Psychological distress, depression, anxiety and life satisfaction following COVID-19 infection: Evidence from 11 UK longitudinal population studies

Ellen J. Thompson, Jean Stafford, Bettina Moltrecht, Charlotte F. Huggins, Alex S.F. Kwong, Richard J. Shaw, Paola Zaninotto, Kishan Patel, Richard J. Silverwood, Eoin McElroy, Matthias Pierce, Michael J. Green, Ruth Bowyer, Jane Maddock, Kate Tilling, Srinivasa Vittal Katikireddi, George B. Ploubidis, David J. Porteous, Nicholas J. Timpson, Nish ChaturvediClaire Steves, Prvaeetha Patalay

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


Background: Evidence on associations between COVID-19 illness and mental health is mixed. We aimed to examine whether COVID-19 is associated with deterioration in mental health while considering: 1) pre-pandemic mental health, 2) time since infection; 3) subgroup differences; and 4) confirmation of infection via self-reported test, and serology data.

Methods: Using data from 11 UK longitudinal studies, with 2 to 8 repeated measures of mental health (psychological distress, depression, anxiety and life satisfaction) and COVID-19 between April 2020 and April 2021, we standardised continuous mental health scales within each study across time. We investigated associations between COVID-19 (self-report, test-confirmed, serology-confirmed) and mental health using generalized estimating equations. We examined whether associations varied by age, sex, ethnicity, education and pre-pandemic mental health.

Findings: Participants were 54,442 individuals (aged 18-90+, 39% men, 90.2% White). Pooled estimates of standardized differences in outcomes suggested associations between COVID-19 and subsequent psychological distress (0.10 [95%CI: 0.06; 0.13], I2=42.8%), depression (0.08 [0.05; 0.10], I2=20.8%), anxiety (0.08 [0.05; 0.10], I2=0%), and lower life satisfaction (-0.06 [-0.08; -0.04], I2=29.2%). Associations did not vary by time since infection until 3+ months and were present in all age groups, with some evidence of stronger effects in those aged 50+. Self-reported COVID-19, whether suspected or test-confirmed and irrespective of serology status, was associated with poorer mental health.

Interpretation: Self-reporting COVID-19 was longitudinally associated with deterioration in mental health and life satisfaction. Our findings highlight the need for greater post-infection mental health service provision, given the substantial prevalence of COVID-19 in the UK and worldwide.
Original languageEnglish
JournalThe Lancet Psychiatry
Publication statusPublished - 14 Oct 2022


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