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Nichols E, Petrosyan S, Khobragade P, Banerjee J, Angrisani M, Dey S, Bloom DE, Schaner S, Dey AB, Lee J. Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nationwide survey. BMJ Glob Health 2024; 9:e013365. [PMID: 38286516 PMCID: PMC10826618 DOI: 10.1136/bmjgh-2023-013365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/20/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over 2 years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context. METHODS We used data from the Real-Time Insights of COVID-19 in India cohort study (N=3709). We used covariate-adjusted linear regression models with generalised estimating equations to assess associations between mental health (Patient Health Questionnaire (PHQ-4) score; range 0-12) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender and rural/urban residence. RESULTS Mental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.10 units; 95% CI 0.06 to 0.13), government stringency index (0.14 units; 95% CI 0.11 to 0.18), self-reported major financial impacts (1.20 units; 95% CI 1.09 to 1.32) and COVID-19 infection in the household (0.36 units; 95% CI 0.23 to 0.50). CONCLUSION While the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-aged and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics.
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Affiliation(s)
- Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Sarah Petrosyan
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Pranali Khobragade
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Joyita Banerjee
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Marco Angrisani
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
| | - Sharmistha Dey
- All India Institute of Medical Sciences, New Delhi, India
| | - David E Bloom
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Simone Schaner
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
| | - Aparajit B Dey
- Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
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Parkinson A, Wykes T. The anxiety of the lone editor: fraud, paper mills and the protection of the scientific record. J Ment Health 2023; 32:865-868. [PMID: 37697484 DOI: 10.1080/09638237.2023.2232217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 09/13/2023]
Affiliation(s)
| | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- South London and Maudsley NHS Foundation Trust, UK
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Nichols E, Petrosyan S, Khobragade P, Banerjee J, Angrisani M, Dey S, Bloom DE, Schaner S, Dey AB, Lee J. Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nation-wide survey. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.13.23295513. [PMID: 37745425 PMCID: PMC10516061 DOI: 10.1101/2023.09.13.23295513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Introduction The COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over two years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context. Methods We used data from the Real-Time Insights of COVID-19 in India (RTI COVID-India) cohort study (N=3,662). We used covariate-adjusted linear regression models with generalized estimating equations to assess associations between mental health (PHQ-4 score) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender, and rural/urban residence. Results Mental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly and independently associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.041 SD units; 95% Confidence Interval 0.030 - 0.053), government stringency index (0.060 SD units; 0.048 - 0.072), self-reported major financial impacts (0.45 SD units; 0.41-0.49), and COVID-19 infection in the household (0.11 SD units; 0.07-0.16). Conclusion While the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-age and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics.
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Affiliation(s)
- Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Sarah Petrosyan
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Pranali Khobragade
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Joyita Banerjee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Marco Angrisani
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - Sharmistha Dey
- All India Institute of Medical Sciences, New Delhi, India
| | - David E. Bloom
- Harvard School of Public Health, Boston, Massachusetts, USA
| | - Simone Schaner
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - AB Dey
- Venu Geriatric Institute, New Delhi, India
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
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