Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 299, Issue -, Pages 118-125Publisher
ELSEVIER
DOI: 10.1016/j.jad.2021.11.031
Keywords
COVID-19; Mental health; Anxiety; Depression; PTSD; Sleep disturbance
Categories
Funding
- NIHR Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust
- King's College London
- Research Capability Funding through North Bristol Trust Research and Innovation department
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The systematic review found that most participants experienced mild or no anxiety and depression symptoms in the long-term mental health outcomes after COVID-19 infection. Sleep disturbances were primarily reported as mild, and the prevalence of PTSD was similar to anxiety and depression.
Background: Acute effects of COVID-19 can be life-threatening. Alterations in mental health during the active infection have been documented, but the long-term consequences are less clear. Method: A systematic review was undertaken to investigate the effect of COVID-19 infection on long-term mental health outcomes. Three databases [PubMed, Medline (Ovid) and Cochrane library] were searched between 1st October 2019 and 29th August 2021 with additional hand searching to identify all published studies reporting symptoms of generalised anxiety, depression, post-traumatic stress disorder (PTSD), or sleep disturbance in participants at least one month after COVID-19 infection. The prevalence and mean symptom score of each were assessed. Results: Eight hundred and eighty five studies were found, of which 33 were included in the review involving a total of 6743 participants. The studies' risk of bias were typically fair quality. The median study age of participants was 57.8 years (IQR 49.3-60.7), with 63.0% male (IQR 57.0%-73.0%). Participants typically experienced no or mild symptoms of long-term anxiety (GAD-7, STAI-S, HADS) and depression (PHQ-9, BDI, PHQ-2, HADS). Prevalence varied depending on the measurement tool. Sleep disturbances (primarily insomnia) were most commonly reported as mild. PTSD prevalence was similar to anxiety and depression. Conclusion: The overall effect of the pandemic has been linked with worsening psychiatric symptoms. However, the long-term effect from direct COVID-19 infection has been associated with no or mild symptoms. Studies exhibited the long-term prevalence of anxiety, depression, PTSD, and sleep disturbances to be comparable to general population levels.
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