The mental strain in Sweden during the covid-19 pandemic
Since the emergence of the pandemic coronavirus disease 2019 (COVID-19) in late 2019, much attention has been paid to the mental health aspect of this disease. Of the 4,500,000 documents on covid-19 available in Google Scholar, more than 1,150,000 were about the impact of the pandemic on mental health in November 2021.
Study: Indicators for mental health in Sweden during a 12-month period during the covid-19 pandemic. Image credit: A Plus Vector / Shutterstock
However, most of these published data contained small samples and presented preliminary results that were difficult to generalize and difficult to replicate. During the first months of the pandemic, the withdrawal rates were also quite alarming. Therefore, larger studies need to be conducted to get a more general idea of the pandemic’s impact on mental health.
A new study published in the pre-print server medRxiv* aimed to determine the psychological burden for adults in Sweden through data collected in the Omtanke2020 study between 9.th June 2020 and 8th June 2021.
About the study
Participants in the study were recruited through social media campaigns and online invitations. Only those participants who responded to at least three of the four mental health measures, anxiety, depression, stress and post-traumatic stress disorder (PTSD), were included in the study. The participants responded to 11 monthly follow-ups after the basic data collection.
Data on age, relationship, gender, employment status, general lifestyle, region and health were collected from all recruited participants. Furthermore, participants were also asked if they had joined the study through personal invitations or social media campaigns.
Depressive symptoms and their severity were screened by Patient Health Questionnaire (PHQ-9). Anxiety disorders were screened with the scale for generalized anxiety disorders (GAD-7). PTSD was screened using the COVID-19-adjusted Primary Care PTSD Screen. Stress levels were evaluated using the Perceived Stress Scale (PSS-4). The study also measured other mental health indicators such as sleep deprivation, loneliness and general physical and mental well-being. COVID-19 status was confirmed by either PCR or antibody testing and reported by itself.
Study result
The study results indicated that the age of the participants varied from 18 to 94 years with the proportion of female participants higher compared to men. Participants were divided into three groups based on the covid-19 test and diagnosis, positive, negative, and those who did not undergo testing before participating in the study. 8.5% of the participants were reported to have been diagnosed with covid-19 before participating in the study.
The results reported that 78.7% of the participants had mild or minimal depressive symptoms, while 9.1% had moderately severe or severe depressive symptoms. 85.1% of the participants were found to have mild or minimal anxiety symptoms, while 5.7% were found to have severe anxiety symptoms. Depressive symptoms were found to be strongly correlated with anxiety disorders, happiness and general mental health, while happiness was strongly correlated with mental health compared to physical health.
Regional differences were observed among most of the results. In addition, age was inversely correlated with depression, anxiety, and PTSD. The amount of sleep was found to correlate negatively with anxiety and depression. The self-recruited participants showed a higher risk of having mental outcomes than the invited participants. The covid-19-infected participants also had a higher risk of developing depression and anxiety. Overall, depressive symptoms showed the greatest variation during the study period, while PTSD was the most stable.
The current study results were comparable with reports from other countries. In summary, it can be stated that the current study was quite effective in determining the increase in mental health during the pandemic. However, more research needs to be done to validate the regional differences in Sweden and other countries. Understanding the case of regional disparities can help alleviate the mental strain of the pandemic and set up appropriate intervention programs.
Restrictions
The study had some limitations. First, the study was not free from selection bias. Second, the younger age groups were underrepresented in the study. Third, the type of recruitment was related to mental health outcomes.
*Important message
medRxiv publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered as crucial, guide clinical practice / health-related behavior or be treated as established information.