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

Veeleah Lok; Hugo Sjöqvist; Anna Sidorchuk; Pär Flodin; Walter Osika; Michael Daly; Philip Hyland; Lars H. Andersen; Peter Fallesen; Marcelo C. Cabrera; Ann K. S. Knudsen; Karen Wetherall; Emily Widnall; Jenny M. Groarke; Cherie Armour; Christina Dalman; Anna-Clara Hollander; Maria Niemi

doi:10.1192/j.eurpsy.2023.2467

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

Veeleah Lok, Hugo Sjöqvist, Anna Sidorchuk, Pär Flodin, Walter Osika, Michael Daly, Philip Hyland, Lars H. Andersen, Peter Fallesen, Marcelo C. Cabrera, Ann K. S. Knudsen, Karen Wetherall, Emily Widnall, Jenny M. Groarke, Cherie Armour, Christina Dalman, Anna-Clara Hollander, Maria Niemi^*

^*Corresponding author for this work

School of Psychology

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

23 Downloads (Pure)

Abstract

Background
Early studies of common mental disorders (CMDs) during the COVID-19 pandemic mainly report increases; however, more recent findings have been mixed. Also, studies assessing the effects of restriction measures on CMDs show varied results. The aim of this meta-analysis was to assess changes in levels of CMDs from pre-/early to during the pandemic and the effects of restriction policies in the European population.

Methods
We searched for studies assessing both pre-pandemic and peri-pandemic self-reported emotional distress and symptoms of depression or anxiety among nationally/regionally representative samples in Europe and collected microdata from those studies. Estimates of corona containment index were related to changes in CMDs using random-effects meta-regression.

Results
Our search strategy resulted in findings from 15 datasets drawn from 8 European countries being included in the meta-analysis. There was no evidence of change in the prevalence of emotional distress, anxiety, or depression from before to during the pandemic; but from early pandemic periods to later periods, there were significant decreases in emotional distress and anxiety. Increased school restrictions and social distancing were associated with small increases in self-reported emotional distress.

Conclusions
Despite initial concerns of increased emotional distress and mental illness due to the COVID-19 pandemic, the results from this meta-analysis indicate that there was a decrease in emotional distress and no change in anxiety or depression in the general population in Europe. Overall, our findings support the importance of strong governance when implementing periodic and robust restriction measures to combat the spread of COVID-19.

Original language	English
Article number	e87
Number of pages	12
Journal	European psychiatry : the journal of the Association of European Psychiatrists
Volume	66
Issue number	1
DOIs	https://doi.org/10.1192/j.eurpsy.2023.2467
Publication status	Published - 26 Oct 2023

Bibliographical note

Funding Information:
Funding for this research was provided through the Horizon 2020 research and innovation program (V.L, P.F., C.D., A-C.H., W.O., M.N., grant number 101016233), Nuffield Foundation; UK Research and Innovation; Wellcome Trust (D.F. F.B.); ROCKWOOL Foundation (L.H.A., PFallesen, M.C.C., grant number 1227); Swedish Research Council for Health, Working Life and Welfare (PFallesen, grant number 2016-07099), and NIHR School for Public Health Research (EW grant reference number PD-SPH-2015). The funder had no role in the design, completion, or writing up of the study.

Publisher Copyright:
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association.

Keywords

Meta-analysis
depression
COVID-19 restrictions
anxiety
social distancing

ASJC Scopus subject areas

Psychiatry and Mental health

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Changes in anxiety and depression during the COVID-19 pandemic in the European population: a meta-analysis of changes and associations with restriction policies
Copyright 2023 The Authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
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Lok, V., Sjöqvist, H., Sidorchuk, A., Flodin, P., Osika, W., Daly, M., Hyland, P., Andersen, L. H., Fallesen, P., Cabrera, M. C., Knudsen, A. K. S., Wetherall, K., Widnall, E., Groarke, J. M., Armour, C., Dalman, C., Hollander, A.-C., & Niemi, M. (2023). Changes in anxiety and depression during the COVID-19 pandemic in the European population: a meta-analysis of changes and associations with restriction policies: A meta-analysis of changes and associations with restriction policies. European psychiatry : the journal of the Association of European Psychiatrists, 66(1), Article e87. https://doi.org/10.1192/j.eurpsy.2023.2467

Lok, Veeleah ; Sjöqvist, Hugo ; Sidorchuk, Anna et al. / Changes in anxiety and depression during the COVID-19 pandemic in the European population: a meta-analysis of changes and associations with restriction policies : A meta-analysis of changes and associations with restriction policies. In: European psychiatry : the journal of the Association of European Psychiatrists. 2023 ; Vol. 66, No. 1.

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

abstract = "Background Early studies of common mental disorders (CMDs) during the COVID-19 pandemic mainly report increases; however, more recent findings have been mixed. Also, studies assessing the effects of restriction measures on CMDs show varied results. The aim of this meta-analysis was to assess changes in levels of CMDs from pre-/early to during the pandemic and the effects of restriction policies in the European population. Methods We searched for studies assessing both pre-pandemic and peri-pandemic self-reported emotional distress and symptoms of depression or anxiety among nationally/regionally representative samples in Europe and collected microdata from those studies. Estimates of corona containment index were related to changes in CMDs using random-effects meta-regression. Results Our search strategy resulted in findings from 15 datasets drawn from 8 European countries being included in the meta-analysis. There was no evidence of change in the prevalence of emotional distress, anxiety, or depression from before to during the pandemic; but from early pandemic periods to later periods, there were significant decreases in emotional distress and anxiety. Increased school restrictions and social distancing were associated with small increases in self-reported emotional distress. Conclusions Despite initial concerns of increased emotional distress and mental illness due to the COVID-19 pandemic, the results from this meta-analysis indicate that there was a decrease in emotional distress and no change in anxiety or depression in the general population in Europe. Overall, our findings support the importance of strong governance when implementing periodic and robust restriction measures to combat the spread of COVID-19. ",

keywords = "Meta-analysis, depression, COVID-19 restrictions, anxiety, social distancing",

author = "Veeleah Lok and Hugo Sj{\"o}qvist and Anna Sidorchuk and P{\"a}r Flodin and Walter Osika and Michael Daly and Philip Hyland and Andersen, \{Lars H.\} and Peter Fallesen and Cabrera, \{Marcelo C.\} and Knudsen, \{Ann K. S.\} and Karen Wetherall and Emily Widnall and Groarke, \{Jenny M.\} and Cherie Armour and Christina Dalman and Anna-Clara Hollander and Maria Niemi",

note = "Funding Information: Funding for this research was provided through the Horizon 2020 research and innovation program (V.L, P.F., C.D., A-C.H., W.O., M.N., grant number 101016233), Nuffield Foundation; UK Research and Innovation; Wellcome Trust (D.F. F.B.); ROCKWOOL Foundation (L.H.A., PFallesen, M.C.C., grant number 1227); Swedish Research Council for Health, Working Life and Welfare (PFallesen, grant number 2016-07099), and NIHR School for Public Health Research (EW grant reference number PD-SPH-2015). The funder had no role in the design, completion, or writing up of the study. Publisher Copyright: {\textcopyright} The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association.",

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doi = "10.1192/j.eurpsy.2023.2467",

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Lok, V, Sjöqvist, H, Sidorchuk, A, Flodin, P, Osika, W, Daly, M, Hyland, P, Andersen, LH, Fallesen, P, Cabrera, MC, Knudsen, AKS, Wetherall, K, Widnall, E, Groarke, JM, Armour, C, Dalman, C, Hollander, A-C & Niemi, M 2023, 'Changes in anxiety and depression during the COVID-19 pandemic in the European population: a meta-analysis of changes and associations with restriction policies: A meta-analysis of changes and associations with restriction policies', European psychiatry : the journal of the Association of European Psychiatrists, vol. 66, no. 1, e87. https://doi.org/10.1192/j.eurpsy.2023.2467

Changes in anxiety and depression during the COVID-19 pandemic in the European population: a meta-analysis of changes and associations with restriction policies: A meta-analysis of changes and associations with restriction policies. / Lok, Veeleah; Sjöqvist, Hugo; Sidorchuk, Anna et al.
In: European psychiatry : the journal of the Association of European Psychiatrists, Vol. 66, No. 1, e87, 26.10.2023.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Changes in anxiety and depression during the COVID-19 pandemic in the European population: a meta-analysis of changes and associations with restriction policies

T2 - A meta-analysis of changes and associations with restriction policies

AU - Lok, Veeleah

AU - Sjöqvist, Hugo

AU - Sidorchuk, Anna

AU - Flodin, Pär

AU - Osika, Walter

AU - Daly, Michael

AU - Hyland, Philip

AU - Andersen, Lars H.

AU - Fallesen, Peter

AU - Cabrera, Marcelo C.

AU - Knudsen, Ann K. S.

AU - Wetherall, Karen

AU - Widnall, Emily

AU - Groarke, Jenny M.

AU - Armour, Cherie

AU - Dalman, Christina

AU - Hollander, Anna-Clara

AU - Niemi, Maria

N1 - Funding Information: Funding for this research was provided through the Horizon 2020 research and innovation program (V.L, P.F., C.D., A-C.H., W.O., M.N., grant number 101016233), Nuffield Foundation; UK Research and Innovation; Wellcome Trust (D.F. F.B.); ROCKWOOL Foundation (L.H.A., PFallesen, M.C.C., grant number 1227); Swedish Research Council for Health, Working Life and Welfare (PFallesen, grant number 2016-07099), and NIHR School for Public Health Research (EW grant reference number PD-SPH-2015). The funder had no role in the design, completion, or writing up of the study. Publisher Copyright: © The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association.

PY - 2023/10/26

Y1 - 2023/10/26

N2 - Background Early studies of common mental disorders (CMDs) during the COVID-19 pandemic mainly report increases; however, more recent findings have been mixed. Also, studies assessing the effects of restriction measures on CMDs show varied results. The aim of this meta-analysis was to assess changes in levels of CMDs from pre-/early to during the pandemic and the effects of restriction policies in the European population. Methods We searched for studies assessing both pre-pandemic and peri-pandemic self-reported emotional distress and symptoms of depression or anxiety among nationally/regionally representative samples in Europe and collected microdata from those studies. Estimates of corona containment index were related to changes in CMDs using random-effects meta-regression. Results Our search strategy resulted in findings from 15 datasets drawn from 8 European countries being included in the meta-analysis. There was no evidence of change in the prevalence of emotional distress, anxiety, or depression from before to during the pandemic; but from early pandemic periods to later periods, there were significant decreases in emotional distress and anxiety. Increased school restrictions and social distancing were associated with small increases in self-reported emotional distress. Conclusions Despite initial concerns of increased emotional distress and mental illness due to the COVID-19 pandemic, the results from this meta-analysis indicate that there was a decrease in emotional distress and no change in anxiety or depression in the general population in Europe. Overall, our findings support the importance of strong governance when implementing periodic and robust restriction measures to combat the spread of COVID-19.

AB - Background Early studies of common mental disorders (CMDs) during the COVID-19 pandemic mainly report increases; however, more recent findings have been mixed. Also, studies assessing the effects of restriction measures on CMDs show varied results. The aim of this meta-analysis was to assess changes in levels of CMDs from pre-/early to during the pandemic and the effects of restriction policies in the European population. Methods We searched for studies assessing both pre-pandemic and peri-pandemic self-reported emotional distress and symptoms of depression or anxiety among nationally/regionally representative samples in Europe and collected microdata from those studies. Estimates of corona containment index were related to changes in CMDs using random-effects meta-regression. Results Our search strategy resulted in findings from 15 datasets drawn from 8 European countries being included in the meta-analysis. There was no evidence of change in the prevalence of emotional distress, anxiety, or depression from before to during the pandemic; but from early pandemic periods to later periods, there were significant decreases in emotional distress and anxiety. Increased school restrictions and social distancing were associated with small increases in self-reported emotional distress. Conclusions Despite initial concerns of increased emotional distress and mental illness due to the COVID-19 pandemic, the results from this meta-analysis indicate that there was a decrease in emotional distress and no change in anxiety or depression in the general population in Europe. Overall, our findings support the importance of strong governance when implementing periodic and robust restriction measures to combat the spread of COVID-19.

KW - Meta-analysis

KW - depression

KW - COVID-19 restrictions

KW - anxiety

KW - social distancing

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DO - 10.1192/j.eurpsy.2023.2467

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JO - European psychiatry : the journal of the Association of European Psychiatrists

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Lok V, Sjöqvist H, Sidorchuk A, Flodin P, Osika W, Daly M et al. Changes in anxiety and depression during the COVID-19 pandemic in the European population: a meta-analysis of changes and associations with restriction policies: A meta-analysis of changes and associations with restriction policies. European psychiatry : the journal of the Association of European Psychiatrists. 2023 Oct 26;66(1):e87. doi: 10.1192/j.eurpsy.2023.2467