrossRefGoogle ScholarPubMed
Bridgland, V. M. E., Moeck, E. K., Green, D. M., Swain, T. L., Nayda, D. M., Matson, L. A., … Takarangi, M. K. T. (2021). Why the COVID-19 pandemic is a traumatic stressor. PLoS ONE, 16(1), 115. https://doi.org/10.1371/journal.pone.0240146CrossRefGoogle ScholarPubMed
Brunoni, A. R., Suen, P. J. C., Bacchi, P. S., Razza, L. B., Klein, I., Dos Santos, L. A., … Benseñor, I. M. (2021). Prevalence and risk factors of psychiatric symptoms and diagnoses before and during the COVID-19 pandemic: Findings from the ELSA-Brasil COVID-19 mental health cohort. Psychological Medicine, 53(2), 112.CrossRefGoogle ScholarPubMed
Bussone, S., Pesca, C., Tambelli, R., & Carola, V. (2020). Psychological health issues subsequent to SARS-Cov 2 restrictive measures: The role of parental bonding and attachment style. Frontiers in Psychiatry, 11, 19.CrossRefGoogle ScholarPubMed
Campos, J. A. D. B., Campos, L. A., Bueno, J. L., & Martins, B. G. (2021). Emotions and mood swings of pharmacy students in the context of the coronavirus disease of 2019 pandemic. Currents in Pharmacy Teaching & Learning, 13(6), 635642.CrossRefGoogle ScholarPubMed
Capuano, R., Altieri, M., Bisecco, A., d'Ambrosio, A., Docimo, R., Buonanno, D., … Gallo, A. (2021). Psychological consequences of COVID-19 pandemic in Italian MS patients: Signs of resilience? Journal of Neurology, 268(3), 743750.CrossRefGoogle ScholarPubMed
Chakraborty, A., & Karmakar, S. (2020). Impact of COVID-19 on obsessive compulsive disorder (OCD). Iranian Journal of Psychiatry, 15(3), 256259.Google ScholarPubMed
Chandola, T., Kumari, M., Booker, C. L., & Benzeval, M. (2020). The mental health impact of COVID-19 and lockdown-related stressors among adults in the UK. Psychological Medicine, 52(14), 110.Google ScholarPubMed
Conti, E., Sgandurra, G., De Nicola, G., Biagioni, T., Boldrini, S., Bonaventura, E., … Battini, R. (2020). Behavioural and emotional changes during COVID-19 lockdown in an Italian paediatric population with neurologic and psychiatric disorders. Brain Sciences, 10(12), 115.CrossRefGoogle Scholar
Cooley, S. A., Nelson, B., Doyle, J., Rosenow, A., & Ances, B. M. (2021). Collateral damage: Impact of SARS-CoV-2 pandemic in people living with HIV. Journal of Neurovirology, 27(1), 168170.CrossRefGoogle ScholarPubMed
Cox, R. C., & Olatunji, B. O. (2021). Linking insomnia and OCD symptoms during the coronavirus pandemic: Examination of prospective associations. Journal of Anxiety Disorders, 77, 18.CrossRefGoogle ScholarPubMed
da Freitas, F. F., de Medeiros, A. C. Q., & de Lopes, F. A. (2021). Effects of social distancing during the COVID-19 pandemic on anxiety and eating behavior – a longitudinal study. Frontiers in Psychology, 12, 111.CrossRefGoogle Scholar
Daly, M., & Robinson, E. (2021). Anxiety reported by US adults in 2019 and during the 2020 COVID-19 pandemic: Population-based evidence from two nationally representative samples. Journal of Affective Disorders, 286, 296300.CrossRefGoogle ScholarPubMed
Davide, P., Andrea, P., Martina, O., Andrea, E., Davide, D., & Mario, A. (2020). The impact of the COVID-19 pandemic on patients with OCD: Effects of contamination symptoms and remission state before the quarantine in a preliminary naturalistic study. Psychiatry Research, 291, 15.CrossRefGoogle Scholar
De France, K., Hancock, G. R., Stack, D. M., Serbin, L. A., & Hollenstein, T. (2021). The mental health implications of COVID-19 for adolescents: Follow-up of a four-wave longitudinal study during the pandemic. The American Psychologist, 77(1), 8599.CrossRefGoogle ScholarPubMed
Deng, J., Zhou, F., Hou, W., Silver, Z., Wong, C. Y., Chang, O., … Huang, E. (2021). The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Research, 301, 120. https://doi.org/10.1016/j.psychres.2021.113863CrossRefGoogle ScholarPubMed
Ebrahimi, O. V., Hoffart, A., & Johnson, S. U. (2021). Physical distancing and mental health during the COVID-19 pandemic: Factors associated with psychological symptoms and adherence to pandemic mitigation strategies. Clinical Psychological Science, 9(3), 489506.CrossRefGoogle Scholar
Elmer, T., Mepham, K., & Stadtfeld, C. (2020). Students under lockdown: Comparisons of students’ social networks and mental health before and during the COVID-19 crisis in Switzerland. PLoS ONE, 15(7), 122.CrossRefGoogle ScholarPubMed
Emery, R. L., Johnson, S. T., Simone, M., Loth, K. A., Berge, J. M., & Neumark-Sztainer, D. (2021). Understanding the impact of the COVID-19 pandemic on stress, mood, and substance use among young adults in the greater Minneapolis-St. Paul area: Findings from project EAT. Social Science & Medicine, 276(1982), 110.CrossRefGoogle ScholarPubMed
Ergenekon, A. P., Yilmaz Yegit, C., Cenk, M., Bas Ikizoglu, N., Atag, E., Gokdemir, Y., … Karadag, B. (2021). Depression and anxiety in mothers of home ventilated children before and during COVID-19 pandemic. Pediatric Pulmonology, 56(1), 264270.CrossRefGoogle ScholarPubMed
Evans, S., Alkan, E., Bhangoo, J. K., Tenenbaum, H., & Ng-Knight, T. (2021). Effects of the COVID-19 lockdown on mental health, wellbeing, sleep, and alcohol use in a UK student sample. Psychiatry Research, 298, 17.CrossRefGoogle Scholar
Faravelli, C., Lo Sauro, C., Lelli, L., Pietrini, F., Lazzeretti, L., Godini, L., … Ricca, V. (2012). The role of life events and HPA axis in anxiety disorders: A review. Current Pharmaceutical Design, 18(35), 56635674. https://doi.org/10.2174/138161212803530907CrossRefGoogle ScholarPubMed
Feinberg, M. E., Mogle, J. A., Lee, J.-K., Tornello, S. L., Hostetler, M. L., Cifelli, J. A., … Hotez, E. (2021). Impact of the COVID-19 pandemic on parent, child, and family functioning. Family Process, 61, 362375.Google ScholarPubMed
Fiorillo, A., & Gorwood, P. (2020). The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. European Psychiatry, 63(1), e32. https://doi.org/10.1192/j.eurpsy.2020.35CrossRefGoogle ScholarPubMed
Flentje, A., Obedin-Maliver, J., Lubensky, M. E., Dastur, Z., Neilands, T., & Lunn, M. R. (2020). Depression and anxiety changes among sexual and gender minority people coinciding with onset of COVID-19 pandemic. Journal of General Internal Medicine, 35(9), 27882790.CrossRefGoogle ScholarPubMed
Fruehwirth, J. C., Biswas, S., & Perreira, K. M. (2021). The Covid-19 pandemic and mental health of first-year college students: Examining the effect of Covid-19 stressors using longitudinal data. PLoS ONE, 16(3), e0247999.CrossRefGoogle ScholarPubMed
Gagné, M.-H., Piché, G., Clément, M.-È., & Villatte, A. (2021). Families in confinement: A pre–post COVID-19 study. Couple and Family Psychology: Research and Practice, 10(4), 260270.CrossRefGoogle Scholar
Giel, K. E., Schurr, M., Zipfel, S., Junne, F., & Schag, K. (2021). Eating behaviour and symptom trajectories in patients with a history of binge eating disorder during COVID-19 pandemic. European Eating Disorders Review: The Journal of the Eating Disorders Association, 29(4), 657662.CrossRefGoogle ScholarPubMed
Gosselin, A., Melchior, M., Carillon, S., Gubert, F., Ridde, V., Kohou, V., … Desgrées du Loû, A. (2021). Deterioration of mental health and insufficient Covid-19 information among disadvantaged immigrants in the greater Paris area. Journal of Psychosomatic Research, 146, 15.CrossRefGoogle ScholarPubMed
Gruber, J., Prinstein, M. J., Clark, L. A., Rottenberg, J., Abramowitz, J. S., Albano, A. M., … Weinstock, L. M. (2021). Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action. American Psychologist, 76(3), 409426. https://doi.org/10.1037/amp0000707CrossRefGoogle Scholar
Gul, Z. B. (2021). Depression and sexual functions in epilepsy patients: Comparison before and during the COVID-19 pandemic. Annals of Medical Psychology, 180, 16.Google ScholarPubMed
Guzick, A. G., Candelari, A., Wiese, A. D., Schneider, S. C., Goodman, W. K., & Storch, E. A. (2021). Obsessive–compulsive disorder during the COVID-19 pandemic: A systematic review. Current Psychiatry Reports, 23(11), 71. https://doi.org/10.1007/s11920-021-01284-2CrossRefGoogle ScholarPubMed
Haliwa, I., Wilson, J., Lee, J., & Shook, N. J. (2021). Predictors of change in mental health during the COVID-19 pandemic. Journal of Affective Disorders, 291, 331337.CrossRefGoogle ScholarPubMed
Hamadani, J. D., Hasan, M. I., Baldi, A. J., Hossain, S. J., Shiraji, S., Bhuiyan, M. S. A., … Pasricha, S.-R. (2020). Immediate impact of stay-at-home orders to control COVID-19 transmission on socioeconomic conditions, food insecurity, mental health, and intimate partner violence in Bangladeshi women and their families: An interrupted time series. The Lancet Global Health, 8(11), e1380e1389.CrossRefGoogle ScholarPubMed
Hamm, M. E., Brown, P. J., Karp, J. F., Lenard, E., Cameron, F., Dawdani, A., … Lenze, E. J. (2020). Experiences of American older adults with pre-existing depression during the beginnings of the COVID-19 pandemic: A multicity, mixed-methods study. The American Journal of Geriatric Psychiatry, 28(9), 924932.CrossRefGoogle ScholarPubMed
Herrera, M. S., Elgueta, R., Fernández, M. B., Giacoman, C., Leal, D., Marshall, P., … Bustamante, F. (2021). A longitudinal study monitoring the quality of life in a national cohort of older adults in Chile before and during the COVID-19 outbreak. BMC Geriatrics, 21(1), 112.CrossRefGoogle Scholar
Hill, M. L., Nichter, B., Na, P. J., Norman, S. B., Morland, L. A., Krystal, J. H., & Pietrzak, R. H. (2021). Mental health impact of the COVID-19 pandemic in U.S. military veterans: A population-based, prospective cohort study. Psychological Medicine, 53, 112.Google ScholarPubMed
Hyland, P., Shevlin, M., Murphy, J., McBride, O., Fox, R., Bondjers, K., … Vallières, F. (2021). A longitudinal assessment of depression and anxiety in the Republic of Ireland before and during the COVID-19 pandemic. Psychiatry Research, 300, 17.CrossRefGoogle ScholarPubMed
Ilgen, O., Kurt, S., Aydin, C., Bilen, E., & Kula, H. (2021). COVID-19 pandemic effect on female sexual function. Polish Gynecology, 92, 856859.Google ScholarPubMed
Jacobs, M., & Burch, A. E. (2021). Anxiety during the pandemic: Racial and ethnic differences in the trajectory of fear. Journal of Affective Disorders, 292, 5866.CrossRefGoogle ScholarPubMed
Jelinek, L., Göritz, A. S., Miegel, F., Moritz, S., & Kriston, L. (2021). Predictors of trajectories of obsessive-compulsive symptoms during the COVID-19 pandemic in the general population in Germany. Translational Psychiatry, 11(1), 111.CrossRefGoogle ScholarPubMed
Kendler, K. S., & Gardner, C. O. (2016). Depressive vulnerability, stressful life events and episode onset of major depression: A longitudinal model. Psychological Medicine, 46(9), 18651874. https://doi.org/10.1017/S0033291716000349CrossRefGoogle ScholarPubMed
Khosravani, V., Aardema, F., Samimi Ardestani, S. M., & Sharifi Bastan, F. (2021). The impact of the coronavirus pandemic on specific symptom dimensions and severity in OCD: A comparison before and during COVID-19 in the context of stress responses. Journal of Obsessive-Compulsive and Related Disorders, 29, 16.CrossRefGoogle ScholarPubMed
Kidd, J. D., Jackman, K. B., Barucco, R., Dworkin, J. D., Dolezal, C., Navalta, T. V., … Bockting, W. O. (2021). Understanding the impact of the COVID-19 pandemic on the mental health of transgender and gender nonbinary individuals engaged in a longitudinal cohort study. Journal of Homosexuality, 68(4), 592611.CrossRefGoogle ScholarPubMed
King, L. S., Feddoes, D. E., Kirshenbaum, J. S., Humphreys, K. L., & Gotlib, I. H. (2021). Pregnancy during the pandemic: The impact of COVID-19-related stress on risk for prenatal depression. Psychological Medicine, 53(1), 170180.CrossRefGoogle ScholarPubMed
Knowles, K. A., & Olatunji, B. O. (2021). Anxiety and safety behavior usage during the COVID-19 pandemic: The prospective role of contamination fear. Journal of Anxiety Disorders, 77, 15.CrossRefGoogle ScholarPubMed
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., … Zimmerman, M. (2017). The hierarchical taxonomy of psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454477. https://doi.org/10.1037/abn0000258CrossRefGoogle ScholarPubMed
Koushik, N. S. (2020). A population mental health perspective on the impact of COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy, 12(5), 529530. https://doi.org/10.1037/tra0000737CrossRefGoogle ScholarPubMed
Krendl, A. C., & Perry, B. L. (2021). The impact of sheltering in place during the COVID-19 pandemic on older adults’ social and mental well-being. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 76(2), e53e58.CrossRefGoogle ScholarPubMed
Krishnamoorthy, Y., Nagarajan, R., Saya, G. K., & Menon, V. (2020). Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Research, 293, 111. https://doi.org/10.1016/j.psychres.2020.113382CrossRefGoogle ScholarPubMed
Lau, A. L. D., Chi, I., Cummins, R. A., Lee, T. M. C., Chou, K.-L., & Chung, L. W. M. (2008). The SARS (Severe Acute Respiratory Syndrome) pandemic in Hong Kong: Effects on the subjective wellbeing of elderly and younger people. Aging and Mental Health, 12(6), 746760. https://doi.org/10.1080/13607860802380607.CrossRefGoogle Scholar
Lau, J. F., Shariff, R., & Meehan, A. (2021). Are biased interpretations of ambiguous social and non-social situations a precursor, consequence or maintenance factor of youth loneliness? Behaviour Research and Therapy, 140, 18.CrossRefGoogle ScholarPubMed
Lee, C. M., Cadigan, J. M., & Rhew, I. C. (2020). Increases in loneliness among young adults during the COVID-19 pandemic and association with increases in mental health problems. The Journal of Adolescent Health, 67(5), 714717.CrossRefGoogle ScholarPubMed
Li, H. Y., Cao, H., Leung, D. Y. P., & Mak, Y. W. (2020). The psychological impacts of a COVID-19 outbreak on college students in China: A longitudinal study. International Journal of Environmental Research and Public Health, 17(11), 111.Google Scholar
Liu, R. T., & Miller, I. (2014). Life events and suicidal ideation and behavior: A systematic review. Clinical Psychology Review, 34(3), 181192. https://doi.org/10.1016/j.cpr.2014.01.006CrossRefGoogle ScholarPubMed
Liu, X., Jin, X., Zhang, Y., Zhang, L., Li, Y., & Ma, J. (2021). Effect of coronavirus disease 2019 on the psychology and behavior of patients on methadone maintenance treatment in Wuhan, China: A clinical observational study. Frontiers in Psychiatry, 12, 16.Google Scholar
Lorentz, M. S., Chagas, L. B., Perez, A. V., da Silva Cassol, P. A., Vettorazzi, J., & Lubianca, J. N. (2021). Correlation between depressive symptoms and sexual dysfunction in postpartum women during the COVID-19 pandemic. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 258, 162167.CrossRefGoogle ScholarPubMed
Loret de Mola, C., Martins-Silva, T., Carpena, M. X., Del-Ponte, B., Blumenberg, C., Martins, R. C., … Cesar, J. A. (2021). Maternal mental health before and during the COVID-19 pandemic in the 2019 Rio Grande birth cohort. Brazilian Journal of Psychiatry, 43(4), 402406.CrossRefGoogle Scholar
Lugo-Marín, J., Gisbert-Gustemps, L., Setien-Ramos, I., Español-Martín, G., Ibañez-Jimenez, P., Forner-Puntonet, M., … Ramos-Quiroga, J. A. (2021). COVID-19 pandemic effects in people with autism spectrum disorder and their caregivers: Evaluation of social distancing and lockdown impact on mental health and general status. Research in Autism Spectrum Disorders, 83, 111.CrossRefGoogle ScholarPubMed
Luijten, M. A. J., van Muilekom, M. M., Teela, L., Polderman, T. J. C., Terwee, C. B., Zijlmans, J., … Haverman, L. (2021). The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents. Quality of Life Research, 30(10), 27952804.CrossRefGoogle ScholarPubMed
Luo, M., Guo, L., Yu, M., Jiang, W., & Wang, H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public – a systematic review and meta-analysis. Psychiatry Research, 291, 29. https://doi.org/10.1016/j.psychres.2020.113190Google ScholarPubMed
Magson, N. R., Freeman, J. Y. A., Rapee, R. M., Richardson, C. E., Oar, E. L., & Fardouly, J. (2021). Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. Journal of Youth and Adolescence, 50(1), 4457.CrossRefGoogle ScholarPubMed
Mancini, A. D. (2020). Heterogeneous mental health consequences of COVID-19: Costs and benefits. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S15S16. https://doi.org/10.1037/tra0000894CrossRefGoogle ScholarPubMed
McArthur, C., Saari, M., Heckman, G. A., Wellens, N., Weir, J., Hebert, P., … Hirdes, J. P. (2021). Evaluating the effect of COVID-19 pandemic lockdown on long-term care residents’ mental health: A data-driven approach in New Brunswick. Journal of the American Medical Directors Association, 22(1), 187192.CrossRefGoogle ScholarPubMed
McLaughlin, K. (2020). Early life stress and psychopathology. In Harkness, K. L. & Hayden, E. P. (Eds.), The Oxford handbook of stress and mental health (pp. 4474; By K. McLaughlin). Oxford, UK: Oxford University Press. https://doi.org/10.1093/oxfordhb/9780190681777.013.3Google Scholar
Minhas, M., Belisario, K., González-Roz, A., Halladay, J., Murphy, J. G., & MacKillop, J. (2021). COVID-19 impacts on drinking and mental health in emerging adults: Longitudinal changes and moderation by economic disruption and sex. Alcoholism: Clinical and Experimental Research, 45, 14481457.CrossRefGoogle ScholarPubMed
Mink van der Molen, D. R., Bargon, C. A., Batenburg, M. C. T., Gal, R., Young-Afat, D. A., van Stam, L. E., … Verkooijen, H. M. (2021). (Ex-)breast cancer patients with (pre-existing) symptoms of anxiety and/or depression experience higher barriers to contact health care providers during the COVID-19 pandemic. Breast Cancer Research and Treatment, 186(2), 577583.CrossRefGoogle ScholarPubMed
Mishra, R., Park, C., York, M. K., Kunik, M. E., Wung, S.-F., Naik, A. D., & Najafi, B. (2021). Decrease in mobility during the COVID-19 pandemic and its association with increase in depression among older adults: A longitudinal remote mobility monitoring using a wearable sensor. Sensors, 21(9), 112.CrossRefGoogle ScholarPubMed
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. Annals of Internal Medicine, 151(4), 221296.CrossRefGoogle ScholarPubMed
Necho, M., Tsehay, M., Birkie, M., Biset, G., & Tadesse, E. (2021). Prevalence of anxiety, depression, and psychological distress among the general population during the COVID-19 pandemic: A systematic review and meta-analysis. International Journal of Social Psychiatry, 67(7), 892906. https://doi.org/10.1177/00207640211003121CrossRefGoogle ScholarPubMed
Nogueira, J., Gerardo, B., Silva, A. R., Pinto, P., Barbosa, R., Soares, S., … Freitas, S. (2021). Effects of restraining measures due to COVID-19: Pre- and post-lockdown cognitive status and mental health. Current Psychology, 41(10), 110.Google ScholarPubMed
Novotný, J. S., Gonzalez-Rivas, J. P., Kunzová, Š, Skladaná, M., Pospíšilová, A., Polcrová, A., … Stokin, G. B. (2020). Risk factors underlying COVID-19 lockdown-induced mental distress. Frontiers in Psychiatry, 11, 111.CrossRefGoogle ScholarPubMed
OECD. (2021). Caregiving in crisis: Gender inequality in paid and unpaid work during COVID-19 [OECD Policy Responses to Coronavirus (COVID-19)], 125. https://doi.org/10.1787/3555d164-enCrossRefGoogle Scholar
Öhman, A. (2008). Fear and anxiety: Overlaps and dissociations. In Lewis, M., Haviland-Jones, J. M. & Barrett, L. F. (Eds.), Handbook of emotions (pp. 709728). New York, NY: The Guilford Press.Google Scholar
Öhman, A., & Mineka, S. (2001). Fears, phobias, and preparedness: Toward an evolved module of fear and fear learning. Psychological Review, 108(3), 483522. https://doi.org/10.1037/0033-295X.108.3.483CrossRefGoogle ScholarPubMed
Pan, K.-Y., Kok, A. A. L., Eikelenboom, M., Horsfall, M., Jörg, F., Luteijn, R. A., … Penninx, B. W. J. H. (2021). The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: A longitudinal study of three Dutch case-control cohorts. The Lancet. Psychiatry, 8(2), 121129.CrossRefGoogle ScholarPubMed
Perzow, S. E. D., Hennessey, E.-M. P., Hoffman, M. C., Grote, N. K., Davis, E. P., & Hankin, B. L. (2021). Mental health of pregnant and postpartum women in response to the COVID-19 pandemic. Journal of Affective Disorders Reports, 4, 17.CrossRefGoogle ScholarPubMed
Peters, A., Rospleszcz, S., Greiser, K. H., Dallavalle, M., & Berger, K. (2020). The impact of the COVID-19 pandemic on self-reported health. Deutsches Arzteblatt International, 117(50), 861867.Google ScholarPubMed
Pfefferbaum, B., & North, C. S. (2020). Mental health and the Covid-19 pandemic. New England Journal of Medicine, 383(6), 510512. https://doi.org/10.1056/NEJMp2008017CrossRefGoogle ScholarPubMed
Ramiz, L., Contrand, B., Rojas Castro, M. Y., Dupuy, M., Lu, L., Sztal-Kutas, C., & Lagarde, E. (2021). A longitudinal study of mental health before and during COVID-19 lockdown in the French population. Globalization and Health, 17(1), 116.CrossRefGoogle ScholarPubMed
Rivera, J., Castrejón, I., Vallejo-Slocker, L., Offenbächer, M., Molina-Collada, J., Trives, L., … Vallejo, M. A. (2021). Clinical impact of confinement due to the COVID-19 pandemic on patients with fibromyalgia: A cohort study. Clinical and Experimental Rheumatology, 39(3), 7881.CrossRefGoogle Scholar
Robinson, E., Sutin, A. R., Daly, M., & Jones, A. (2022). A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic in 2020. Journal of Affective Disorders, 296, 567576. https://doi.org/10.1016/j.jad.2021.09.098CrossRefGoogle ScholarPubMed
Rogers, A. A., Ha, T., & Ockey, S. (2021). Adolescents’ perceived socio-emotional impact of COVID-19 and implications for mental health: Results from a U.S.-based mixed-methods study. Journal of Adolescent Health, 68(1), 4352.CrossRefGoogle ScholarPubMed
Rutherford, B. R., Choi, C. J., Chrisanthopolous, M., Salzman, C., Zhu, C., Montes-Garcia, C., … Roose, S. P. (2021). The COVID-19 pandemic as a traumatic stressor: Mental health responses of older adults with chronic PTSD. The American Journal of Geriatric Psychiatry, 29(2), 105114.CrossRefGoogle ScholarPubMed
Sacre, J. W., Holmes-Truscott, E., Salim, A., Anstey, K. J., Drummond, G. R., Huxley, R. R., … Shaw, J. E. (2021). Impact of the COVID-19 pandemic and lockdown restrictions on psychosocial and behavioural outcomes among Australian adults with type 2 diabetes: Findings from the PREDICT cohort study. Diabetic Medicine, 00, 110.Google Scholar
Salari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., … Khaledi-Paveh, B. (2020). Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: A systematic review and meta-analysis. Globalization and Health, 16(1), 10951096. https://doi.org/10.1186/s12992-020-00589-wGoogle ScholarPubMed
Saraswathi, I., Saikarthik, J., Senthil Kumar, K., Madhan Srinivasan, K., Ardhanaari, M., & Gunapriya, R. (2020). Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: A prospective longitudinal study. PeerJ, 8, 125.CrossRefGoogle Scholar
Seitz, K. I., Bertsch, K., & Herpertz, S. C. (2021). A prospective study of mental health during the COVID-19 pandemic in childhood trauma-exposed individuals: Social support matters. Journal of Traumatic Stress, 34(3), 477486.CrossRefGoogle ScholarPubMed
Siew, S. K. H., Mahendran, R., & Yu, J. (2021). Directional effects of social isolation and quality of life on anxiety levels among community-dwelling older adults during a COVID-19 lockdown. The American Journal of Geriatric Psychiatry, 12, 12741279.CrossRefGoogle Scholar
Soriano-Ferrer, M., Morte-Soriano, M. R., Begeny, J., & Piedra-Martínez, E. (2021). Psychoeducational challenges in Spanish children with dyslexia and their parents’ stress during the COVID-19 pandemic. Frontiers in Psychology, 12, 115.CrossRefGoogle ScholarPubMed
Stojanov, A., Stojanov, J., Milosevic, V., Malobabic, M., Stanojevic, G., Stevic, M., & Djordjevic, G. (2020). The impact of the coronavirus disease-2019 pandemic on the psychological status and quality of life of myasthenia gravis patients. Annals of Indian Academy of Neurology, 23(4), 510514.CrossRefGoogle ScholarPubMed
Strizović, S., Vojvodić, N., Kovačević, M., Pejović, A., Bukumirić, Z., Sokić, D., & Ristić, A. J. (2021). Influence of COVID-19 pandemic on quality of life in patients with epilepsy – follow-up study. Epilepsy & Behavior, 121, 15.CrossRefGoogle ScholarPubMed
Tanir, Y., Karayagmurlu, A., Kaya, İ, Kaynar, T. B., Türkmen, G., Dambasan, B. N., … Coşkun, M. (2020). Exacerbation of obsessive compulsive disorder symptoms in children and adolescents during COVID-19 pandemic. Psychiatry Research, 293, 25.CrossRefGoogle ScholarPubMed
Teng, Z., Pontes, H. M., Nie, Q., Griffiths, M. D., & Guo, C. (2021). Depression and anxiety symptoms associated with internet gaming disorder before and during the COVID-19 pandemic: A longitudinal study. Journal of Behavioral Addictions, 10, 169180.CrossRefGoogle ScholarPubMed
Thombs, B. D., Kwakkenbos, L., Henry, R. S., Carrier, M.-E., Patten, S., Harb, S., … Benedetti, A. (2020). Changes in mental health symptoms from pre-COVID-19 to COVID-19 among participants with systemic sclerosis from four countries: A scleroderma patient-centered intervention network (SPIN) cohort study. Journal of Psychosomatic Research, 139, 110.CrossRefGoogle ScholarPubMed
Thorisdottir, I. E., Asgeirsdottir, B. B., Kristjansson, A. L., Valdimarsdottir, H. B., Jonsdottir Tolgyes, E. M., Sigfusson, J., … Halldorsdottir, T. (2021). Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: A longitudinal, population-based study. The Lancet Psychiatry, 8, 663672.CrossRefGoogle ScholarPubMed
Twenge, J. M., & Joiner, T. E. (2020). Mental distress among U.S. adults during the COVID-19 pandemic. Journal of Clinical Psychology, 76(12), 21702182.CrossRefGoogle ScholarPubMed
Ugurlucan, F. G., Yasa, C., Ates Tikiz, M., Evruke, I., Isik, C., Dural, O., … Akhan, S. E. (2021). Effect of the COVID-19 pandemic and social distancing measures on the sexual functions of women treated for vaginismus (genitopelvic pain/penetration disorder). International Urogynecology Journal, 32(5), 12651271.CrossRefGoogle Scholar
van Zyl, L. E., Rothmann, S., & Zondervan-Zwijnenburg, M. A. J. (2021). Longitudinal trajectories of study characteristics and mental health before and during the COVID-19 lockdown. Frontiers in Psychology, 12, 113.CrossRefGoogle ScholarPubMed
Villani, E. R., Vetrano, D. L., Damiano, C., Paola, A. D., Ulgiati, A. M., Martin, L., … Carfì, A. (2020). Impact of COVID-19-related lockdown on psychosocial, cognitive, and functional well-being in adults with down syndrome. Frontiers in Psychiatry, 11, 17.CrossRefGoogle ScholarPubMed
Waugh, C. E., Leslie-Miller, C. J., & Cole, V. T. (2022). Coping with COVID-19: The efficacy of disengagement for coping with the chronic stress of a pandemic. Anxiety, Stress. & Coping, 36(1), 5266. https://doi.org/10.1080/10615806.2022.2081841CrossRefGoogle ScholarPubMed
Winkler, P., Mohrova, Z., Mlada, K., Kuklova, M., Kagstrom, A., Mohr, P., & Formanek, T. (2021). Prevalence of current mental disorders before and during the second wave of COVID-19 pandemic: An analysis of repeated nationwide cross-sectional surveys. Journal of Psychiatric Research, 139, 167171.CrossRefGoogle ScholarPubMed
Wong, S. Y. S., Zhang, D., Sit, R. W. S., Yip, B. H. K., Chung, R. Y.-N., Wong, C. K. M., … Mercer, S. W. (2020). Impact of COVID-19 on loneliness, mental health, and health service utilisation: A prospective cohort study of older adults with multimorbidity in primary care. The British Journal of General Practice, 70(700), e817e824.CrossRefGoogle ScholarPubMed
Yang, X., Hu, H., Zhao, C., Xu, H., Tu, X., & Zhang, G. (2021). A longitudinal study of changes in smart phone addiction and depressive symptoms and potential risk factors among Chinese college students. BMC Psychiatry, 21, 19.CrossRefGoogle ScholarPubMed
Yang, Z., Ji, L.-J., Yang, Y., Wang, Y., Zhu, L., & Cai, H. (2021). Meaning making helps cope with COVID-19: A longitudinal study. Personality and Individual Differences, 174, 16.CrossRefGoogle ScholarPubMed
Yildirim, O. A., Poyraz, K., & Erdur, E. (2021). Depression and anxiety in cancer patients before and during the SARS-CoV-2 pandemic: Association with treatment delays. Quality of Life Research, 30(7), 110.CrossRefGoogle ScholarPubMed
Yocum, A. K., Zhai, Y., McInnis, M. G., & Han, P. (2021). Covid-19 pandemic and lockdown impacts: A description in a longitudinal study of bipolar disorder. Journal of Affective Disorders, 282, 12261233.CrossRefGoogle Scholar
Zambelli, Z., Fidalgo, A. R., Halstead, E. J., & Dimitriou, D. (2021). Acute impact of a national lockdown during the COVID-19 pandemic on wellbeing outcomes among individuals with chronic pain. Journal of Health Psychology, 27(5), 112.Google ScholarPubMed
Zhang, B., Zaman, A., Silenzio, V., Kautz, H., & Hoque, E. (2020). The relationships of deteriorating depression and anxiety with longitudinal behavioral changes in google and YouTube use during COVID-19: Observational study. JMIR Mental Health, 7(11), e24012.CrossRefGoogle ScholarPubMed
Zhao, S. Z., Wong, J. Y. H., Luk, T. T., Wai, A. K. C., Lam, T. H., & Wang, M. P. (2020). Mental health crisis under COVID-19 pandemic in Hong Kong, China. International Journal of Infectious Diseases, 100, 431433.CrossRefGoogle ScholarPubMed
Figure 0

Figure 1. PRISMA diagram showing study selection process.

Figure 1

Figure 2. Distribution of studies in each symptom cluster reporting either an increase, decrease, or no change in symptoms. Colors reflect the reported statistical significance of each symptom change.

Figure 2

Figure 3. Spread of effect sizes for studies where Cohen's d was reported or could be calculated (k = 55). Effect sizes <0 indicate symptom decrease; effect sizes >0 indicate symptom increase. See Supplementary Table S4 for studies corresponding to point labels.

Figure 3

Table 1. Summary of included studies, sample characteristics, and symptom change results

Supplementary material: File

Blendermann et al. supplementary material

Blendermann et al. supplementary material
Download Blendermann et al. supplementary material(File)
File 71.3 KB