The COVID-19 Mental Disorders Collaborators conclude that, throughout 2020, the pandemic led to a 27·6% increase in cases of major depressive disorders and 25·6% increase in cases of anxiety disorders globally.1 However, we propose that these prevalence estimates are likely to be substantially inflated. Decades of trauma research has shown that, for most people, negative life events such as bereavement or disaster exposure are typically followed by resilience (minimal effect on symptoms of anxiety, or depression, or both) or recovery (initial short-term increase in symptoms of anxiety, or depression, or both, followed by recovery).2 This pattern matches what large-scale studies and reviews3, 4, 5 have found in the context of COVID-19. In a meta-analysis of longitudinal cohort studies,3 there was an acute increase in mental health symptoms at the pandemic onset. Symptoms declined significantly over time and were indistinguishable from prepandemic symptom profiles within a few months of the outbreak.
Psychological adaptation matters in the context of the collaborators’ study,1 because the authors’ estimates of the COVID-19 impact are based on studies done primarily during the very early phase of the pandemic (data collection for 39 of 48 studies occurred primarily between March and May, 2020; appendix). At that time, symptoms of anxiety or depression were at their most severe and probably represented an acute reaction to an unexpected and unknown emerging crisis. The authors then extrapolated from those immediate reactions to infer how SARS-CoV-2 infection rates and human mobility affected mental health throughout 2020. However, a failure to take into account the short-lived nature of changes in mental health symptoms during the pandemic and the potentially diminishing relationship between indicators of COVID-19 impact and anxiety or depression throughout 2020, means that prevalence estimates might be grossly overestimated in the collaborators’ study.
We declare no competing interests.
Supplementary Material
References
- 1.COVID-19 Mental Disorders Collaborators Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398:1700–1712. doi: 10.1016/S0140-6736(21)02143-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Chen S, Bonanno GA. Psychological adjustment during the global outbreak of COVID-19: a resilience perspective. Psychol Trauma. 2020;12:S51–S54. doi: 10.1037/tra0000685. [DOI] [PubMed] [Google Scholar]
- 3.Robinson E, Sutin AR, Daly M, Jones A. A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic in 2020. J Affect Disord. 2022;296:567–576. doi: 10.1016/j.jad.2021.09.098. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Daly M, Robinson E. Psychological distress and adaptation to the COVID-19 crisis in the United States. J Psychiatr Res. 2021;136:603–609. doi: 10.1016/j.jpsychires.2020.10.035. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Fancourt D, Steptoe A, Bu F. Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study. Lancet Psychiatry. 2021;8:141–149. doi: 10.1016/S2215-0366(20)30482-X. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.