Adults were psychologically resilient to the Covid-19 pandemic

Adults in England largely appeared to be psychologically resilient to developing depression or anxiety during the pandemic, a study by University of Manchester researchers has shown.

The analysis of data from 16.5 million people attending general practice and 41 thousand respondents to a survey where people reported their symptoms over time, published in The Lancet Regional Health - Europe, shows that while mental distress reported in the surveys increased in the short term during the first two waves of the pandemic, the numbers affected quickly returned to pre-pandemic levels.

In addition, the study showed that the pandemic appears to have changed the ways in which people manage their mental health and access mental health care: although levels of mental distress went up in the surveys, the numbers of people seeking formal support from their GPs went down, and remained low by the end of 2021 -the period studied.

The study showed:

Overall, primary care presentations for depression or anxiety dropped during the first wave by 4.6 fewer monthly appointments per 1000 patients and remained lower than expected up to the end of the study (December 2021).

Self-reported psychological distress in the survey data exceeded expected levels during the first and second waves by 37% and 28% respectively, returning towards expected levels during the third wave.

Women showed a larger drop in GP presentations compared to men following the pandemic, yet their mental health was more greatly affected.

Fewer people were started on medications used to treat depression or anxiety, such as antidepressants, however fewer people stopped using their treatment.

Despite periods of distress during the pandemic, we did not find an enduring effect on anxiety and depressioncommon mental health problems which doctors regularly see patients for. But the fall in primary care presentations for anxiety or depression suggests that many people changed the way they used healthcare for mental distress, and there may be a shortfall between the number of people with anxiety or depression who need treatment but do not get it
According to the authors, the pandemic was likely to have changed how anxiety and low mood is managed, with fewer people attending treatment for potentially milder and more transient mental health problems.

The team also found the decrease in primary care appointments for depression or anxiety was greater than decreases for other diseases, such as urinary tract infections, arthritis or diabetes.

The study drew upon data from the Clinical Practice Research Datalink (CPRD) and the UK Household Longitudinal Survey (UKHLS).

The researchers analysed monthly changes in presentations and prescribed medications for anxiety and depression, as well as self-reported psychological distress from January 2015 to December 2021.

Senior author Dr Matthias Pierce from The Centre for Women’s Mental Health at The University of Manchester said: "Despite periods of distress during the pandemic, we did not find an enduring effect on anxiety and depression -common mental health problems which doctors regularly see patients for.

"But the fall in primary care presentations for anxiety or depression suggests that many people changed the way they used healthcare for mental distress, and there may be a shortfall between the number of people with anxiety or depression who need treatment but do not get it.

"However, more treatment does not necessarily translate into more people receiving the help they need. Common mental disorders may be better tackled by improving prevention measures and the quality of treatment. The pandemic can now provide a point of reflection in how treatment for these disorders is delivered."

The paper ’ Changes to healthcare utilisation and symptoms for common mental health problems over the first 21 months of the COVID-19 pandemic: parallel analyses of electronic health records and survey data in England’ is available here