Tempering Optimism from Repeated Longitudinal Mental Health Surveys

Details

• Personal Author:
  Czeisler MÉ ; Czeisler, Charles A. ; Howard ME ; Rajaratnam SMW ; Wiley JF
• Description:
  The prevalence of adverse mental health symptoms increased during the initial phase of the COVID-19 pandemic. Establishing whether the rise in symptoms has persisted is crucial. The finding of Daisy Fancourt and colleagues was encouraging, in that anxiety and depression symptoms decreased among participants with at least two longitudinal follow-up measures in the UCL COVID-19 Social Study. However, our optimism was tempered by our own data revealing non-response bias in a retrospective analysis of participants in The COVID-19 Outbreak Public Evaluation (COPE) Initiative. Adjusting for demographic differences in longitudinal survey participation, respondents who completed more than two out of four invited surveys between April and September, 2020, had significantly lower prevalence of adverse mental health symptoms at the first timepoint (April, 2020) than those who did not. Furthermore, respondents who had anxiety or depression symptoms in May, 2020, after not having had these symptoms in April, 2020, had higher odds of completing fewer follow-up surveys compared with respondents without these symptoms (anxiety symptoms, adjusted odds ratio [aOR] 1·7 [95% CI 1·2-2·3], p=0·0015; depression symptoms, aOR 1·6 [95% CI 1·2-2·1], p=0·0046). Together, these data suggest that respondents who consistently completed surveys had better mental health initially and had more favourable trajectories than those who did not do the follow-up surveys. Fancourt and colleagues analysed data from the subset of the UCL COVID-19 Social Study participants who completed at least three surveys. Although no response rate was reported, we do know that their criteria excluded 22828 (38·5%) of 59348 participants who completed at least one survey. This raises the question: were the 22828 individuals who they excluded from analysis different from the participants analysed? If so, the reported mental health improvement might partially reflect survivorship bias. The answer to this question is consequential, as a premature conclusion that adverse mental health symptoms have decreased could affect mental health service planning. Assessment and management of mental health during the pandemic remain urgently needed. However, sampling and design choices should inform interpretation of findings. Although Fancourt and colleagues implemented measures to address biases, including population weighting and latent growth models to reduce sociodemographic and confounder biases, neither of these measures address potential survivorship bias. Our data suggest that individuals who completed more than two surveys in 2020 might be more resilient than those who did not. Future research should further characterise survivorship bias in longitudinal mental health surveys. Repeated cross-sectional surveillance can be used to estimate population-level mental health with time. Indeed, findings obtained by this design in the USA indicate that adverse mental health symptoms documented early in the pandemic have not abated. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Mental Health Nervous System Occupational Health Safety Surveys And Questionnaires
• Keywords:
  Coronavirus COVID-19 Longitudinal Study Mental Health Psychological Responses Questionnaires Statistical Quality Control
• ISSN:
  2215-0366
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  274-275
• Volume:
  8
• Issue:
  4
• NIOSHTIC Number:
  nn:20062347
• Citation:
  Lancet Psychiatry 2021 Apr; 8(4):274-275
• Contact Point Address:
  Mark É. Czeisler, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
• Email:
  mark.czeisler@fulbrightmail.org
• Federal Fiscal Year:
  2021
• NORA Priority Area:
  Healthcare and Social Assistance
• Performing Organization:
  Brigham and Women's Hospital, Boston, Massachusetts
• Peer Reviewed:
  False
• Start Date:
  20190901
• Source Full Name:
  The Lancet Psychiatry
• End Date:
  20230831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a564fc61f4c2985f6e6ee8672ac8c9e53930720627c262a4ab7c2e9c9342e7d8a9661c7724cb902e4752c609c71ea0e9bf94712940cffd5ab1a6130f83e2a8e2
• Download URL:
  https://stacks.cdc.gov/view/cdc/225614/cdc_225614_DS1.pdf
• File Type:
  [PDF - 43.78 KB ]