How Do Mental Health Symptoms Change During the COVID-19 Pandemic?

What you need to know

• This study looks at how mental health symptoms change over time during the pandemic by following the same people across multiple time points
• Rather than just looking at overall averages, the researchers examine different patterns of symptoms that emerge in subgroups of people
• Understanding what factors predict changes in mental health can help identify who may need support and what protective factors promote wellbeing

Background

When studying mental health during the pandemic, most research has focused only on mental illness symptoms without considering wellbeing. However, mental health is more than just the absence of symptoms - it also includes positive aspects like feeling able to cope with stress and function well in daily life. Someone could have some symptoms but still maintain good wellbeing, or have no symptoms but poor wellbeing.

Additionally, looking only at average symptoms across large groups can mask important differences in how individuals respond. For example, while some people may develop lasting mental health problems, others may be resilient or recover quickly. Understanding these different patterns can help target support where it’s most needed.

The Current Study

This study follows over 2,000 adults in the Netherlands across three time points during the pandemic, spaced 6 months apart. The researchers are measuring three key aspects of mental health:

1. Post-traumatic stress disorder (PTSD) symptoms - intrusive memories, avoidance, negative mood changes, and being constantly on guard

2. Adjustment disorder symptoms - having a hard time adapting to stressful changes, with excessive worry and preoccupation

3. Wellbeing - positive mental health like feeling cheerful, calm, and able to handle daily life

Rather than just calculating averages, they use statistical techniques to identify subgroups of people with similar patterns of symptoms over time. For example, they expect to find groups like:

• People with consistently good mental health (low symptoms, good wellbeing)
• People with severe ongoing problems (high symptoms, poor wellbeing)
• People who struggle to adjust but don’t develop trauma symptoms
• People with mainly trauma symptoms
• People with some symptoms but maintained wellbeing

Predicting Changes

The study also examines what factors predict whether someone stays in the same pattern or shifts to a different one over time. Key factors they’re looking at include:

Demographics:

• Gender
• Ethnicity
• History of childhood trauma

Work/Education:

• Being a student
• Working in healthcare

Health Background:

• Previous mental health diagnoses
• Current physical health status

Pandemic Experiences:

• Having COVID-19
• Losing a loved one
• Income loss
• Loss of social connections

Understanding these predictors can help identify who may be at higher risk of developing problems and need extra support. It can also reveal protective factors that help people maintain good mental health despite challenges.

Why This Matters

Most pandemic mental health research has been:

• Limited to measuring problems without wellbeing
• Cross-sectional (one time point only)
• Focused on averages rather than individual differences

This study provides a more complete picture by:

• Including both symptoms and wellbeing
• Following people over time
• Identifying different patterns of response
• Examining what predicts changes

This knowledge can help:

• Screen for those at risk
• Develop prevention programs
• Target interventions appropriately
• Promote factors that support resilience

Conclusions

• Mental health during the pandemic involves both symptoms and wellbeing, which don’t always align
• Different people show different patterns of response over time
• Understanding predictors of changes can help identify who needs support and how to provide it effectively
• Taking a comprehensive, long-term view helps develop better mental health interventions

The researchers are part of the Dutch Society for Traumatic Stress Studies and are collaborating with 10 other European countries. Results will be shared through academic publications, conferences, professional networks, and public media to help improve mental health support during and after the pandemic.