Young people’s anxiety levels doubled during first COVID-19 lockdown, says study, but easing of restrictions unlikely to bring any improvement to mental health

The number of young people with anxiety doubled from 13% to 24%, during the early stages of the COVID-19 pandemic and lockdown 1, according to new research from the University of Bristol. The study, using Bristol’s Children of the 90s questionnaire data, showed that young people (27-29 years) reported higher levels of anxiety during the early phases of the pandemic in the first national lockdown and this was higher than their parents.

Researchers also found that anxiety levels continued to remain high even when lockdown restrictions were eased in June and thus a similar situation may be expected this winter. The findings also suggest that this could be worse for individuals with a history of mental health problems, women and those who had experienced pre-pandemic financial problems. These findings have been highlighted by Public Health England to help influence policy and the government’s understanding of the impact of COVID-19 on mental health.

There was no evidence that depression was higher overall, however, specific groups of individuals were more likely to experience greater levels of depression and anxiety during the pandemic.

Bristol’s Children of the 90s health study recruited 14,500 pregnant mothers in 1991-2 and has collected almost three decades of detailed health and lifestyle data about the mothers and their babies, who will soon be turning 30. For this study, researchers compared participants’ previous years’ of data with findings from two 2020 COVID-19 questionnaires to understand the impact of the pandemic on mental health.

Who is at risk of poorer mental health during COVID-19?

Certain groups within the study were at greater risk of increased anxiety and/or depression during COVID-19, even after accounting for their previous history of depression and anxiety. These were women, those with pre-existing mental and physical health conditions, those living alone during the pandemic, those self-isolating as a result of COVID-19 and those who had experienced recent financial problems. Interestingly, some factors, such as living alone, were only linked to greater depression and others, such being a parent, only linked to anxiety. Researchers did not find evidence of an elevated risk of anxiety in key workers or healthcare workers. These findings were observed in both the younger and older generations and replicated in an additional group of over 4000 Scottish individuals - implying these effects may not just be specific to individuals in the South-West. Alongside the data from Children of the 90s, the research also looked at data from another longitudinal study - Generation Scotland.

Researchers are now looking at why some groups of people may have poorer mental health during the pandemic and the role of worries and health behaviours such as sleep and exercise levels. A further questionnaire examining the impact of the England’s second lockdown is planned for December.

Co-lead researcher Dr Alex Kwong, Senior Research Associate in Psychiatric Genetic Epidemiology at University of Bristol, commented: “The highly detailed Children of the 90s questionnaire data reveals a worrying rise in young people’s anxiety - this looks like it is due to the pandemic itself and potentially the societal and economic fallout caused by the lockdown measures used to control the spread of the virus. Evidence suggests this is not going to be a short-term issue and that mental health support and interventions are urgently required to reduce some of the mental health inequalities that have emerged.’

COVID-19 in Children of the 90s

The Children of the 90s’ first two COVID-19 questionnaires uncovered details about participants’ COVID-19 symptoms, plus their work, finances, lifestyle and diet - helping to understand more about their own, their parents’ and their children’s physical and mental health.

As might be expected in a study heavily based in the south west of England, only a small percentage had tested positive for COVID-19, but a larger and more representative number of participants have experienced at least one of the primary COVID-19 symptoms - loss of smell/taste (13%), new persistent cough (21%) or fever (23%). A subsequent antibody testing study by Children of the 90s found that 4.3% of those who took part tested positive for antibodies, suggesting they had previously had an infection with COVID-19.

Professor Nic Timpson, principal investigator of Children of the 90s comments: “Longitudinal health studies like Children of the 90s are so important as they repeatedly measure an individual’s mental health (as well as lifestyle and general health) over different time points throughout their life. With this study, it enabled us to compare preand post-pandemic data to fully understand the impact of COVID-19 on mental health. Such detailed, contextualised health data is unique, providing valuable evidence for policymakers and Public Health England.’

Co-lead researcher Dr Rebecca Pearson, Senior Lecturer in Psychiatric Epidemiology and the University of Bristol said: “The findings suggest that there is a need to protect mental health at this time (especially managing anxiety) and support mental health services. It is especially important to learn lessons from the first lockdown now that we are in a second lockdown. The findings also provide evidence for supporting specific groups at greater mental health risk, such as those living alone. Support bubbles for single adults and single parents (which have been allowed from the outset this lockdown) could be beneficial to mental health, but we need to understand the role of social isolation better’.

Professor David Porteous, Principal Investigator for Generation Scotland said: “This study shows beyond doubt how COVID-19 is affecting mental health, particularly in younger people. The strength of the study is really three-fold. First, both Children of the 90s and Generation Scotland had mental health measures from before and repeat measures during the pandemic. Second, each cohorts findings echo the other. Third, the findings are not a quirk of locality - young adults in both Scotland and around Bristol were similarly affected. The study shows that indirect effects of COVID-19 are profound and widespread and felt most acutely by young adults. They as much as any group will bear the long-term brunt of the COVID experience and post-pandemic recovery.’