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Depression, anxiety and stress during the COVID-19 pandemic: results from a New Zealand cohort study on mental wellbeing

Research output: Contribution to journalArticlepeer-review

Norina Gasteiger, Kavita Vedhara, Adam Massey, Ru Jia, Kieran Ayling, Trudie Chalder, Carol Coupland, Elizabeth Broadbent

Original languageEnglish
JournalBMJ Open
Accepted/In press15 Mar 2021


  • bmjopen-2020-045325.R1_Proof_hi

    bmjopen_2020_045325.R1_Proof_hi.pdf, 781 KB, application/pdf

    Uploaded date:22 Mar 2021

    Version:Accepted author manuscript

    Licence:CC BY

King's Authors


Objectives: The COVID-19 pandemic has caused unprecedented disruption to daily life. This study investigated depression, anxiety and stress in New Zealand (NZ) during the first ten weeks of the COVID-19 pandemic, and associated psychological and behavioural factors. It also compares the results with a similar cross-sectional study in the United Kingdom (UK).
Design: Cross-sectional study
Setting: NZ community cohort
Participants: N= 681 adults (>18 years) in NZ. The cohort was predominantly female (89%) with a mean age of 42 (range 18-87). Most (74%) identified as NZ/European and almost half (46%) were keyworkers. Most were non-smokers (97%) and 20% identified themselves as having clinical risk factors which would put them at increased or greatest risk of COVID-19.
Main outcome measures: Depression, anxiety, stress, positive mood and engagement in health behaviours (smoking, exercise, alcohol consumption)
Results: Depression and anxiety significantly exceeded population norms (p<0.0001). Being younger (p<0.0001) and most at-risk of COVID-19 (p<0.05) were associated with greater depression, anxiety, and stress. Greater positive mood, lower loneliness, and greater exercise were protective factors for all outcomes (p<0.0001). Smoking (p=0.037) and alcohol consumption (p<0.05) were associated with increased anxiety. Pet ownership was associated with lower depression (p=0.006) and anxiety (p=0.008). When adjusting for age and gender differences, anxiety (p=0.002) and stress (p=0.007) were significantly lower in NZ than the UK. The NZ sample reported lower perceived risk (p<0.0001) and worry about COVID-19 (p<0.0001) than the UK sample.
Conclusions: The NZ population had higher depression and anxiety compared to population norms. Younger people and those most at-risk of COVID-19 reported poorer mental health. Interventions should promote frequent exercise, and reduce loneliness and unhealthy behaviours.

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