Mental health and resilience after the covid-19 pandemic: a multi-ethnic longitudinal survey

Jennifer Sumner; Mark Chen; Alexius Matthias Soh Sheng En; Vanessa Lim Wei Xun; Sin Hui Neo; Yee Wei Lim

doi:10.1186/s12889-023-17230-1

Mental health and resilience after the covid-19 pandemic: a multi-ethnic longitudinal survey

BMC Public Health. 2023 Nov 25;23(1):2340. doi: 10.1186/s12889-023-17230-1.

Authors

Jennifer Sumner^{1

2}, Mark Chen³, Alexius Matthias Soh Sheng En³, Vanessa Lim Wei Xun³, Sin Hui Neo⁴, Yee Wei Lim^{5

4}

Affiliations

¹ Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. Jennyssumner@gmail.com.
² Medical Affairs - Research Innovation & Enterprise, Alexandra Hospital, National University Health System, 378 Alexandra Road, Singapore, 159964, Singapore. Jennyssumner@gmail.com.
³ National Centre of Infectious Diseases, Singapore, Singapore.
⁴ Medical Affairs - Research Innovation & Enterprise, Alexandra Hospital, National University Health System, 378 Alexandra Road, Singapore, 159964, Singapore.
⁵ Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Abstract

Background: Longitudinal work on the impact of COVID-19 on population mental health and resilience beyond the first year of the pandemic is lacking. We aimed to understand how mental health and resilience evolved during the pandemic (2020) and two years later (2022) in a multi-ethnic Singaporean population. In addition, we assessed what characteristics were associated with mental health and resilience scores.

Methods: We surveyed and analysed two balanced panel samples up to four times between 30^th April 2020 and 11^th July 2022. One panel assessed psychological distress (Kessler-10) and well-being (short Warwick Edinburgh Mental Well-being scale) n = 313, and one panel assessed resilience (10-item Connor-Davidson Resilience Scale^©) n = 583. A linear panel regression model with random effects assessed the temporal patterns for psychological distress, well-being, and resilience.

Results: Mean psychological distress scores (Kessler-10) were relatively stable over time and were not statistically significantly worse than baseline at any follow-up. Well-being scores improved over time and were significantly better than baseline by the third survey (22^nd Jul-18th Aug 2020) (0.54 p = 0.007, Cohen's _d 0.12). Scores had worsened by the last survey (27^th June-11^th July 2022) but were not significantly different from baseline 0.20 p = 0.30. Resilience scores declined over time. Scores at both follow-ups (14th Aug- 4th Sep 2020 and 27^th June-11^th July 2022) were statistically significantly lower than baseline: -1.69 p < 0.001 (Cohen's _d 0.25) and -0.96 p = 0.006 (Cohen's _d 0.14), respectively.

Conclusions: Our study joins a body of work measuring the longitudinal effects of COVID-19 on population mental health and resilience. While, the magnitude of the effect related to resilience decline is small, our findings indicate that particular attention should be given to ongoing population surveillance, with the aim of maintaining good health and well-being.

Keywords: COVID-19; Mental health; Pandemics; Public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Asian People
COVID-19* / epidemiology
Ethnicity
Humans
Mental Health
Pandemics
Resilience, Psychological*
Singapore