Covid-19 did not impact people’s mental health all that much, says new study

Scores of studies and research have been conducted on how the Covid-19 pandemic affected people’s mental health. A general census in many of these studies said that we faced a viral pandemic and a pandemic of deteriorating mental health.

But recently, a team of researchers at McGill University in Canada published a study in the British Medical Journal, reviewing 137 unique studies from around the world comparing general mental health, anxiety symptoms, or depression symptoms before and during the Covid-19 pandemic. 

Surprisingly, they concluded that the changes in mental health effects were ‘close to zero and not statistically significant, and significant changes were of minimal to small magnitudes.’

Senior author of the paper and psychiatry professor at McGill University, Brett Thombs, said some of the public narratives around the mental health impacts of Covid-19 were based on “poor-quality studies and anecdotes,” which became “self-fulfilling prophecies,” adding that there was a need for more “rigorous science”.

Women impacted the most

The comprehensive study says that among the subgroups, women or female participants were the only groups that experienced a worsening of symptoms but in small amounts. 

The study notes that this is a matter of concern as intimate partner violence towards women increased during the pandemic. Most single-parent families tend to be headed by women, and women earn less and are more likely to live in poverty than men. Women are also overrepresented in healthcare jobs and provide most family and elder care. 

The other subgroups that experienced worsened depression symptoms were older adults, university students, and people from a sexual or gender minority group.

Another subgroup that experienced heightened symptoms of anxiety and poor general mental health as parents.

However, previous studies dispute this

A few other similar studies say that covid-19 has led to a widespread decline in population and mental health. However, the McGill review says that the methods used by these studies are not intended for estimating prevalence and can be highly misleading.

A key thing to note, however, is that most of the 137 studies were from high-income, upper-middle-income, or upper-middle-income countries, meaning low-income groups, which are at more risk of uncertainty (job security, cost of living, and medical expenses) during an event like a pandemic were not taken into account.

In a 2022 research published in PLOS One, the researchers looked at the Big 5 personality traits - agreeableness, conscientiousness, extraversion, neuroticism, and openness - and concluded that individuals have become aggressive and mean. They attributed this to a result of the pandemic.

And researchers at Oxford University, in a paper published in The Lancet in 2020, showed how 18% of coronavirus patients later developed mental illness — including depression, anxiety, dementia, and insomnia — in 90 days or less.

What seems to be missing in the McGill review are the effects of the pandemic among disadvantaged groups, as the paper does not focus on lower-income countries or children, young people and those with existing mental health problems.

Study abstract:

Objective To synthesise results of mental health outcomes in cohorts before and during the covid-19 pandemic.

Design Systematic review.

Data sources Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints.

Eligibility criteria for selecting studies Studies comparing general mental health, anxiety symptoms, or depression symptoms assessed from 1 January 2020 or later with outcomes collected from 1 January 2018 to 31 December 2019 in any population, and comprising ≥90% of the same participants before and during the covid-19 pandemic or using statistical methods to account for missing data. Restricted maximum likelihood random effects meta-analyses (worse covid-19 outcomes representing positive change) were performed. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist for Prevalence Studies.

Results As of 11 April 2022, 94 411 unique titles and abstracts including 137 unique studies from 134 cohorts were reviewed. Most of the studies were from high income (n=105, 77%) or upper middle income (n=28, 20%) countries. Among general population studies, no changes were found for general mental health (standardised mean difference (SMD)change 0.11, 95% confidence interval −0.00 to 0.22) or anxiety symptoms (0.05, −0.04 to 0.13), but depression symptoms worsened minimally (0.12, 0.01 to 0.24). Among women or female participants, general mental health (0.22, 0.08 to 0.35), anxiety symptoms (0.20, 0.12 to 0.29), and depression symptoms (0.22, 0.05 to 0.40) worsened by minimal to small amounts. In 27 other analyses across outcome domains among subgroups other than women or female participants, five analyses suggested that symptoms worsened by minimal or small amounts, and two suggested minimal or small improvements. No other subgroup experienced changes across all outcome domains. In three studies with data from March to April 2020 and late 2020, symptoms were unchanged from pre-covid-19 levels at both assessments or increased initially then returned to pre-covid-19 levels. Substantial heterogeneity and risk of bias were present across analyses.

Conclusions High risk of bias in many studies and substantial heterogeneity suggest caution in interpreting results. Nonetheless, most symptom change estimates for general mental health, anxiety symptoms, and depression symptoms were close to zero and not statistically significant, and significant changes were of minimal to small magnitudes. Small negative changes occurred for women or female participants in all domains. The authors will update the results of this systematic review as more evidence accrues, with study results posted online (https://www.depressd.ca/covid-19-mental-health).

Review registration PROSPERO CRD42020179703.