Well-being differences and changes in people with somatic and psychiatric disorders or multimorbidities: modelling COVID-19... 2026 Adam et al

[Andy]

Full title: Well-being differences and changes in people with somatic and psychiatric disorders or multimorbidities: modelling COVID-19 as a global natural experiment of stress vulnerability

Background Somatic and psychiatric illnesses and multimorbidities increase stress-vulnerability and decrease well-being.

Objective We aimed to identify high-risk disorder profiles for lower well-being and well-being decline under stress, modelling COVID-19 as a natural experiment.

Methods The global Collaborative Outcomes Study on Health and Functioning during Infection Times survey assessed the World Health Organization-Five Well-being Index (WHO-5) (0–100) retrospectively pre-pandemic and intra-pandemically. Mixed-effects models, controlling for demographic/pandemic-related covariates, examined coprimary outcomes: total pre-pandemic WHO-5 and pre-to-intra-pandemic change (estimating β); pre-pandemic WHO-5 <50, new pre-to-intra-pandemic WHO-5 <50 and WHO-5 decrease ≥10 (estimating ORs±95% CIs). Fixed effects were self-reported somatic and psychiatric diagnoses and within-and-across multimorbidities.

Findings Altogether, 121 066 adults (female=64.0%, white=69.0%, age=42.0±15.9 years, countries=155) with illnesses (any=49.8%/somatic=44.8%/psychiatric=16.3%) and multimorbidities (any=32.8%/somatic=27.3%/psychiatric=7.4%/somatic-psychiatric=10.8%) were analysed. Well-being was 2–3-fold worse with psychiatric disorders (pre-pandemic: autism-spectrum disorder (β=−7.00±2.93/OR=1.27–2.65), schizophrenia/schizoaffective disorder (β=−5.39±3.42/OR=1.09–2.64); pre-to-intra-pandemic: major depressive disorder (β=−2.45±0.89/OR=1.25–1.55), post-traumatic stress disorder (β=−1.98±1.42/OR=1.19–1.67)) versus somatic disorders (pre-pandemic: diarrhoea (β=−3.29±2.49/OR=1.11–2.15), chronic skin disease (CSD) (β=−2.53±1.44/OR=1.11–1.65); pre-to-intra-pandemic: CSD (β=−2.31±1.47/OR=1.23–1.75), injury (β=−2.22±0.99/OR=1.11–1.40)). Multimorbidities were associated with non-linear/supra-additive adverse outcomes beyond single disorders (pre-pandemic: anorexia nervosa+schizophrenia/schizoaffective disorder (β=−27.58±12.71/OR=1.41–19.94), inflammatory bowel disease+psychosis (β=−24.89±10.59/OR=2.68–24.25), stroke+osteoarthritis (β=−13.68±7.33/OR=1.23–6.48); pre-to-intra-pandemic: haemorrhoids+obsessive-compulsive disorder (β=−8.86±6.54/OR=1.22–5.21), binge-eating disorder/bulimia nervosa+social anxiety disorder (β=−6.87±5.49/OR=0.78–2.85), back pain+retinopathy (β=−6.55±6.54/OR=1.04–4.69)). Dose–response relationships were observed between the number of disorders and poorer well-being (pre-pandemic per diagnosis: psychiatric (β=−1.22±0.23/OR=1.11–1.17), somatic (β=−0.21±0.13/OR=1.02–1.05); pre-to-intra-pandemic per diagnosis: psychiatric (β=−0.37±0.24/OR=1.04–1.10)).

Conclusions Poor well-being and further decline under stress were observed particularly with psychiatric illnesses and complex psychiatric and mixed psychiatric-somatic multimorbidity.

Clinical implications The finding of supra-additive multimorbidity burden highlights a need for targeted care models, beyond individual conditions. Vulnerable groups require support during crises, beyond COVID-19.

Open access

 

[rvallee]

The premise of this is absurd. Scientific studies depend on a principle of "all other things being equal". This is here is a case where almost nothing in the conditions studied is equal. People's experiences of the pandemic differed wildly, from mostly positive to mostly negative and everything in-between. For me it changed absolutely nothing. It was about equivalent as a moderate storm thousands of kilometers away. If it wasn't from following the news, I would have barely noticed aside from twice getting vaccinated, about the only difference it made.

To claim that this is a study of stress really emphasizes how utterly garbage the concept, its applications and studies are.

 

[Peter T]

For me it changed absolutely nothing.

For me the pandemic was a largely positive experience. As more things went on line my world expanded, and things like live streaming funerals meant I was participating in a way I had not been able to for some years, also my godchildren had more time and inclination to Skype, etc.

Perhaps the only negatives were when friends and family came down with Covid, though I was lucky no one I knew directly died, and having to wipe down with disinfectant anything coming into the house,

 

[MrMagoo]

For me the pandemic was a largely positive experience. As more things went on line my world expanded, and things like live streaming funerals meant I was participating in a way I had not been able to for some years, also my godchildren had more time and inclination to Skype, etc.

Perhaps the only negatives were when friends and family came down with Covid, though I was lucky no one I knew directly died, and having to wipe down with disinfectant anything coming into the house,

Yeah it’s terrible to say it, but the pandemic was a great time for me having just become severe and been fired from my job. I immediately got benefits, didn't need to get a job or to look for one, wasn’t required to leave the house/bed for months and nobody I knew died of Covid. The NHS finally took my ME seriously and let me get referred to an ME service and they accepted me.
Previous attempts just resulted in “we think it’s FM/depression” alas I was turned away by Peter White and Bart’s and South London & Maudsley without even getting in to see Trudie Chalder!