BMJ Mental Health (Feb 2024)
Changes in the prevalence of mental health problems during the first year of the pandemic: a systematic review and dose-response meta-analysis
- ,
- Toshi A Furukawa,
- Edoardo G Ostinelli,
- Andrea Cipriani,
- Pim Cuijpers,
- Lin Ma,
- Akira Onishi,
- Tianjing Li,
- Georgia Salanti,
- Helen Herrman,
- Vikram Patel,
- Christian Kieling,
- Sanae Kishimoto,
- Ronald C Kessler,
- Samuele Cortese,
- Seena Fazel,
- Marialena Trivella,
- Akira Sato,
- Yikang Zhu,
- Raman Sharma,
- Matthias Egger,
- Simone N. Vigod,
- Yu-Kang Tu,
- Tou-Yuan Tsai,
- Yuan-Pang Wang,
- Irene Bighelli,
- Alessandro Rodolico,
- Stefan Leucht,
- Michael Ostacher,
- Ian White,
- Virginia Chiocchia,
- Ethan Sahker,
- Rie Toyomoto,
- Kazufumi Yoshida,
- Trevor Thompson,
- Dongfang Wang,
- Jing Tian,
- Katharine A Smith,
- Gonzalo Arrondo,
- Meenakshi Sharma,
- Silviya Ralovska,
- Andreas D Haas,
- Michael A Wewege,
- Bartosz Helfer,
- Erika Kalocsanyiova,
- Harrison Nelson,
- Gandy Dolores-Maldonado,
- Caroline Zangani,
- Kenji Omae,
- Shimeng Dong,
- Shino Kikuchi,
- Thomy Tonia,
- James S W Hong,
- Natalie Luise Peter,
- Letao Sun,
- Aurélie M Lasserre,
- Alexander Holloway,
- Leila Darwish,
- Andrea Zucchetti,
- Amin Sharifan,
- Ana Cristina Solis,
- Antonio Vita,
- Carmen Concerto,
- Chinonso Igwesi-Chidobe,
- Carlos Rios-Gonzalez,
- Anna Ceraso,
- Daniel Prates Baldez,
- Dicle Dilay Demir,
- Ying-Chun Lin,
- Elena Invernizzi,
- Gabriel Henrique Beraldi,
- Gamze Erzin,
- Giulia Ottaviano,
- Graciela J Balbin-Ramón,
- Chin-Yen Ho,
- Helio Elkis,
- Yun Chen Liu,
- Javier Ballesteros,
- Johanna Schneckenburger,
- Jessie Jingxia Lin,
- Abdulkadir Usman Sambo,
- Lena Feber,
- Mattia Marchetti,
- Mauro Italia,
- Mengchang Qin,
- Yi-Chih Lin,
- Nurul Husna Salahuddin,
- Rossella Virgillito,
- Ogulcan Ciray,
- Sergio A Covarrubias-Castillo,
- Yun Hsia,
- Shiue-Shiuan Tu,
- Vidya Giri Shankar
Affiliations
- Toshi A Furukawa
- 7 Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
- Edoardo G Ostinelli
- 5 Department of Health Sciences, University of Milan, Milan, Italy
- Andrea Cipriani
- 1 Department of Psychiatry, University of Oxford, Oxford, UK
- Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Lin Ma
- Dermatology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
- Akira Onishi
- Kobe univesity graduate school of medicine, Rheumatology and Clinical Immunology, Kobe, Japan
- Tianjing Li
- associate professor
- Georgia Salanti
- 13 Institute of Social and Preventive Medicine and Clinical Trials, University of Bern, Bern, Switzerland
- Helen Herrman
- Orygen Youth Health Research Centre and Centre for Youth Mental Health, Orygen Ltd, Melbourne, Victoria, Australia
- Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Christian Kieling
- 9 Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Sanae Kishimoto
- Department of Human Behavior and Health Promotion, Kyoto University, Kyoto, Japan
- Ronald C Kessler
- McNeil family professor of health care policy
- Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Seena Fazel
- 1 Department of Psychiatry, University of Oxford, Oxford, UK
- Marialena Trivella
- 3 Centre for Statistics in Medicine, University of Oxford, Oxford, UK
- Akira Sato
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
- Yikang Zhu
- 3 Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Raman Sharma
- 1 General Surgery, Maulana Azad Medical College, Delhi, India
- Matthias Egger
- head of department and professor of epidemiology and public health
- Simone N. Vigod
- 2 ICES, Toronto, Ontario, Canada
- Yu-Kang Tu
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Tou-Yuan Tsai
- Emergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi County, Taiwan
- Yuan-Pang Wang
- Irene Bighelli
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
- Alessandro Rodolico
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Sicilia, Italy
- Stefan Leucht
- 1 Department of Psychiatry and Psychotherapy, School of Medicine and Health, Technical University of Munich, Munich, Bavaria, Germany
- Michael Ostacher
- 4 Department of Psychiatry, School of Medicine, Stanford University, Stanford, California, USA
- Ian White
- 6 MRC Clinical Trials Unit, University College London, London, UK
- Virginia Chiocchia
- 6 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Ethan Sahker
- 1 Department of Health Promotion and Human Behavior, Graduate School of Medicine / School of Public Health, Kyoto University, Kyoto, Japan
- Rie Toyomoto
- Departments of Health Promotion and Human Behavior and Clinical Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
- Kazufumi Yoshida
- Departments of Health Promotion and Human Behavior and Clinical Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
- Trevor Thompson
- 8 Cente for Chronic Illness and Ageing, University of Greenwich, London, UK
- Dongfang Wang
- City of Hope, Duarte, CA, USA
- Jing Tian
- 1University of Tasmania, Menzies Institute for Medical Research, Hobart, Australia
- Katharine A Smith
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK;
- Gonzalo Arrondo
- 9 Mind-Brain Group. Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Meenakshi Sharma
- Indian Council of Medical Research, New Delhi, India
- Silviya Ralovska
- 12 Department of Neurology, Psychiatry, Physiotherapy and Rehabilitation, Preventive Medicine, and Public Health, Sofia University St Kliment Ohridski, Sofia, Bulgaria
- Andreas D Haas
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
- Michael A Wewege
- doctoral candidate
- Bartosz Helfer
- Meta-Research Centre, University of Wrocław, Wrocław, Poland
- Erika Kalocsanyiova
- Institute of Lifecourse Development, University of Greenwich, London, UK
- Harrison Nelson
- Queen`s University Faculty of Health Sciences, Kingston, Ontario, Canada
- Gandy Dolores-Maldonado
- Nucleo de Investigación en Alimentación y Nutrición Pública - NIANP, Departamento de Nutrición, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Caroline Zangani
- 1 Department of Psychiatry, Oxford University, Oxford, UK
- Kenji Omae
- 3 Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/ School of Public Health, Kyoto, Japan
- Shimeng Dong
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
- Shino Kikuchi
- 1 Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Kyoto, Japan
- Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- James S W Hong
- 2 Oxford Health NHS Foundation Trust, Oxford, UK
- Natalie Luise Peter
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine and Health, Technical University of Munich, München, Germany
- Letao Sun
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, California, USA
- Aurélie M Lasserre
- 4 Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Alexander Holloway
- 1 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Leila Darwish
- 2 Department of Psychiatry and Psychotherapy, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Andrea Zucchetti
- Amin Sharifan
- Ana Cristina Solis
- Antonio Vita
- Carmen Concerto
- Chinonso Igwesi-Chidobe
- Carlos Rios-Gonzalez
- Anna Ceraso
- Daniel Prates Baldez
- Dicle Dilay Demir
- Ying-Chun Lin
- Elena Invernizzi
- Gabriel Henrique Beraldi
- Gamze Erzin
- Giulia Ottaviano
- Graciela J Balbin-Ramón
- Chin-Yen Ho
- Helio Elkis
- Yun Chen Liu
- Javier Ballesteros
- Johanna Schneckenburger
- Jessie Jingxia Lin
- Abdulkadir Usman Sambo
- Lena Feber
- Mattia Marchetti
- Mauro Italia
- Mengchang Qin
- Yi-Chih Lin
- Nurul Husna Salahuddin
- Rossella Virgillito
- Ogulcan Ciray
- Sergio A Covarrubias-Castillo
- Yun Hsia
- Shiue-Shiuan Tu
- Vidya Giri Shankar
- DOI
- https://doi.org/10.1136/bmjment-2024-301018
- Journal volume & issue
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Vol. 27,
no. 1
Abstract
Aim To describe the pattern of the prevalence of mental health problems during the first year of the COVID-19 pandemic and examine the impact of containment measures on these trends.Methods We identified articles published until 30 August 2021 that reported the prevalence of mental health problems in the general population at two or more time points. A crowd of 114 reviewers extracted data on prevalence, study and participant characteristics. We collected information on the number of days since the first SARS-CoV-2 infection in the study country, the stringency of containment measures and the number of cases and deaths. We synthesised changes in prevalence during the pandemic using a random-effects model. We used dose-response meta-analysis to evaluate the trajectory of the changes in mental health problems.Results We included 41 studies for 7 mental health conditions. The average odds of symptoms increased during the pandemic (mean OR ranging from 1.23 to 2.08). Heterogeneity was very large and could not be explained by differences in participants or study characteristics. Average odds of psychological distress, depression and anxiety increased during the first 2 months of the pandemic, with increased stringency of the measures, reported infections and deaths. The confidence in the evidence was low to very low.Conclusions We observed an initial increase in the average risk of psychological distress, depression-related and anxiety-related problems during the first 2 months of the pandemic. However, large heterogeneity suggests that different populations had different responses to the challenges imposed by the pandemic.