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Klaser K, Thompson EJ, Nguyen LH, Sudre CH, Antonelli M, Murray B, Canas LS, Molteni E, Graham MS, Kerfoot E, Chen L, Deng J, May A, Hu C, Guest A, Selvachandran S, Drew DA, Modat M, Chan AT, Wolf J, Spector TD, Hammers A, Duncan EL, Ourselin S, Steves CJ. Anxiety and depression symptoms after COVID-19 infection: results from the COVID Symptom Study app. J Neurol Neurosurg Psychiatry 2021; 92:1254-1258. [PMID: 34583944 PMCID: PMC8599635 DOI: 10.1136/jnnp-2021-327565] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/07/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Mental health issues have been reported after SARS-CoV-2 infection. However, comparison to prevalence in uninfected individuals and contribution from common risk factors (eg, obesity and comorbidities) have not been examined. We identified how COVID-19 relates to mental health in the large community-based COVID Symptom Study. METHODS We assessed anxiety and depression symptoms using two validated questionnaires in 413148 individuals between February and April 2021; 26998 had tested positive for SARS-CoV-2. We adjusted for physical and mental prepandemic comorbidities, body mass index (BMI), age and sex. FINDINGS Overall, 26.4% of participants met screening criteria for general anxiety and depression. Anxiety and depression were slightly more prevalent in previously SARS-CoV-2-positive (30.4%) vs SARS-CoV-2-negative (26.1%) individuals. This association was small compared with the effect of an unhealthy BMI and the presence of other comorbidities, and not evident in younger participants (≤40 years). Findings were robust to multiple sensitivity analyses. Association between SARS-CoV-2 infection and anxiety and depression was stronger in individuals with recent (<30 days) versus more distant (>120 days) infection, suggesting a short-term effect. INTERPRETATION A small association was identified between SARS-CoV-2 infection and anxiety and depression symptoms. The proportion meeting criteria for self-reported anxiety and depression disorders is only slightly higher than prepandemic.
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Affiliation(s)
- Kerstin Klaser
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Ellen J Thompson
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Long H Nguyen
- Clinical & Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Harvard Medical School, Boston, Massachusetts, USA
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Harvard Medical School, Boston, Massachusetts, USA
| | - Carole H Sudre
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Medical Physics and Bioengineering, UCL Centre for Medical Image Computing (CMIC), London, UK
- MRC Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London, UK
| | - Michela Antonelli
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Benjamin Murray
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Liane S Canas
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Erika Molteni
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Mark S Graham
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Eric Kerfoot
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Liyuan Chen
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Jie Deng
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | | | | | | | | | - David A Drew
- Clinical & Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Harvard Medical School, Boston, Massachusetts, USA
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Harvard Medical School, Boston, Massachusetts, USA
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Andrew T Chan
- Clinical & Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Harvard Medical School, Boston, Massachusetts, USA
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Alexander Hammers
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- PET Centre, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Emma L Duncan
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
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