Changes in anxiety and depression during the COVID-19 pandemic in the European population: A meta-analysis of changes and associations with restriction policies

Trajectories of depressive symptoms across different age groups from adolescence to old age before and during the COVID-19 pandemic: A national household survey in China

OBJECTIVE

The COVID-19 pandemic has been associated with depressive symptoms. However, little is known about trajectories across different age groups. This study aimed to examine trajectories of depressive symptoms before and during the COVID-19 pandemic across different age groups and identify factors associated with these trajectories.

METHODS

This population-based household survey included 19,545 participants from various age groups (10-18 years, n = 2260; 19-34 years, n = 4801; 35-49 years, n = 4892; 50-64 years, n = 5238; 65+ years, n = 2354) in two waves conducted in 2018 and 2020. Depressive symptoms were measured using the short version of the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were used for data analysis.

RESULTS

An increase in depressive symptoms was observed during the COVID-19 pandemic compared to the pre-COVID period. Four trajectories of depressive symptoms were identified: High-risk, increasing, decreasing, and low-risk. Female gender and lower income in older age groups, as well as lower levels of exercise in older age groups, poorer physical health in all ages, and lower well-being in all ages were identified as risk factors for experiencing depressive symptom trajectories compared with the low-risk trajectory.

LIMITATIONS

Self-reported tools other than clinical diagnosis were employed.

CONCLUSIONS

This population-based study highlights the importance of tailoring prevention and intervention strategies for different age groups, considering specific risk and protective factors. Such targeted approaches can effectively address the diverse trajectories of depressive symptoms observed during the COVID-19 pandemic.

Influence of the COVID-19 pandemic on the prevalence of depression in U.S. adults: evidence from NHANES

The impact of the COVID-19 pandemic on the epidemiological characteristics of depression among adults in the U.S. remains unclear. This study aims to analyze trends in depression prevalence over time and quantify the effect of the COVID-19 pandemic on its prevalence. Using data from 2007 to 2023 provided by the National Health and Nutrition Examination Surveys (NHANES), this study examined 36,472 participants. Results revealed an increasing trend in depression prevalence among U.S. adults from 2007 to 2023. Notably, the overall weighted prevalence of depression following the COVID-19 pandemic (12.4%, 95% CI: 10.6-14.1%) was significantly higher than in all years prior to the pandemic. Subgroups such as females, Mexican Americans, and young adults experienced particularly pronounced increases. By analyzing data from two survey cycles close to the onset of the COVID-19 outbreak, the study identified a significant impact of the pandemic on depression prevalence, with an adjusted odds ratio of 1.58 (95% CI: 1.28-1.94). Individuals with lower socioeconomic status and those without pre-existing conditions exhibited greater increases in depression prevalence, whereas the emotional health of individuals who smoke appeared unaffected by the pandemic.

Tackling persistent neurological symptoms in patients following acute COVID-19 infection: an update of the literature

INTRODUCTION

The COVID-19 pandemic has taught myriad lessons and left several questions we are yet to comprehend. Initially, the scientific community was concerned with the management of acute disease and immunization. Once the peak of the pandemic receded, it became clear that a proportion of patients were far from fully recovered. Researchers started to recognize those persisting symptoms as a new entity termed 'Long COVID,' where neurological symptoms are evident and have a major impact on quality of life.

AREAS COVERED

The main purpose of this narrative review is to analyze and synthesize the current literature regarding Long COVID, its relation to the nervous system, and to explore the evidence on treatments for persistent neurological symptoms. The most common reported and observed neurologic manifestations include fatigue, cognitive impairment, pain, polyneuropathy, and neuropsychiatric disorders. A variety of pharmacologic and non-pharmacologic therapies have been evaluated and yielded mixed results. Many of them focused on immunomodulation and none currently have U.S. FDA approval.

EXPERT OPINION

Challenges remain in terms of clinical characterization and prognosis of Long COVID, besides understanding its pathophysiology. Standardization of biomarkers and diagnostic criteria will allow the use of common nomenclature and data elements in the design of future clinical studies.

Substance Use and Mental Health in Emerging Adult University Students Before, During, and After the COVID-19 Pandemic in Mexico: A Comparative Study

BACKGROUND

The COVID-19 pandemic significantly impacted mental health and substance use patterns, particularly among young adults.

OBJECTIVE

This study aimed to assess changes in anxiety, depression, self-esteem, and substance use among university students in Mexico before, during, and after the pandemic.

METHODS

Using a repeated cross-sectional design, this study was conducted with university students in Mexico across three periods: pre-pandemic (2017 and 2019); during the pandemic (2021); and post-pandemic (2023). A total of 2167 students were interviewed during one of the three periods. Standardized scales measured anxiety, depression, self-esteem, Erotic Response and Sexual Orientation Scale (EROS), and substance use.

RESULTS

showed a marked and significant increase in the proportion of students with anxiety (40.0%, 71.7%, and 79.6%) and depression (14.4%, 61.9%, and 62.6%) during the pre-pandemic, pandemic, and post-pandemic periods, respectively. Self-esteem significantly decreased during and after the pandemic, compared to pre-pandemic, particularly among females. The proportion of students categorized as moderate/high-risk for their substance use changed over time, showing a reduction in alcohol use (from 29.9% to 20.2%) and tobacco use (from 26.0% to 18.2%) but an increase in sedative use (from 7.1% to 11.7%), before vs after the pandemic, respectively. Multivariate analysis revealed that anxiety, low self-esteem, and increased sedative use were consistently linked to a heightened risk of depression during and after the pandemic. Notably, anxiety and depression levels remained in a proportion significantly elevated even in the post-pandemic period.

CONCLUSIONS

These findings underscore the enduring impact of the COVID-19 pandemic on the mental health of university students, highlighting the urgent need for targeted interventions, early detection strategies, and customized educational programs to effectively support students' mental well-being in the ongoing post-pandemic era.

COVID-19 and self-reported health of the Norwegian adult general population: A longitudinal study 3 months before and 9 months into the pandemic

The COVID-19 pandemic had a global impact on daily lives, and this study aimed to assess the effects on broader aspects of health in the general population of Norway. This population-based cohort study assessed changes in health of the Norwegian general population from 3 months before to 9 months during the COVID-19 pandemic. Sampling was based on the results of Norwegian surveys designed for collecting general population norms for health measurement instruments. In December 2019, 12,790 randomly selected adults aged ≥18 years received a postal questionnaire. The 3,200 respondents received a similar follow-up postal questionnaire including the EQ-5D-5L, PROMIS-29 instruments, and questions about respondents having or having had COVID-19. Score changes were compared to estimates for the minimal important change (MIC) and age-related change. Association of instrument change scores with baseline characteristics, health problems, and having had COVID-19 was determined using multivariable linear regression. Of 3101 respondents with unchanged addresses, 2423 (78.1%) responded to the second survey. For all respondents, EQ VAS and PROMIS-29 scores for 6 of 8 domains were slightly poorer (p<0.01) than before COVID-19, and the mean change was below the MIC. In multivariable analyses, the greatest number of poorer outcomes were associated with being female, 18-29 years, or ≥80 years of age (p<0.01); > MIC for ≥ 80 years of age and EQ-5D index, PROMIS-29 physical function and social participation. Respondents who had COVID-19 had poorer outcomes for PROMIS-29 social participation (> MIC). Those reporting COVID-19 in their partner/family and not themselves, had poorer outcomes for PROMIS-29 anxiety and social participation. About 9 months into the COVID-19 pandemic, EQ-5D-5L and PROMIS-29 domain scores showed slightly poorer health in the Norwegian adult general population compared to 1 year earlier in the same respondents. The overall changes were less than expected for age-related change. Relatively poor outcomes defined as important, included general health and social participation for the elderly, and the latter for those having had COVID-19. In conclusion, this study found no evidence for a decline in important aspects of adult general population health in Norway that might be attributed to the pandemic at approximately 9 months.

Uncertainties of Economic Policy and Government Management Stability Played Important Roles in Increasing Suicides in Japan from 2009 to 2023

Standardized suicide mortality rates per 100,000 (SMRs) in Japan consistently decreased from 2009 to 2019 but increased from 2020. The causes of these temporal SMR fluctuations remain to be clarified. Therefore, this study was conducted to identify the causalities underlying the recently transformed fluctuations of suicide mortality in Japan. Monthly suicide numbers disaggregated by sex and social standing, and political uncertainty indices, such as economic policy uncertainty (EPU) and government management instability (AENROP), were obtained from Japanese government databases. Interrupted time-series analysis was performed to analyze temporal fluctuations of SMRs disaggregated by sex/social standing associated with the three General Principles of Suicide Prevention Policy (GPSPP) periods and the COVID-19 pandemic. Panel data and vector autoregressive analyses were conducted to investigate causalities from political uncertainties to SMRs. During the first and second GPSPPs (2009-2017), all SMRs disaggregated by sex and social standing decreased, whereas those of unemployed females did not change. During the third GPSPP (2017-2022), decreasing trends in all SMRs were attenuated compared to previous periods. All female SMRs, except unemployed females, showed sharp increases synchronized with the pandemic outbreak. No male SMRs showed sharply increasing at the pandemic outbreak. SMRs of unemployed males/females drastically increased in the later periods of the pandemic, while SMRs of employed and multiple-person/single-person household males did not increase during the pandemic. SMR of unemployed males was positively related to AENROP but not EPU. Other male SMRs were positively related to EPU/AENROP. On the contrary, not all female SMRs were related to EPU/AENROP. Increasing AENROP generally contributed to increasing male SMRs throughout the observation period; however, susceptibility to AENROP and/or political information might have unexpectedly contributed to suppressing the sharply increasing male SMRs induced by large-scale social shocks (the COVID-19 pandemic outbreak) in Japan.

Longitudinal trajectories of anxiety and depression in subjects with different mental disorders after one year in the COVID-19 pandemic

The aim of this study was to prospectively assess the development and trajectories of anxiety and depressive symptoms among subjects with different mental disorders, during the 3rd wave of the COVID-19 pandemic (T0, March-April 2021) while strict containment measures were applied in Italy, and after 3 months (T1, June-July 2021), with reduced restrictive measures. A sample of 527 subjects, with different DSM-5 diagnoses, was enrolled at nine Italian psychiatric outpatient services. Assessments at T0 and T1 included the Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, and the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms. Differences in anxiety and depressive symptoms rates emerged across different mental disorders and a general improvement at T1 was detected for all of them in both the GAD-7 and PHQ-9 scores, except for Psychosis and Obsessive-Compulsive Disorder (OCD). Patients with Feeding and Eating Disorders (FED) reported statistically significantly higher: GAD-7 scores than those with Bipolar Disorder (BD), at both times, and Anxiety Disorders at baseline; PHQ-9 scores than all other diagnostic categories, at both times. Unemployment, no COVID-19 infection, OCD were predictive variables related to GAD-7 scores at T1, while being unmarried, BD or FED related to PHQ-9 scores at T1. Subjects with mental disorders reported anxiety and depressive symptoms during the third pandemic wave and most of patients showed an improvement over a 3-month follow-up, despite differences emerged among diagnostic categories and for the variables involved. Further studies are needed to deepen knowledge on pandemic impact on patients with mental disorders.