Psychiatric Epidemiology During the COVID-19 Pandemic

Our review critically examines research on trends in mental health among US adults following the COVID-19 pandemic's onset and makes recommendations for research on the topic.

Studies comparing pre-pandemic nationally representative government surveys ("benchmark surveys") with pandemic-era non-benchmark surveys generally estimated 3-4-fold increases in the prevalence of adverse mental-health outcomes following the pandemic's onset. However, studies analyzing trends in repeated waves of a single survey, which may carry a lower risk of bias, generally estimated much smaller increases in adverse outcomes. Likewise in our analysis of benchmark surveys, we estimated <1% increases in the prevalence of adverse outcomes from 2018/2019-2021. Finally, studies analyzing vital-statistics data estimated spiking fatal-overdose rates, but stable suicide rates.

Although fatal-overdose rates increased substantially following the pandemic's onset, evidence suggests the population prevalence of other adverse mental-health outcomes may have departed minimally from prior years' trends, at least through 2021. Future research on trends through the pandemic's later stages should prioritize leveraging repeated waves of benchmark surveys to minimize risk of bias.