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Comparative Study
. 2021 Feb:143:106362.
doi: 10.1016/j.ypmed.2020.106362. Epub 2020 Dec 31.

A longitudinal study of psychological distress in the United States before and during the COVID-19 pandemic

Joshua Breslau  1 , Melissa L Finucane  2 , Alicia R Locker  3 , Matthew D Baird  4 , Elizabeth A Roth  5 , Rebecca L Collins  6
Affiliations
Comparative Study

A longitudinal study of psychological distress in the United States before and during the COVID-19 pandemic

Joshua Breslau et al. Prev Med. 2021 Feb.

Abstract

The COVID-19 pandemic has caused financial stress and disrupted daily life more quickly than any prior economic downturn and on a scale beyond any prior natural disaster. This study aimed to assess the impact of the pandemic on psychological distress and identify vulnerable groups using longitudinal data to account for pre-pandemic mental health status. Clinically significant psychological distress was assessed with the Kessler-6 in a national probability sample of adults in the United States at two time points, February 2019 (T1) and May 2020 (T2). To identify increases in distress, psychological distress during the worst month of the past year at T1 was compared with psychological distress over the past 30-days at T2. Survey adjusted logistic regression was used to estimate associations of demographic characteristics at T1 (gender, age, race, and income) and census region at T2 with within-person increases in psychological distress. The past-month prevalence of serious psychological distress at T2 was as high as the past-year prevalence at T1 (10.9% vs. 10.2%). Psychological distress was strongly associated across assessments (X2(4) = 174.6, p < .0001). Increase in psychological distress above T1 was associated with gender, age, household income, and census region. Equal numbers of people experienced serious psychological distress in 30-days during the pandemic as did over an entire year prior to the pandemic. Mental health services and research efforts should be targeted to those with a history of mental health conditions and groups identified as at high risk for increases in distress above pre-pandemic levels.

Keywords: COVID-19 pandemic; Longitudinal study; Mental health; Psychological distress.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Individual Change in Psychological Distress during the COVID-19 Pandemic, American Life Panel, N = 1870 Percents outside the bars represent population prevalence at each time point. Percents within the bars represent the proportions at each level of distress at T1 who transitioned to each level of distress at T2; these proportions are also reflected in the width of the bars. Turquoise bards indicate increases in distress, yellow bars indicate decreases in distress and grey bars indicate no change. Psychological distress assessed with the Kessler-6, with categorization as defined in the text. The pre-COVID-19 assessment was conducted in February 2019 and referred to the worst month of the past year. The COVID-19 assessment was conducted in May 2020 and referred to the past 30 days. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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