Refuting the myth of a ‘tsunami’ of mental ill-health in populations affected by COVID-19: Evidence that response to the pandemic is heterogeneous, not homogeneous

Mark Shevlin; Sarah Butter; Orla McBride; Jamie Murphy; Jilly Gibson Miller; Todd K Hartman; Liat Levita; Liam Mason; A. P. Martinez; Ryan McKay; Thomas VA Stocks; Kate Bennett; Philip Hyland; Richard Bentall

doi:10.1017/S0033291721001665

Refuting the myth of a ‘tsunami’ of mental ill-health in populations affected by COVID-19: Evidence that response to the pandemic is heterogeneous, not homogeneous

Mark Shevlin, Sarah Butter, Orla McBride, Jamie Murphy, Jilly Gibson Miller, Todd K Hartman, Liat Levita, Liam Mason, A. P. Martinez, Ryan McKay, Thomas VA Stocks, Kate Bennett, Philip Hyland, Richard Bentall

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Abstract

Background: The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population.

Methods: The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics.

Results: Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories.

Conclusions: A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels.

Original language	English
Pages (from-to)	429-437
Number of pages	9
Journal	Psychological Medicine
Volume	53
Issue number	2
Early online date	20 Apr 2021
DOIs	https://doi.org/10.1017/S0033291721001665
Publication status	Published - Jan 2023

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Cite this

Shevlin, M., Butter, S., McBride, O., Murphy, J., Gibson Miller, J., Hartman, T. K., Levita, L., Mason, L., Martinez, A. P., McKay, R., Stocks, T. VA., Bennett, K., Hyland, P., & Bentall, R. (2023). Refuting the myth of a ‘tsunami’ of mental ill-health in populations affected by COVID-19: Evidence that response to the pandemic is heterogeneous, not homogeneous. Psychological Medicine, 53(2), 429-437. https://doi.org/10.1017/S0033291721001665

@article{4c7119cc03d24b3a8384eea5ceca5498,

title = "Refuting the myth of a {\textquoteleft}tsunami{\textquoteright} of mental ill-health in populations affected by COVID-19: Evidence that response to the pandemic is heterogeneous, not homogeneous",

abstract = " Background: The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. Methods: The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Results: Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Conclusions: A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels. ",

author = "Mark Shevlin and Sarah Butter and Orla McBride and Jamie Murphy and {Gibson Miller}, Jilly and Hartman, {Todd K} and Liat Levita and Liam Mason and Martinez, {A. P.} and Ryan McKay and Stocks, {Thomas VA} and Kate Bennett and Philip Hyland and Richard Bentall",

year = "2023",

month = jan,

doi = "10.1017/S0033291721001665",

language = "English",

volume = "53",

pages = "429--437",

journal = "Psychological Medicine",

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Shevlin, M, Butter, S, McBride, O, Murphy, J, Gibson Miller, J, Hartman, TK, Levita, L, Mason, L, Martinez, AP, McKay, R, Stocks, TVA, Bennett, K, Hyland, P & Bentall, R 2023, 'Refuting the myth of a ‘tsunami’ of mental ill-health in populations affected by COVID-19: Evidence that response to the pandemic is heterogeneous, not homogeneous', Psychological Medicine, vol. 53, no. 2, pp. 429-437. https://doi.org/10.1017/S0033291721001665

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T1 - Refuting the myth of a ‘tsunami’ of mental ill-health in populations affected by COVID-19

T2 - Evidence that response to the pandemic is heterogeneous, not homogeneous

AU - Shevlin, Mark

AU - Butter, Sarah

AU - McBride, Orla

AU - Murphy, Jamie

AU - Gibson Miller, Jilly

AU - Hartman, Todd K

AU - Levita, Liat

AU - Mason, Liam

AU - Martinez, A. P.

AU - McKay, Ryan

AU - Stocks, Thomas VA

AU - Bennett, Kate

AU - Hyland, Philip

AU - Bentall, Richard

PY - 2023/1

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N2 - Background: The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. Methods: The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Results: Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Conclusions: A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels.

AB - Background: The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. Methods: The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Results: Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Conclusions: A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels.

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