Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study

BMJ Open. 2020 Sep 15;10(9):e040620. doi: 10.1136/bmjopen-2020-040620.


Objectives: Previous pandemics have resulted in significant consequences for mental health. Here, we report the mental health sequelae of the COVID-19 pandemic in a UK cohort and examine modifiable and non-modifiable explanatory factors associated with mental health outcomes. We focus on the first wave of data collection, which examined short-term consequences for mental health, as reported during the first 4-6 weeks of social distancing measures being introduced.

Design: Cross-sectional online survey.

Setting: Community cohort study.

Participants: N=3097 adults aged ≥18 years were recruited through a mainstream and social media campaign between 3 April 2020 and 30 April 2020. The cohort was predominantly female (n=2618); mean age 44 years; 10% (n=296) from minority ethnic groups; 50% (n=1559) described themselves as key workers and 20% (n=649) identified as having clinical risk factors putting them at increased risk of COVID-19.

Main outcome measures: Depression, anxiety and stress scores.

Results: Mean scores for depression ([Formula: see text] =7.69, SD=6.0), stress ([Formula: see text] =6.48, SD=3.3) and anxiety ([Formula: see text] = 6.48, SD=3.3) significantly exceeded population norms (all p<0.0001). Analysis of non-modifiable factors hypothesised to be associated with mental health outcomes indicated that being younger, female and in a recognised COVID-19 risk group were associated with increased stress, anxiety and depression, with the final multivariable models accounting for 7%-14% of variance. When adding modifiable factors, significant independent effects emerged for positive mood, perceived loneliness and worry about getting COVID-19 for all outcomes, with the final multivariable models accounting for 54%-57% of total variance.

Conclusions: Increased psychological morbidity was evident in this UK sample and found to be more common in younger people, women and in individuals who identified as being in recognised COVID-19 risk groups. Public health and mental health interventions able to ameliorate perceptions of risk of COVID-19, worry about COVID-19 loneliness and boost positive mood may be effective.

Keywords: mental health; psychiatry; public health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Affect
  • Age Factors
  • Aged
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Betacoronavirus
  • COVID-19
  • Cohort Studies
  • Coronavirus Infections / epidemiology*
  • Depression / epidemiology*
  • Depression / psychology
  • Employment*
  • Ethnic Groups
  • Female
  • Humans
  • Loneliness / psychology
  • Male
  • Middle Aged
  • Minority Groups
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Risk Factors
  • SARS-CoV-2
  • Sex Factors
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • United Kingdom / epidemiology
  • Young Adult