Depressive Symptoms and Anxiety During the COVID-19 Pandemic: Large, Longitudinal, Cross-sectional Survey

James J MacDonald; Ryan Baxter-King; Lynn Vavreck; Arash Naeim; Neil Wenger; Karen Sepucha; Annette L Stanton

doi:10.2196/33585

Depressive Symptoms and Anxiety During the COVID-19 Pandemic: Large, Longitudinal, Cross-sectional Survey

JMIR Ment Health. 2022 Feb 10;9(2):e33585. doi: 10.2196/33585.

Authors

James J MacDonald¹, Ryan Baxter-King², Lynn Vavreck^{2

3}, Arash Naeim⁴, Neil Wenger⁵, Karen Sepucha⁶, Annette L Stanton^{1

7}

Affiliations

¹ Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.
² Department of Political Science, College of Letters and Sciences, University of California, Los Angeles, Los Angeles, CA, United States.
³ Department of Communication, College of Letters and Sciences, University of California, Los Angeles, Los Angeles, CA, United States.
⁴ Center for SMART Health, Clinical and Translational Science Institute, University of California, Los Angeles, Los Angeles, CA, United States.
⁵ Division of General Internal Medicine and Health Sciences Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
⁶ Health Decision Sciences Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
⁷ Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.

PMID: 35142619
PMCID: PMC8834874
DOI: 10.2196/33585

Abstract

Background: The COVID-19 pandemic has influenced the mental health of millions across the globe. Understanding factors associated with depressive symptoms and anxiety across 12 months of the pandemic can help identify groups at higher risk and psychological processes that can be targeted to mitigate the long-term mental health impact of the pandemic.

Objective: This study aims to determine sociodemographic features, COVID-19-specific factors, and general psychological variables associated with depressive symptoms and anxiety over 12 months of the pandemic.

Methods: Nationwide, cross-sectional electronic surveys were implemented in May (n=14,636), July (n=14,936), October (n=14,946), and December (n=15,265) 2020 and March/April 2021 (n=14,557) in the United States. Survey results were weighted to be representative of the US population. The samples were drawn from a market research platform, with a 69% cooperation rate. Surveys assessed depressive symptoms in the past 2 weeks and anxiety in the past week, as well as sociodemographic features; COVID-19 restriction stress, worry, perceived risk, coping strategies, and exposure; intolerance of uncertainty; and loneliness.

Results: Across 12 months, an average of 24% of respondents reported moderate-to-severe depressive symptoms and 32% reported moderate-to-severe anxiety. Of the sociodemographic variables, age was most consistently associated with depressive symptoms and anxiety, with younger adults more likely to report higher levels of those outcomes. Intolerance of uncertainty and loneliness were consistently and strongly associated with the outcomes. Of the COVID-19-specific variables, stress from COVID-19 restrictions, worry about COVID-19, coping behaviors, and having COVID-19 were associated with a higher likelihood of depressive symptoms and anxiety.

Conclusions: Depressive symptoms and anxiety were high in younger adults, adults who reported restriction stress or worry about COVID-19 or who had had COVID-19, and those with intolerance of uncertainty and loneliness. Symptom monitoring as well as early and accessible intervention are recommended.

Keywords: COVID-19; anxiety; depression; health intervention; mental health; pandemic; psychological variables; public health; symptom monitoring; younger adults.

©James J MacDonald, Ryan Baxter-King, Lynn Vavreck, Arash Naeim, Neil Wenger, Karen Sepucha, Annette L Stanton. Originally published in JMIR Mental Health (https://mental.jmir.org), 10.02.2022.