Presentation Information
[O-19-02]Trajectories of Changes in Mental Health Symptoms During COVID-19: Evidence from a Systematic Review and Meta-analysis of 284 Studies
*Yin Wu1,2, Ying Sun2,3, Marc Parsons4, Nadia P González-Domínguez2, Suiqiong Fan2, Letong Li2, Xiaowen Jiang2, Amina Tasleem2, Kexin Li2, Yutong Wang2, Tiffany Dal Santo2,5, Jill T Boruff6, Palak Desai2, Monica D’Onofrio2, Ankur Krishnan2, Claire Adams, Chen He2, Andrea Benedetti4,8,9, Brett D Thombs2,4,5,7,8 (1.Shanghai Jiao Tong University(China), 2.Lady Davis Institute for Medical Research, Jewish General Hospital(Canada), 3.Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland(United States of America), 4.Department of Epidemiology, Biostatistics and Occupational Health, McGill University(Canada), 5.Department of Psychiatry, McGill University(Canada), 6.Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University(Canada), 7.Department of Psychology, McGill University(Canada), 8.Department of Medicine, McGill University(Canada), 9.Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre(Canada))
Keywords:
mental health,pandemic,Psychiatric Epidemiology
Background: Few systematic reviews could provide a comprehensive synthesis of the impact of the COVID-19 pandemic on mental health outcomes during the pandemic.
Objectives: To synthesize the trajectories of changes in general mental health, anxiety, and depression symptoms of diverse populations throughout the COVID-19 pandemic.
Methods: We conducted a living systematic review and searched among 9 databases. We conducted meta-regression with linear mixed models. Risk of bias (ROB) was assessed using an adapted Joanna Briggs Institute Checklist for Prevalence Studies.
Results: As of April 03, 2023, we reviewed 149,026 unique citations and included 284 eligible studies from 275 cohorts that had multiple data points of COVID-19 mental health outcomes during the pandemic. Most publications (275, 97%) reported all time points between January 1, 2020 and December 31, 2021, and were from high-income (226, 80%) or upper-middle income (54, 19%) countries. The main analysis results suggest no consistent pattern of temporal effects on changes of mental health outcomes. Each quarter of a year since COVID-19 onset was associated with a minimal improvement in general mental health (0.02 standardized mean difference (SMD), 95%CI -0.02 to -0.02) and in depression symptoms (0.03 SMD, 95%CI -0.03 to -0.03), while with minimally worsened anxiety symptoms (0.02 SMD, 95%CI 0.02 to 0.02). Estimates of all covariates’ effects were close to zero or inconsistent, except the country stringency index which was associated with all three outcomes minimally (0.02 - 0.05 SMD; 95%CI 0.02 to 0.03 - 0.05 to 0.05). Results among 18 subgroups including general population suggested no consistent pattern of changing with time across all outcomes. Substantial heterogeneity and ROB were present across analyses.
Conclusions: Generally high ROB and the extreme heterogeneity makes it essential to interpret findings cautiously. However, there is no clear trend of change across mental outcomes throughout the COVID-19 pandemic.
Objectives: To synthesize the trajectories of changes in general mental health, anxiety, and depression symptoms of diverse populations throughout the COVID-19 pandemic.
Methods: We conducted a living systematic review and searched among 9 databases. We conducted meta-regression with linear mixed models. Risk of bias (ROB) was assessed using an adapted Joanna Briggs Institute Checklist for Prevalence Studies.
Results: As of April 03, 2023, we reviewed 149,026 unique citations and included 284 eligible studies from 275 cohorts that had multiple data points of COVID-19 mental health outcomes during the pandemic. Most publications (275, 97%) reported all time points between January 1, 2020 and December 31, 2021, and were from high-income (226, 80%) or upper-middle income (54, 19%) countries. The main analysis results suggest no consistent pattern of temporal effects on changes of mental health outcomes. Each quarter of a year since COVID-19 onset was associated with a minimal improvement in general mental health (0.02 standardized mean difference (SMD), 95%CI -0.02 to -0.02) and in depression symptoms (0.03 SMD, 95%CI -0.03 to -0.03), while with minimally worsened anxiety symptoms (0.02 SMD, 95%CI 0.02 to 0.02). Estimates of all covariates’ effects were close to zero or inconsistent, except the country stringency index which was associated with all three outcomes minimally (0.02 - 0.05 SMD; 95%CI 0.02 to 0.03 - 0.05 to 0.05). Results among 18 subgroups including general population suggested no consistent pattern of changing with time across all outcomes. Substantial heterogeneity and ROB were present across analyses.
Conclusions: Generally high ROB and the extreme heterogeneity makes it essential to interpret findings cautiously. However, there is no clear trend of change across mental outcomes throughout the COVID-19 pandemic.