Objectives: This study investigated perceived loneliness, anxiety, and depression among young adults in the UK across five timepoints: pre-pandemic (December 2019), two coronavirus disease (COVID-19) lockdowns (March–June 2020, January–April 2021), and two post-lockdown phases (November–December 2021, May 2022). It aimed to assess mental health resilience, defined as a return to baseline levels post-lockdown, and identify critical timepoints where loneliness predicted mental health outcomes.Methods: A total of 158 participants (aged 18–82, predominantly under 25) completed online questionnaires measuring mental health (Patient Health Questionnaire-8 (PHQ-8); General Anxiety Disorder-7 (GAD-7)) and loneliness (DeJong Gierveld Loneliness Scale) at two data collection points, under a cross-sectional design. Retrospective data were collected for pre-pandemic and lockdown periods, while prospective data were gathered post-lockdown. Linear mixed models and regression analyses were used to examine changes in mental health and loneliness over time and to identify predictive relationships.Results: Loneliness and mental health significantly deteriorated during lockdowns, with depression and anxiety scores worsening from pre-pandemic levels. Partial recovery was observed post-lockdown, but scores remained above baseline. Loneliness emerged as a key predictor of mental health outcomes, particularly during post-lockdown phases. The immediate post-lockdown period was identified as a critical window for interventions.Conclusions: COVID-19 lockdowns were associated with heightened loneliness and mental health challenges, with sustained effects post-lockdown. Timely interventions targeting loneliness, especially after periods of social restriction, are essential to mitigate long-term mental health impacts and inform future responses to global crises.

Background

There is substantial evidence showing that mental health of young people has been more vulnerable to the COVID-19 pandemic than that of other age groups in Western well-off countries, including Switzerland and Germany [1-5]. However, studies of a longer trend, spanning pre-, during post-pandemic period tend to suggest that young people adapted to the challenges of the pandemic. That is, an initial increase in mental health problems has been to some extent compensated by a decline, with the trend going back to baseline – that is characterised by a continuous overall rise in mental health problems [5]. We are not aware of any existing quantitative research on how the mental health of children in care has evolved during the pandemic, with qualitative interviews constituting most of the evidence to date.

Mental health of children in care

As shown by the interviews conducted across professions with child protection responsibilities in the United Kingdom, referrals were more serious and complex during the pandemic [6, 7]. This might have been due to delays in identifying the children’s needs, because of the reduced contact with professionals [6, 7]. Moreover, transitioning to online forms of contact disrupted communication between children in care and their biological families, and between children and their caregivers, hindering reunification [8-11]. This might have contributed to the children feeling abandoned, which could negatively impact their mental health [12]. Finally, interviews with representatives from 67 non-governmental organisations in 14 different countries indicated that, because of the pandemic, children in residential care were being returned to their biological families without receiving appropriate preparation and counselling, potentially resulting in greater risk to these children [13]. On the other hand, some children reported improved mental health during the lockdowns. This was due to reduced pressure associated with not having to attend school, which was often a source of conflict with their carers [7]. Others appeared to enjoy better mental health due to improved relationships with carers and residential staff as they spent more time together [12]. Also, there were some reports of relationships between young people and families being perceived as more supportive during the pandemic, which could have also contributed to better mental health of young people in care [7, 14]. Hence, based on the current, mainly qualitative, evidence it is difficult to speculate about the nature of the population-average trend in mental health of young people in care. The experiences of children in care appear to be highly heterogeneous, which could be associated both improved and worsened mental health.

Discrepancies between children’s and caregiver’s reports

Another layer of complexity is that the trends may vary depending on who provides information about young people’s mental health. Studies show only moderate correlations between reports by young people themselves and their parents, teachers or stepparents [15-17]. A recent study investigated trends in mental health of Dutch children and adolescents (8–18 years), both from general and clinical populations, comparing reports of children and their parents [18]. It found that while in the general population the child and parents reports followed a similar secular trend – with internalising problems increasing between the pre-pandemic and during pandemic – in the clinical population there was a substantial discrepancy between the informants. Children in the clinical population disclosed increasing internalising problems from pre-pandemic and over the course of the pandemic, while a stable trend was observed in parental reports. The predictors of these disagreements are unknown. When parents reported more symptoms in previous studies, low educational level of the parent, low income and male gender of the child, parents’ mental health and the quality of parent-child relationships appeared to be important in explaining parent-child discrepancies [16, 19]. Due to these disagreements, it is important to examine trends in mental health among children in care across different informants, as they may point towards differences findings.

References 1. Blendermann M, Ebalu TI, Obisie-Orlu IC, Fried EI, Hallion LS. A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic. Psychol Med. 2023:1-24. 2. Cénat JM, Farahi SMMM, Dalexis RD, Darius WP, Bekarkhanechi FM, Poisson H, et al. The global evolution of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis of longitudinal studies. Journal of Affective Disorders. 2022;315:70-95. 3. Sun Y, Wu Y, Fan S, Dal Santo T, Li L, Jiang X, et al. Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts. BMJ. 2023;380:e074224. 4. Prati G, Mancini AD. The psychological impact of COVID-19 pandemic lockdowns: a review and meta-analysis of longitudinal studies and natural experiments. Psychol Med. 2021;51(2):201-11. 5. Gondek D, Vandecasteele L, Sánchez-Mira N, Steinmetz S, Mehmeti T, Voorpostel M. The COVID-19 pandemic and wellbeing in Switzerland-worse for young people? Child and Adolescent Psychiatry and Mental Health. 2024;18(1):67. 6. Baginsky M, Manthorpe J. The impact of COVID-19 on Children’s Social Care in England. Child Abuse & Neglect. 2021;116:104739. 7. Driscoll J, Hutchinson A, Lorek A, Kiss K, Kinnear E. Hearing the Voice of the Child through the Storm of the Pandemic: The Impact of covid-19 Measures on the Detection of and Response to Child Protection Concerns. The International Journal of Children's Rights. 2021;29(2):400-25. 8. Haffejee S, Levine DT. 'When will I be free': Lessons from COVID-19 for Child Protection in South Africa. Child Abuse Negl. 2020;110(Pt 2):104715. 9. Neil E, Copson R, Sorensen P. Contact during lockdown:How are children and their birth families keeping in touch? Briefing paper. London: Nuffield Family Justice Observatory/University of East Anglia; 2020. 10. Callejas LM, Abella AD, Ismajli F. Rapid Ethnographic Assessment of Pandemic Restrictions in Child Welfare: Lessons from Parent and Provider Experiences. Human Organization. 2020;79(4):304-12. 11. Singer J, Brodzinsky D. Virtual parent-child visitation in support of family reunification in the time of COVID-19. Developmental Child Welfare. 2020;2(3):153-71. 12. Ofsted. COVID-19 series: briefing on children's social care. Manchester, UK: The Office for Standards in Education, Children’s Services and Skills (Ofsted) 2020. 13. Wilke NG, Howard AH, Pop D. Data-informed recommendations for services providers working with vulnerable children and families during the COVID-19 pandemic. Child Abuse Negl. 2020;110(Pt 2):104642. 14. Ferguson H, Kelly L, Pink S. Research Briefing Two: Disruption and renewal of social work and child protection during COVID-19 and beyond. Birmingham, UK: University of Birmingham; 2020. 15. Rescorla LA, Ewing G, Ivanova MY, Aebi M, Bilenberg N, Dieleman GC, et al. Parent–Adolescent Cross-Informant Agreement in Clinically Referred Samples: Findings From Seven Societies. Journal of Clinical Child & Adolescent Psychology. 2017;46(1):74-87. 16. Brocker SA, Steinbach A, Augustijn L. Parent-child Discrepancies in Reporting Children’s Mental Health: Do Physical Custody Arrangements in Post-separation Families Matter? Child Indicators Research. 2024;17(1):197-220. 17. Van Roy B, Groholt B, Heyerdahl S, Clench-Aas J. Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors. BMC Psychiatry. 2010;10(1):56. 18. Fischer K, Tieskens JM, Luijten MAJ, Zijlmans J, van Oers HA, de Groot R, et al. Internalizing problems before and during the COVID-19 pandemic in independent samples of Dutch children and adolescents with and without pre-existing mental health problems. Eur Child Adolesc Psychiatry. 2023;32(10):1873-83. 19. Van Roy B, Groholt B, Heyerdahl S, Clench-Aas J. Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors. BMC Psychiatry. 2010;10:56. 20. Döpfner M, Plück J, Kinnen C, Arbeitsgruppe Deutsche Child Behavior Checklist. CBCL/4-18R, YSR and TRF: German school-age forms of the Child Behavior Checklist by Thomas M. Achenbach. Göttingen: Hogrefe; 2014. 21. Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms & profiles: an integrated system of mult-informant assessment. Burlington: University of Vermont, Research Center for Children, Youth & Families; 2001. 22. Chen FF. Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling. 2007;14(3):464-504. 23. Ditzen J, Karavias Y, Westerlund J. Testing and Estimating Structural Breaks in Time Series and Panel Data in Stata," Discussion Papers 21-14. Department of Economics, University of Birmingham: Birmingham, UK; 2021. 24. Bai J, Perron P. Estimating and Testing Linear Models with Multiple Structural Changes. Econometrica. 1998;66(1):47-78.

This data was collected to explore the effects of the COVID-19 pandemic and the pandemic restrictions on people with severe mental ill health. The data was collected between July 2020 and December 2020. Participants were asked about their use of and ability to access health services during the pandemic, their physical and mental health, loneliness and social isolation, digital connectivity, health related behaviours (e.g, smoking , physical activity etc) and employment. People with severe mental ill health experience a mortality gap of between 15 and 20 years compared to the general population and it is possible that the COVID-19 pandemic will lead to worse inequalities for vulnerable groups, people with severe mental ill health are one such group. The aim of this project therefore was to explore and effects of the COVID-19 pandemic and pandemic restrictions on people with severe mental ill health, in terms of access to health services, their physical and mental health, health risk behaviours, loneliness and social isolation and digital connectivity. Participants completed questions in the the following domains, health and wellbeing, service use, everyday habits, social support, use of internet and digital services and employment. Participants were sampled with a range of demographics and contacted by telephone and invited to take part in the study. Participants were offered the option of completing the survey over the phone with a researcher, online or hard copy which they completed and returned in the post.

At the start of the COVID-19 pandemic, there was uncertainty surrounding the diagnosis, prevalence, phenotype, duration, and treatment of Long COVID. This study aimed to (A) describe the clinical phenotype of post-COVID symptomatology in children and young people (CYP) with laboratory-confirmed SARS-CoV-2 infection compared with test-negative controls, (B) produce an operational research definition of Long COVID in CYP, and (C) establish its prevalence in CYP.

In total 219,175 CYP aged 11-17 years who had a positive (n=91,014) or negative (n=128,161) PCR test for SARS-CoV-2 between September 2020 and March 2021 in England were invited to participate. Test-positive and test-negative CYP were matched, at study invitation, on month of test, age, sex, and geographical region. 31,012 consenting CYP enrolled into the study at 3-, 6- or 12-months after their index-PCR test and, depending on when they enrolled, they were also invited to fill in follow-up questionnaires at 6-, 12-, and 24-months post index-test. The overall response rate was 14.1%, with retention across sweeps varying from 36.6% to 54.1%.

A sub-study was set up in January 2022 when the Omicron variant was dominant. In the sub-study an additional 5,135 CYP who were PCR positive for the first time in January 2021 were invited, along with 4,507 who were reinfected during this period, and 5,157 who remained PCR-negative. 3,046 consenting CYP enrolled into the sub-study and filled in questionnaires at 0-, 3-, and 6- and 12-months after testing.

The datasets include repeat self-reported information on CYP's physical and mental health over time, using validated scales. For the main sample, flexible survey weights have been developed to re-weight analyses to be nationally representative of CYP in England.

Further information is available on the UCL Long COVID in Children and Young People (The CLoCk Study) webpages.

Suitable data analysis software
The depositor provides these data in R format (.rda). Users are strongly advised to analyse them in R, as transfer to other formats may result in unforeseen issues.

IntroductionThe COVID-19 pandemic increased public use of digital mental health technologies. However, little is known about changes in user engagement with these platforms during the pandemic. This study aims to assess engagement changes with a digital mental healthcare service during COVID-19.MethodsA cohort study based on routinely collected service usage data from a digital mental health support service in the United Kingdom. Returning users aged 14–25 years that interacted for a maximum of two months were included. The study population was divided into pre-COVID and COVID cohorts. Demographic and usage information between cohorts were compared and usage clusters were identified within each cohort. Differences were tested using Chi-squared, two-sample Kolmogorov–Smirnov tests and logit regressions.ResultsOf the 624,103 users who joined the service between May 1, 2019, and October 1, 2021, 18,889 (32.81%) met the inclusion criteria: 5,048 in the pre-COVID cohort and 13,841 in the COVID cohort. The COVID cohort wrote more journals; maintained the same focus on messaging practitioners, posting discussions, commenting on posts, and having booked chats; and engaged less in writing journals, setting personal goals, posting articles, and having ad-hoc chats. Four usage profiles were identified in both cohorts: one relatively disengaged, one focused on contacting practitioners through chats/messages, and two broadly interested in writing discussions and comments within the digital community. Despite their broad similarities, usage patterns also exhibited differences between cohorts. For example, all four clusters had over 70% of users attempting to have ad-hoc chats with practitioners in the pre-COVID cohort, compared to one out of four clusters in the COVID cohort. Overall, engagement change patterns during the COVID-19 pandemic were not equal across clusters. Sensitivity analysis revealed varying strength of these defined clusters.DiscussionOur study identified changes in user activity and engagement behavior within a digital mental healthcare service during the COVID-19 pandemic. These findings suggest that usage patterns within digital mental health services may be susceptible to change in response to external events such as a pandemic. Continuous monitoring of engagement patterns is important for informed design and personalized interventions.

Background: The incidence of mental illness has risen since the coronavirus disease 2019 (COVID-19) pandemic. The number of healthcare workers (HCWs) needing mental health support has increased significantly. Objective: This secondary analysis of qualitative data explored the coping strategies of migrant HCWs living in the UK during the COVID-19 pandemic. Our aim was to identify the coping strategies used by migrant HCWs, and how they could be explored post-pandemic as support mechanisms of an increasingly diverse workforce. Method: As part of the United Kingdom Research study into Ethnicity And COVID-19 outcomes among Healthcare workers (UK-REACH), we conducted in-depth semi-structured interviews and focus groups with clinical and non-clinical HCWs across the UK, on Microsoft Teams, from December 2020 to July 2021. We conducted a thematic analysis using Braun and Clarke’s framework to explore the lived experiences of HCWs born overseas and living in the UK during the COVID-19 pandemic. The key themes that emerged were described using Lazarus and Folkman’s transactional model of stress and coping. Results: The emerging themes include stressors (situation triggering stress), appraisal (situation acknowledged as a source of stress), emotion-focused coping (family and social support and religious beliefs), problem-focused coping (engaging in self-care, seeking and receiving professional support), and coping strategy outcomes. The participants described the short-term benefit of the coping strategies as a shift in focus from COVID-19, which reduced their anxiety and stress levels. However, the long-term impact is unknown. Conclusion: We found that some migrant HCWs struggled with their mental health and used various coping strategies during the pandemic. With an increasingly diverse healthcare workforce, it will be beneficial to explore how coping strategies (family and social support networks, religion, self-care, and professional support) could be used in the future and how occupational policies and infrastructure can be adapted to support these communities. Migrant (non-UK-born) HCWs used various coping strategies to sustain their mental health during the COVID-19 pandemic.The study conceptualized the coping mechanisms that enabled participants to cope with the COVID-19 pandemic crisis, using Lazarus and Folkman's transactional model of stress and coping.Future research should explore whether short-term gains due to coping during the pandemic were maintained in the long term. Migrant (non-UK-born) HCWs used various coping strategies to sustain their mental health during the COVID-19 pandemic. The study conceptualized the coping mechanisms that enabled participants to cope with the COVID-19 pandemic crisis, using Lazarus and Folkman's transactional model of stress and coping. Future research should explore whether short-term gains due to coping during the pandemic were maintained in the long term.

Objective: The purpose of this meta-analysis was to summarize the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic.Methods: We applied an optimized search strategy across the PubMed, EMBASE, Scopus, PsycINFO, and four Chinese databases, with hand searching supplemented to identify relevant surveys. Studies were eligible for inclusion if they were published in peer-reviewed literature and used a validated method to assess the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. Heterogeneity was quantified using Q statistics and the I2 statistics. The potential causes of heterogeneity were investigated using subgroup analysis and meta-regression analysis. Sensitivity analysis was performed to examine the robustness of the results.Results: We pooled and analyzed data from 20 studies comprising 10,886 healthcare workers. The prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive–compulsive symptoms, and somatization symptoms was 24.1, 28.6, 44.1, 25.6, 35.0, 16.2, and 10.7%, respectively. Female and nurses had a high prevalence of depression and anxiety. Frontline healthcare workers had a higher prevalence of anxiety and a lower prevalence of depression than the those in the second-line. Furthermore, the proportion of moderate–severe depression and anxiety is higher in the frontline. Additionally, four studies reported on risk factors of mental health problems.Conclusions: In this systematic review, healthcare workers have a relatively high prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive–compulsive symptoms, and somatization symptoms during the COVID-19 pandemic, and focus should be on the healthcare workers at high risk of mental problems. Mental health problems in healthcare workers should be taken seriously, and timely screening and appropriate intervention for the high-risk group are highly recommended.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020179189.

In the first quarter of 2025, an estimated 2.78 million people were economically inactive due to being on long-term sickness leave in the UK, slightly down from a peak of over 2.84 million people in the fourth quarter of 2023. This figure has been rising considerably since 2019, when there were just over two million people economically inactive for this reason. Since the third quarter of 2021, long-term and temporary sickness has been the main reason that people were economically inactive, accounting for 32.1 percent of economic inactivity in the fourth quarter of 2024. What is driving the increase in long-term sickness? It is unclear if there are any specific reasons for the continued growth of long-term sickness in the UK. As of 2022, some of the most common health conditions cited as the reason for long-term sickness were to do with mental health issues, with 313,00 suffering from mental illness, and a further 282,000 for depression-related illness. It is also likely that the COVID-19 pandemic caused an impact, with around 1.8 million people in April 2022 reporting an experience of Long Covid. In general, while the majority of people on long-term sick leave are over the age of 50, there has been a noticeable increase in those aged under 35 being off on long-term sickness. Between 2019 and 2022, the number of those aged between 16 and 34 on long-term sickness increased by 140,000, compared with just 32,000 for those aged between 35 and 49. UK labor market set to continue cooling in 2025? In 2022, the UK labor market was slightly more weighted in favor of workers and people looking for work than usual. Unemployment fell to historical levels, while job vacancies reached a peak of more than 1.3 million in May. Wage growth also remained strong during this period, although as this occurred at a time of high inflation, wages fell in real terms for a long period between November 2021 and June 2023. Although the job market continued to show signs of resilience, for some time, there are signs this is now changing. In December 2024, the UK unemployment rate was 4.4 percent, a joint post-pandemic high, while in the same month job vacancies fell to their lowest level since May 2021.

ObjectiveThis meta-review aimed to provide a comprehensive overview of overall mental health of healthcare professionals during the COVID-19 pandemic.MethodWe conducted a comprehensive literature search on Academic Search Premier, CINAHL, Cochrane Library, and MEDLINE. A predefined eligibility criterion was used to screen the articles. The methodology quality of eligible studies was assessed using Joanna Briggs Institute checklist for systematic reviews. The data were narratively synthesised in line with the meta-review aim.ResultForty systematic reviews (represented as K = 40), which reported data from 1,828 primary studies (N) and 3,245,768 participants, met the inclusion criteria. The findings from a pooled prevalence indicate that anxiety (16–41%, K = 30, N = 701), depression (14–37%, K = 28, N = 584), and stress/post-traumatic stress disorder (18.6–56.5%, K = 24, N = 327) were the most prevailing COVID-19 pandemic-related mental health conditions affecting healthcare workers. Other reported concerns included insomnia, burnout, fear, obsessive-compulsive disorder, somatization symptoms, phobia, substance abuse, and suicidal thoughts. Considering regions/countries, the highest anxiety was reported in the United-Kingdom [22.3, 95% Confidence Interval (CI):7–38, N = 4] compared to other countries, while the highest depression was in the Middle-East, (41, 95% CI:16–60, N = 5) and stress in the Eastern Mediterranean region (61.6, 95% CI:56.4–66.8, N = 2) compared to other regions. The most significant risk factors include female gender, younger age, being a nurse, and frontline professional. The most-reported coping strategies include individual/group psychological support, family/relative support, training/orientation, and the adequacy of personal protective equipment.ConclusionIt was concluded that healthcare professionals (nurses, doctors, allied health) have experienced various mental health issues during COVID-19 pandemic. The meta-review, therefore, recommends targeted interventions and health policies that address specific mental health issues to support health professionals worldwide during the duration of the COVID-19 pandemic and similar future health crises.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD4202126200, identifier: CRD42021262001.

Background: Mental health burden has been massively reported during the COVID-19 pandemic period. Aiming to summarise these data, we present a meta-review of meta-analyses that evaluated the impact of COVID-19 pandemic on anxiety, depressive and stress symptoms, psychological distress, post-traumatic stress disorder/symptoms (PTSD), and sleep disturbance, reporting its prevalence on general public (GP) and health care workers (HCW).Methods: A search was performed in the PubMed, EMBASE, and the Web of Science. Sleep disturbances, psychological distress, stress, and burnout were grouped as “Psychophysiological stress,” and anxiety, depression, and PTSD were grouped as “Psychopathology.” A random-effects model, calculating the pooled prevalence together with 95% confidence interval was performed for each domain. Subgroup analyses were performed for each population type (GP and HCW) and for each mental health outcome. For anxiety and depression, subgroup analysis for population type was performed. Heterogeneity is reported as I2. Publication bias was assessed through visual inspection of the funnel plot, and further tested by Egger's test and trim and fill analyses.Results: A total of 18 meta-analyses were included. The prevalence of psychophysiological stress was 31.99% (CI: 26.88–37.58, I2 = 99.9%). HCW showed a higher prevalence (37.74%, CI: 33.26–42.45, I2 = 99.7%) than the GP (20.67%, 15.07–27.66, I2 = 99.9%). The overall prevalence of insomnia, psychological distress, and stress were, respectively, 32.34% (CI: 25.65–39.84), 28.25% (CI: 18.12–41.20), and 36% (CI: 29.31–43.54). Psychopathology was present at 26.45% (CI: 24.22–28.79, I2 = 99.9%) of the sample, with similar estimates for population (HCW 26.14%, CI: 23.37–29.12, I2 = 99.9%; GP: 26.99%, CI: 23.41–30.9, I2 = 99.9%). The prevalence of anxiety, depression, and PTSD was 27.77% (CI: 24.47–31.32), 26.93% (CI: 23.92–30.17), and 20% (CI: 15.54–24.37), respectively. Similar proportions between populations were found for anxiety (HCW = 27.5%, CI: 23.78–31.55; GP = 28.33%, CI: 22.1–35.5) and depression (HCW = 27.05%, CI: 23.14–31.36; GP = 26.7%, CI: 22.32–31.59). Asymmetry in the funnel plot was found, and a slight increase in the estimate of overall psychopathology (29.08%, CI: 26.42–31.89) was found after the trim and fill analysis.Conclusions: The prevalence of mental health problems ranged from 20 to 36%. HCW presented a higher prevalence of psychophysiological stress than the general population.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=252221, identifier: CRD42021252221.

Characteristics of the adult population aged 65+with multimorbidity and active depression in Northwest London during Covid-19 lockdown (Period 1, 23rd Mar 2020 – 21st June 2021) and post Covid-19 lockdown (Period 2, 22nd June 2021 – 19th Sept 2022).

Multivariate logistic regression model of risk of at least one emergency hospital admission during the Covid-19 lockdown (period 1) and post-lockdown (period 2).

BackgroundThe emergence of a new coronavirus strain caused the COVID-19 pandemic. While vaccines effectively control the infection, it’s important to acknowledge the potential for side effects, including rare cases like psychosis, which may increase with the rising number of vaccinations.ObjectivesOur systematic review aimed to examine cases of new-onset psychosis following COVID-19 vaccination.MethodsWe conducted a systematic review of case reports and case series on new-onset psychosis following COVID-19 vaccination from December 1st, 2019, to November 21st, 2023, using PubMed, MEDLINE, ClinicalKey, and ScienceDirect. Data extraction covered study and participant characteristics, comorbidities, COVID-19 vaccine details, and clinical features. The Joanna Briggs Institute quality assessment tools were employed for included studies, revealing no significant publication bias.ResultsA total of 21 articles described 24 cases of new-onset psychotic symptoms following COVID-19 vaccination. Of these cases, 54.2% were female, with a mean age of 33.71 ± 12.02 years. Psychiatric events were potentially induced by the mRNA BNT162b2 vaccine in 33.3% of cases, and psychotic symptoms appeared in 25% following the viral vector ChAdOx1 nCoV-19 vaccine. The mean onset time was 5.75 ± 8.14 days, mostly reported after the first or second dose. The duration of psychotic symptoms ranged between 1 and 2 months with a mean of 52.48 ± 60.07 days. Blood test abnormalities were noted in 50% of cases, mainly mild to moderate leukocytosis and elevated C-reactive protein. Magnetic resonance imaging results were abnormal in 20.8%, often showing fluid-attenuated inversion recovery hyperintensity in the white matter. Treatment included atypical antipsychotics in 83.3% of cases, typical antipsychotics in 37.5%, benzodiazepines in 50%, 20.8% received steroids, and 25% were prescribed antiepileptic medications. Overall, 50% of patients achieved full recovery.ConclusionStudies on psychiatric side effects post-COVID-19 vaccination are limited, and making conclusions on vaccine advantages or disadvantages is challenging. Vaccination is generally safe, but data suggest a potential link between young age, mRNA, and viral vector vaccines with new-onset psychosis within 7 days post-vaccination. Collecting data on vaccine-related psychiatric effects is crucial for prevention, and an algorithm for monitoring and treating mental health reactions post-vaccination is necessary for comprehensive management.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD42023446270.