Institute for Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic
Juan Pablo Gonzalez-Rivas
International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic; and Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, USA
Šárka Kunzová
International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic
Mária Skladaná
International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic; and Second Department of Internal Medicine, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic
Anna Pospíšilová
International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic
Anna Polcrová
International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic; and Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
Maria Vassilaki
Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
Jose Ramon Medina-Inojosa
Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; and Marriot Heart Disease Research Program, Mayo Clinic, Rochester, Minnesota, USA
Francisco Lopez-Jimenez
Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
Yonas Endale Geda
Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA; and Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix, Arizona, USA
Institute for Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic; and Department of Neurology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
Background Although several studies have documented the impact of the COVID-19 pandemic on mental health, the long-term effects remain unclear. Aims To examine longitudinal changes in mental health before and during the consecutive COVID-19 waves in a well-established probability sample. Method An online survey was completed by the participants of the COVID-19 add-on study at four time points: pre-COVID-19 period (2014–2015, n = 1823), first COVID-19 wave (April to May 2020, n = 788), second COVID-19 wave (August to October 2020, n = 532) and third COVID-19 wave (March to April 2021, n = 383). Data were collected via a set of validated instruments, and analysed with latent growth models. Results During the pandemic, we observed a significant increase in stress levels (standardised β = 0.473, P < 0.001) and depressive symptoms (standardised β = 1.284, P < 0.001). The rate of increase in depressive symptoms (std. covariance = 0.784, P = 0.014), but not in stress levels (std. covariance = 0.057, P = 0.743), was associated with the pre-pandemic mental health status of the participants. Further analysis showed that secondary stressors played a predominant role in the increase in mental health difficulties. The main secondary stressors were loneliness, negative emotionality associated with the perception of COVID-19 disease, lack of resilience, female gender and younger age. Conclusions The surge in stress levels and depressive symptoms persisted across all three consecutive COVID-19 waves. This persistence is attributable to the effects of secondary stressors, and particularly to the status of mental health before the COVID-19 pandemic. Our findings reveal mechanisms underlying the surge in mental health difficulties during the COVID-19 waves, with direct implications for strategies promoting mental health during pandemics.
