Global mental health didn't deteriorate significantly during the first 2 years of the COVID-19 pandemic, concludes a meta-analysis of studies from mostly high- and middle-income countries published yesterday in BMJ.
A team led by researchers at Jewish General Hospital in Montreal reviewed 137 studies comparing general mental health and anxiety and depression symptoms in adults and children from January 1, 2020, to April 11, 2022, with those from January 1, 2018, to December 31, 2019.
The studies included at least 90% of the same participants in both periods. About 75% of participants were adults, and 25% were aged 10 to 19 years. Most studies were from high-income (77%) or upper middle-income (20%) countries.
Women saw slight worsening
In general-population studies, no changes were identified for general mental health (standardized mean difference [SMD], 0.11) or anxiety (SMD, 0.05), although depression slightly worsened (SMD, 0.12). Female participants, however, saw some erosion of general mental health (0.22) and increased anxiety (0.20), and depression (0.22). No other subgroup experienced changes in all three areas.
Among 27 studies involving male subgroups, five suggested a minimal or small worsening of symptoms, while two suggested slight improvement. Three studies with data from March and April 2020 and late 2020 showed either unchanged symptoms or an initial increase followed by a return to prepandemic levels.
Noting study heterogeneity and risk of bias, the authors urged caution in interpreting the results. "The pandemic has affected the lives of many people, and some are now experiencing mental health difficulties for the first time," the authors wrote. "Governments should continue to ensure that mental health supports are available and respond to population needs."
Preventive interventions still needed
In a McGill University news release, senior author Brett Thombs, PhD, said that mental health amid COVID-19 is highly nuanced. "Claims that the mental health of most people has deteriorated significantly during the pandemic have been based primarily on individual studies that are 'snapshots' of a particular situation, in a particular place, at a particular time," he said.
In a related commentary, Carsten Hjorthoj, PhD, and Trine Madsen, PhD, both of the Mental Health Centre Copenhagen, pointed out that the study didn't provide reasons behind the slight deterioration. "Might these deteriorations have occurred even if the pandemic had not occurred, signifying an underlying, but not covid-19 related, pan-societal problem?" they asked.