Factors associated with self-reported anxiety, depression, and general health during the UK lockdown; a cross-sectional survey
Authors: Smith Louise E. , Amlot Richard , Lambert Helen , Oliver Isabel , Robin Charlotte , Yardley Lucy , Rubin G James 
Published: June 2020

ABSTRACTBackgroundTo investigate factors associated with anxiety, depression, and self-reported general health during “lockdown” due to COVID-19 in the UK.MethodsOnline cross-sectional survey of a nationally-representative sample of 2240 participants living in the UK aged 18 years or over (data collected 6-7 May 2020). Participants were recruited from YouGov’s online research panel.OutcomesIn this sample, 21·9% (n=458, 95% CI [20·1% to 23·7%]) reported probable anxiety (scored three or over on the GAD-2); while 23·5% (n=494, 95% CI [21·7% to 25·3]) reported probable depression (scored three or over on the PHQ-2). Poorer mental health was associated with greater financial hardship during the lockdown, thinking that you would lose contact with friends or family if you followed Government measures, more conflict with household members during the lockdown, less sense of community with people in your neighbourhood, and lower perceived effectiveness of Government measures. Females and those who were younger were likely to report higher levels of anxiety and depression. The majority of participants reported their general health as “good” (as measured by the first item of the SF-36). Poorer self-reported general health was associated with psychological distress, greater worry about COVID-19 and markers of inequality.InterpretationRates of self-reported anxiety and depression in the UK during the lockdown were greater than population norms. Reducing financial hardship, promoting social connectedness, and increasing solidarity with neighbours and household members may help ease rifts within the community which are associated with distress, thereby improving mental health. Reducing inequality may also improve general health.RESEARCH IN CONTEXTEvidence before this studyQuarantine is associated with adverse psychological outcomes.Psychological distress during quarantine is associated with greater financial loss, greater perceived susceptibility to and severity of the illness, and greater frustration and boredom during quarantine.Measures put in place to prevent the spread of COVID-19 have highlighted existing inequalities in society, disproportionally affecting younger people, those in lower-income households, and Black and minority ethnic groups.Research in the UK and other countries indicates that rates of anxiety and depression during restrictions of movement such as “lockdown” measures are higher than population norms.Added value of this studyIn this study, 22% of the sample reported anxiety, while 24% reported depression. Normative data indicate that these rates are usually approximately 5% and 7% respectively.Factors associated with psychological distress included greater financial hardship, poorer social connectedness, greater conflict within the household and the wider neighbourhood, being female and of younger age.Self-reported general health in the sample was “good” on average. Factors associated with poorer self-reported general health included markers of inequality and greater worry about COVID-19.Implications of all the available evidenceDecreasing the financial impact of measures put in place to prevent the spread of COVID-19 may help improve mental health.Interventions promoting social connectedness in isolated young people and measures that increase household and neighbourhood solidarity may help improve mental health.