Accepted for/Published in: JMIR Mental Health
Date Submitted: Sep 14, 2021
Date Accepted: Dec 24, 2021
Depressive symptoms and anxiety during May 2020 to April 2021: Implications for emergence from the pandemic
ABSTRACT
Background:
The COVID-19 pandemic has influenced the mental health of millions across the globe. Understanding factors associated with depressive symptoms and anxiety across 12 months of the pandemic can help identify groups at higher risk and psychological processes that can be targeted to mitigate the long-term mental health impact of the pandemic.
Objective:
To determine sociodemographic, COVID-19-specific factors, and general psychological variables associated with depressive symptoms and anxiety over 12 months of the COVID-19 pandemic.
Methods:
Nationwide, cross-sectional electronic surveys were implemented in May (n = 14,636), July (n = 14,936), October (n = 14,946), and December (n = 14,557), 2020 and March/April (n = 14,557), 2021 in the United States. Survey results were weighted to be representative of the U.S. population. The samples were drawn from a market research platform, with a 69% cooperation rate. Surveys assessed depressive symptoms in the past two weeks and anxiety in the past week as well as sociodemographic features; COVID-19 restriction stress, worry, perceived risk, coping strategies, and exposure; intolerance of uncertainty and loneliness.
Results:
Across 12 months, an average of 24% of respondents reported moderate-to-severe depressive symptoms and 32% reported moderate-to-severe anxiety. Of the sociodemographic variables, age was most consistently associated with depressive symptoms and anxiety, with younger adults more likely to report higher levels of those outcomes. Intolerance of uncertainty and loneliness were consistently and strongly associated with the outcomes. Of the COVID-19-specific variables, stress from COVID-19 restrictions, worry about COVID-19, coping behaviors, and having COVID-19 were associated with a higher likelihood of depressive symptoms and anxiety.
Conclusions:
Depressive symptoms and anxiety were high in younger adults, adults who reported restriction stress or worry about COVID-19 or who had had COVID-19, and those with intolerance of uncertainty and loneliness. Symptom monitoring as well as early and accessible intervention are recommended.
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