Trajectories and correlates of poor mental health in India over the course of the Covid-19 pandemic

A nationwide survey

Bibliographic Data

ID21881525
AuthorsEmma Nichols (0000-0002-9005-3872, University of Southern California, corresponding author), Sarah Petrosyan (0000-0001-5122-6155, University of Southern California), Pranali Khobragade (0000-0002-1117-1177, University of Southern California), Joyita Banerjee (0000-0002-3432-9782, University of Southern California), Marco Angrisani (0000-0002-6084-6388, University of Southern California), Sharmistha Dey (0000-0003-4122-7415, All India Institute of Medical Sciences), David E Bloom (0000-0003-3731-3345, Harvard University), Simone Schaner (0000-0001-5722-4265, University of Southern California), Aparajit Ballav Dey (0000-0003-0979-9413, All India Institute of Medical Sciences), Jinkook Lee (0000-0002-6209-719X, University of Southern California)
Year2024
Volume9
Issue1
Pagese013365
Publication date2024-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2023-013365
PMID38286516
OpenAlexW4391326478
LanguageEN
Citations received4
References cited47

INTRODUCTION: The COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over 2 years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context. METHODS: We used data from the Real-Time Insights of COVID-19 in India cohort study (N=3709). We used covariate-adjusted linear regression models with generalised estimating equations to assess associations between mental health (Patient Health Questionnaire (PHQ-4) score; range 0-12) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender and rural/urban residence. RESULTS: Mental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.10 units; 95% CI 0.06 to 0.13), government stringency index (0.14 units; 95% CI 0.11 to 0.18), self-reported major financial impacts (1.20 units; 95% CI 1.09 to 1.32) and COVID-19 infection in the household (0.36 units; 95% CI 0.23 to 0.50). CONCLUSION: While the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-aged and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics

2019-20 coronavirus outbreak · Betacoronavirus · Disease · Environmental health · Mental health · Outbreak · Pandemic · Pathology · Psychiatry · Public health · COVID-19 and Mental Health · Employment and Welfare Studies · Medicine · Mental Health Treatment and Access · Nursing · Psychology · Virology

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