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Comparison of mental health symptoms before & during the covid-19 pandemic: evidence from a systematic review & meta-analysis of 134 cohorts 2023 Sun

Discussion in 'Epidemics (including Covid-19, not Long Covid)' started by Andy, Mar 9, 2023.

  1. Andy

    Andy Committee Member

    Messages:
    21,811
    Location:
    Hampshire, UK
    Abstract

    Objective To synthesise results of mental health outcomes in cohorts before and during the covid-19 pandemic.

    Design Systematic review.

    Data sources Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints.

    Eligibility criteria for selecting studies Studies comparing general mental health, anxiety symptoms, or depression symptoms assessed from 1 January 2020 or later with outcomes collected from 1 January 2018 to 31 December 2019 in any population, and comprising ≥90% of the same participants before and during the covid-19 pandemic or using statistical methods to account for missing data. Restricted maximum likelihood random effects meta-analyses (worse covid-19 outcomes representing positive change) were performed. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist for Prevalence Studies.

    Results As of 11 April 2022, 94 411 unique titles and abstracts including 137 unique studies from 134 cohorts were reviewed. Most of the studies were from high income (n=105, 77%) or upper middle income (n=28, 20%) countries. Among general population studies, no changes were found for general mental health (standardised mean difference (SMD)change 0.11, 95% confidence interval −0.00 to 0.22) or anxiety symptoms (0.05, −0.04 to 0.13), but depression symptoms worsened minimally (0.12, 0.01 to 0.24). Among women or female participants, general mental health (0.22, 0.08 to 0.35), anxiety symptoms (0.20, 0.12 to 0.29), and depression symptoms (0.22, 0.05 to 0.40) worsened by minimal to small amounts. In 27 other analyses across outcome domains among subgroups other than women or female participants, five analyses suggested that symptoms worsened by minimal or small amounts, and two suggested minimal or small improvements. No other subgroup experienced changes across all outcome domains. In three studies with data from March to April 2020 and late 2020, symptoms were unchanged from pre-covid-19 levels at both assessments or increased initially then returned to pre-covid-19 levels. Substantial heterogeneity and risk of bias were present across analyses.

    Conclusions High risk of bias in many studies and substantial heterogeneity suggest caution in interpreting results. Nonetheless, most symptom change estimates for general mental health, anxiety symptoms, and depression symptoms were close to zero and not statistically significant, and significant changes were of minimal to small magnitudes. Small negative changes occurred for women or female participants in all domains. The authors will update the results of this systematic review as more evidence accrues, with study results posted online (https://www.depressd.ca/covid-19-mental-health).

    Open access, https://www.bmj.com/content/380/bmj-2022-074224
     
    RedFox, Sean, Peter Trewhitt and 5 others like this.
  2. Hutan

    Hutan Moderator Staff Member

    Messages:
    26,534
    Location:
    Aotearoa New Zealand
    Just wanted to reiterate that. Note, the data is mostly from high and upper middle income countries.

    So, it turns out all those BPS proponents suggesting widespread anxiety may well have been mistaken.
     
  3. Sean

    Sean Moderator Staff Member

    Messages:
    7,045
    Location:
    Australia
    The mass hysteria is the scare campaign that there is mass hysteria.
     
    Wyva, alktipping, Hutan and 7 others like this.
  4. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

    Messages:
    6,048
    Location:
    UK
    Does anyone have a list of what officially constitutes "mental health", anxiety or depression symptoms?

    If I had a pain in my left big toe would that be classed as a depression or anxiety symptom if I was negative for gout and/or ingrowing toenails? (If I could even get a test for gout done.)
     
    Sean, alktipping, Hutan and 4 others like this.
  5. rvallee

    rvallee Senior Member (Voting Rights)

    Messages:
    12,299
    Location:
    Canada
    Yeah, that's evidence-based medicine. It's always this way. The only context where bad evidence gets used anyway. Somehow, hardly anyone objects.
    I went looking for that. Appears to be described in the supplementary material. Best I can tell it's a mix of about a dozen generalized anxiety or depression questionnaires. So when they say symptoms, they seem to mean stuff like "I feel sad". So not actual symptoms. Being sad is not a medical symptom. They're just mixing stuff up.

    So, frankly, this is useless. It doesn't tell anyone about anything because the questionnaires used for this are all biased, ambiguous and heavily interpreted out of pooled data. Studies like this are only as good as the instruments they use. And they are terrible.
     
    Arnie Pye, Sean, alktipping and 3 others like this.

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