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

Background: The current study argues that population prevalence estimates formental health disorders, or changes in mean scores over time, may notadequately reflect the heterogeneity in mental health response to the COVID-19pandemic within the population.

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

Results: Overallprevalence of anxiety-depression remained stable, while COVID-19 PTSD reducedbetween Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesisedclasses reflecting (i) stability, (ii) improvement, and (iii) deterioration inmental health were identified. Psychological factors were most likely todifferentiate the improving, deteriorating and high-stable classes from thelow-stable mental health trajectories.

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

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