Background: The COVID-19 pandemic disrupted daily social interactions, potentially affecting mental health. Understanding the risk of depressive and anxiety symptoms is essential for guiding mental health strategies during future crises.
Aims: To explore how social networks influenced mental health outcomes during the pandemic and how these relationships changed over time.
Method: Data from the Omtanke2020 study, a prospective cohort study of Swedish adults, were analysed using structural equation modelling (N = 10 918). Surveys at baseline and follow-up at 6 and 12 months assessed social networks, including structural components (e.g. relationship status, frequency of social contact) and perceived components (e.g. emotional support from family, feeling safe at home). Cross-lagged panel modelling was used to observe changes over time in the associations between social network indicators and depressive and anxiety symptoms.
Results: Stronger perceived social support - specifically closeness to family, perceived warmth or love from others and increased societal cohesion - were negatively correlated with depressive and anxiety symptoms across all time points (β coefficients = -0.14 to -0.23, all P < 0.001). Social network variables consistently predicted mental health outcomes, with effect sizes remaining relatively stable over time (β coefficient = -0.17 at baseline, β coefficient = -0.21 at 1-year follow-up).
Conclusions: This study highlights the protective role of the social network - namely perceived social support - in combatting depressive and anxiety symptoms during the COVID-19 pandemic. Interventions that strengthen close interpersonal ties and community cohesion may help mitigate mental health impacts during future public health crises.
Keywords: COVID-19; Social network; anxiety; cohort study; depression.