Shocked-relaxed-tired: Mental health during the three waves of the Covid-19

BackgroundAlthough several studies documented the impact of COVID-19 on mental health, the long-term effects of COVID-19 on mental health remain unclear. AimsTo examine longitudinal changes in mental health prior to and during the consecutive COVID-19 waves in a well-established probability sample. MethodAn online survey was completed by the participants of the COVID-19 add-on study at 4 timepoints (N1=1823, N2=788, N3=532, N4=383): pre-COVID period (2014/2015), 1st COVID-19 wave (April-May, 2020), 2nd COVID-19 wave (August-October, 2020) and 3rd COVID-19 wave (March-April, 2021). Data were collected via a set of validated instruments and analysed using latent growth models. ResultsDuring the pandemic, we observed a significant increase in stress levels (slope=1.127, P<0.001) and depressive symptoms (slope=1.177, P<0.001). The rate of increase in stress levels (cov=2.167, P=0.002), but not in depressive symptoms (cov=0.558, P=0.10), was associated with the pre-pandemic mental health status of the participants. Further analysis revealed two opposing clusters of factors that influenced mental health: loneliness and COVID-19 showed a negative effect on emotionality, while higher resilience acted protectively. A greater increase in stress was observed in women and younger participants. ConclusionsThe surge in stress levels and depressive symptoms persisted across all three consecutive COVID-19 waves. This surge is attributable to the effect of several risk factors including the status of mental health prior to the COVID-19 pandemic. Our findings have implications for strategies promoting resilience and addressing loneliness to mitigate the mental health impact of COVID-19 pandemic.