COVID-19 pandemic's first month linked to equivalent distress levels as entire year prior

The COVID-19 pandemic’s first month was associated with the same amount of psychological distress among the same number of individuals in the entire year prior, according to results of a longitudinal study published in Preventive Medicine.

“Studies have documented immediate adverse effects of natural disasters, including pandemics, on mental health,” Joshua Breslau, PhD, ScD, senior behavioral scientist at RAND, and colleagues wrote. “The literature also suggests that there are strong predictors of vulnerability to the mental health effects of disasters, including pre-disaster mental health status. There is little data yet available on psychological distress during the COVID-19 pandemic and, as is often the case in disaster research, no studies with longitudinal assessments that allow within-person comparisons with pre-pandemic mental health status.”

The investigators sought to determine the pandemic’s effects on psychological distress, as well as to identify vulnerable groups, using longitudinal data to account for mental health status before the pandemic. They used the Kessler-6 among national probability sample of adults in the United States in February 2019 (timepoint one) and May 2020 (timepoint two) to assess clinically significant psychological distress. Further, they compared psychological distress over the past 30 days in May 2020 with psychological distress during the worst month of the past year. They used survey adjusted logistic regression to estimate associations between demographic characteristics at timepoint one, such as gender, age, race and income, and census region at timepoint two with within-person psychological distress increases.

Results showed past-month prevalence of serious psychological distress at timepoint two was as high as the past-year prevalence at timepoint one. The researchers noted a strong association across assessments for psychological distress. Gender, age, household income and census region were linked to increase in psychological distress above timepoint one. The number of people who experienced serious psychological distress in 30 days during the pandemic was equal to the number who did so over the entire year prior to the pandemic. Moreover, more than 12% of participants reported higher levels of psychological distress during the second timepoint vs. the first, with increases in distress more common among women vs. men, those aged under 60 years vs. those aged over 60 years and Hispanic people vs. people of other racial/ethnic groups.

"Elevated psychological distress has been observed during prior disasters, but it has never before been seen as a persistent and complex stressor affecting the entire U.S. population," Breslau said in a press release. "Policymakers should consider targeting services to population groups at high risk for elevated psychological distress during the pandemic, including people vulnerable to the economic consequences of social distancing."