Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: longitudinal analyses of the UK Household Longitudinal Study

Claire L Niedzwiedz, Michael James Green, Michaela Benzeval, Desmond Campbell, Peter Craig, Evangelia Demou, Alastair Leyland, Anna Pearce, Rachel Thomson, Elise Whitley, Srinivasa Vittal Katikireddi, Claire L Niedzwiedz, Michael James Green, Michaela Benzeval, Desmond Campbell, Peter Craig, Evangelia Demou, Alastair Leyland, Anna Pearce, Rachel Thomson, Elise Whitley, Srinivasa Vittal Katikireddi

Abstract

Background: There are concerns that COVID-19 mitigation measures, including the 'lockdown', may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the initial phase of the COVID-19 lockdown and differences across population subgroups.

Methods: Repeated cross-sectional and longitudinal analysis of the UK Household Longitudinal Study, including representative samples of over 27,000 adults (aged 18+) interviewed in four survey waves between 2015 and 2020. A total of 9748 adults had complete data for longitudinal analyses. Outcomes included psychological distress (General Health Questionnaire-12), loneliness, current cigarette smoking, use of e-cigarettes and alcohol consumption. Cross-sectional prevalence estimates were calculated and multilevel Poisson regression assessed associations between time period and the outcomes of interest, as well as differential associations by age, gender, education level and ethnicity.

Results: Psychological distress increased 1 month into lockdown with the prevalence rising from 19.4% (95% CI 18.7% to 20.1%) in 2017-2019 to 30.6% (95% CI 29.1% to 32.3%) in April 2020 (RR=1.3, 95% CI 1.2 to 1.4). Groups most adversely affected included women, young adults, people from an Asian background and those who were degree educated. Loneliness remained stable overall (RR=0.9, 95% CI 0.6 to 1.5). Smoking declined (RR=0.9, 95% CI=0.8,1.0) and the proportion of people drinking four or more times per week increased (RR=1.4, 95% CI 1.3 to 1.5), as did binge drinking (RR=1.5, 95% CI 1.3 to 1.7).

Conclusions: Psychological distress increased 1 month into lockdown, particularly among women and young adults. Smoking declined, but adverse alcohol use generally increased. Effective measures are required to mitigate negative impacts on health.

Keywords: ALCOHOL; HEALTH BEHAVIOUR; INEQUALITIES; MENTAL HEALTH; SMOKING.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

Figures

Figure 1
Figure 1
Mental health and health behaviours before (2017–2019) and during the COVID-19 lockdown (April 2020).
Figure 2
Figure 2
Psychological distress (General Health Questionnaire items) before (2017–2019) and during the COVID-19 lockdown (April 2020).
Figure 3
Figure 3
Mental health and health behaviours before (2017–2019) and during the COVID-19 lockdown (April 2020) by subgroup.

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Source: PubMed

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