Impact of COVID-19 pandemic on mental health in the general population: A systematic review

Jiaqi Xiong, Orly Lipsitz, Flora Nasri, Leanna M W Lui, Hartej Gill, Lee Phan, David Chen-Li, Michelle Iacobucci, Roger Ho, Amna Majeed, Roger S McIntyre, Jiaqi Xiong, Orly Lipsitz, Flora Nasri, Leanna M W Lui, Hartej Gill, Lee Phan, David Chen-Li, Michelle Iacobucci, Roger Ho, Amna Majeed, Roger S McIntyre

Abstract

Background: As a major virus outbreak in the 21st century, the Coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented hazards to mental health globally. While psychological support is being provided to patients and healthcare workers, the general public's mental health requires significant attention as well. This systematic review aims to synthesize extant literature that reports on the effects of COVID-19 on psychological outcomes of the general population and its associated risk factors.

Methods: A systematic search was conducted on PubMed, Embase, Medline, Web of Science, and Scopus from inception to 17 May 2020 following the PRISMA guidelines. A manual search on Google Scholar was performed to identify additional relevant studies. Articles were selected based on the predetermined eligibility criteria.

Results: Relatively high rates of symptoms of anxiety (6.33% to 50.9%), depression (14.6% to 48.3%), post-traumatic stress disorder (7% to 53.8%), psychological distress (34.43% to 38%), and stress (8.1% to 81.9%) are reported in the general population during the COVID-19 pandemic in China, Spain, Italy, Iran, the US, Turkey, Nepal, and Denmark. Risk factors associated with distress measures include female gender, younger age group (≤40 years), presence of chronic/psychiatric illnesses, unemployment, student status, and frequent exposure to social media/news concerning COVID-19.

Limitations: A significant degree of heterogeneity was noted across studies.

Conclusions: The COVID-19 pandemic is associated with highly significant levels of psychological distress that, in many cases, would meet the threshold for clinical relevance. Mitigating the hazardous effects of COVID-19 on mental health is an international public health priority.

Keywords: Anxiety; COVID-19; Depression; General population; Mental health; Post-traumatic stress disorder (PTSD).

Conflict of interest statement

None

Copyright © 2020. Published by Elsevier B.V.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) study selection flow diagram. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

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