The Office for National Statistics (ONS) have published* the results of a survey on depression in adults, investigating incidence before and during the COVID-19 pandemic.
Dr Andreas Reif, Head of Department of Psychiatry, University Hospital Frankfurt, Goethe University, said:
“This survey only took two measurement of the self-report PHQ-9 survey. While this survey often forms part of a diagnosis of depression, if taken only once in a given time period and without any other measurements or input from a trained professional, all it can give is an indication of depressive symptoms. So while this survey can give an indication as to how depressive symptoms may vary, it cannot give us a true indication of changes in rates of depression within the UK population.
“The baseline measurements of depressive symptoms which were used to compare with the situation during pandemic took place between July 2019 and March 2020, while the second took place within just one month. Given the huge span of the baseline measure, many other causes apart from the pandemic (and even chance) might underly the observed change. This survey is unable to directly attribute a causal link between these changes in the past few months and rates of depressive symptoms. The main driver of this change may not be the pandemic as a whole, but particular consequences of it such as isolation, lack of access to support networks or financial hardship, so breaking down what aspects of the pandemic may be driving poorer mental health is important.”
Prof Sir Simon Wessely, Regius Professor of Psychiatry, Institute of Psychiatry Psychology & Neuroscience, King’s College London (IoPPN), said:
“These are symptoms of depression, as measured by a questionnaire, so the true rates of depressive disorder ascertained at interview, the “Gold Standard” for diagnosing mental disorders, is likely to be lower. But what is clear is that the rates have doubled as a result of the pandemic, in keeping with other reports. It is also clear that it is younger rather than older people who are most affected. And this is before the predicted recession bites, when we can expect things to get even worse. This is deeply troubling. We should not simply accept this as the “new norm”. It is new but anything but normal.”
Prof Dame Til Wykes, Professor of Clinical Psychology and Rehabilitation, Institute of Psychiatry Psychology & Neuroscience, King’s College London (IoPPN), said:
“This paper reports data from a longitudinal survey comparing before the pandemic (last year) and during the pandemic (June 2020) using a well-known measure – the PHQ8 – which is used to measure depression and anxiety symptoms (it isn’t making a diagnosis). The population is representative – at least of those who have internet access and the skills to complete the relevant forms.
“They report two main things:
“Almost 1 in 5 people were suffering from depression symptoms during the pandemic which is an increase from the 1 in 10 prior to it. We already have had observational data on experiences of depression but many studies have not used sound measures of these depression symptoms. But we should not forget that a few (1 in 25 adults) saw an improvement in mental health.
“The characteristics of those who developed or who reported depressive symptoms are similar to many other reports. Those who were younger, women, had poorer financial resources, were unemployed in the seven days before completing the questionnaire, had a health problem or had a disability were likely to report depression symptoms. For instance younger people (1 in 3 16-39 year olds) were more likely to report depressive symptoms and they were more likely to have experienced an increase in symptoms. The characteristics are some that could be changed (employment, financial support) as well as some that can’t (age, gender, health condition) which is the same as has been found for studies on depression in the community.
“The study is robust and confirms many of the findings from less structured studies. It tells us that we need to be aware that potentially changing some characteristics like employment may provide some protection for depression. But we need to be careful not to over-interpret the data – the characteristics were identified individually so you can’t add them up.
“This study tells us, yet again, that we might have a mental health crisis after this pandemic. The social effects of distancing and isolation for some affects their emotional wellbeing.
“We can all understand that dealing with tough circumstances like financial stress and unemployment, as well as the fear produced by having an underlying health condition, are likely to put pressure on all our coping mechanisms.
“We don’t know when this pandemic will be over but the news about employment seems likely to put further strain on an already stressed population. The figures for depression are then likely to be much worse. We would then be talking about an unprecedented increase in those in need of help. We need investment in mental health support and treatment services now to ensure that this can be dealt with rather than allowed to escalate and worsen….we can’t wait any longer.”
Prof Guy Goodwin, Emeritus Professor of Psychiatry, Oxford University, said:
“These findings confirm that social factors adversely affected by the pandemic are in turn associated with increased levels of anxiety and depression in the UK population. The results are not surprising and were widely anticipated. They highlight the absence of much reliable evidence on how to prevent mood and anxiety disorders in vulnerable populations. Given that one’s choice and pattern of activities can change mood markedly, behavioural activation is one simple approach that deserves wider consideration and systematic research into its potential benefits.”
Dr Charley Baker, Associate Professor of Mental Health, University of Nottingham, said:
“It’s unsurprising to see these rates of low mood & depressive symptoms emerging – as social beings the longer term impact of isolation and the lessening of a sense of togetherness in adversity will have impacted on people’s mood. The people highlighted as struggling the most are those who are already more vulnerable to low mood, anxiety and poorer wellbeing. It’s important though to avoid over pathologising what might be seen as reasonable responses to the current pandemic, replete as it is with uncertainty & fear. At the same time we need clear investing in services at primary and secondary level to ensure that those who begin to struggle more with their mood & anxiety get the additional support they need. Perhaps we – all of us – need to reach in to proactively support people, rather than expecting people to reach out when this may be even more challenging than when in non-COVID times.”
Prof Elaine Fox, Director, Oxford Centre for Emotions and Affective Neuroscience and Professor of Cognitive and Affective Psychology, University of Oxford, said:
“This report from the ONS presents some worrying data on the rise of depressive symptoms during the pandemic. The sample of just over 3,500 is representative of the British population and the measure of depression used is a well known screening questionnaire – it is important to remember that this does not give a diagnosis but rather an indication of everyday depressive feelings and behaviours. The top–line message is that the number of people experiencing relatively severe depressive symptoms increased from about 1 in 10 to about 1 in 5 from before to during the pandemic. In terms of national and international figures it’s interesting to note that the 1 in 10 figure is actually relatively low as most estimates suggest that about 1 in 5 experience depression at any given time. What is especially informative in this report, although not surprising, is that ability to afford an unexpected expense of £850 led to lower levels of depressive symptoms. Being male and not being disabled in some way also led to reports of lower depressive symptoms. The most worrying aspect of these results in my view is that given the financial problems many are now experiencing, an increasing inability to pay bills is likely to lead to ever increasing levels of depression and anxiety. These economic factors are likely to play an important role in the nations mental health in the coming months and years.”
* Coronavirus and depression in adults, Great Britain: June 2020
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