The challenge

The Covid-19 pandemic has resulted in unprecedented disruption to the fabric of society, our health service and the economy. The effects on mental health are also expected to be significant and potentially long-lasting, triggered by the widespread uncertainty created by the pandemic, and many of the public health interventions (eg social distancing, shielding) deployed to control the spread of the infection.

Relevance

The research has two main aims:

• to describe the short and medium-term effects of the pandemic on mental health,
• investigate how changes in mood might impact on our health.

The experience of stress, and other negative moods, over protracted periods, creates a dysregulation of physiological pathways normally involved in achieving homeostasis. Chief amongst these is the hypothalamic-pituitary-adrenal axis and the production of the hormone cortisol. Evidence shows that dysregulation in this hormone is associated with a range of adverse physical health outcomes, including outcomes related to the immune system and the inflammatory response. The significance of these adverse effects on the immune system is arguably heightened when the ‘threat’ in our environment is the highly infectious pathogen Covid-19 which is capable of giving rise to considerable morbidity and mortality.

Significance

The study will provide an understanding of the psychological and physical impact of the Covid-19 pandemic by measuring both self-reported psychological outcomes, as well as cortisol, to examine the extent to which the psychological effects translate into physiological distress, that may have implications for physical health.

The research

Two main predictions can be made about the psychological impact of the Covid-19 pandemic according to the Stress & Coping Theory. First, individuals will vary in their experience of stress according to their resources (for example, individuals who perceive they are at increased risk of the virus, may experience greater anxiety). Second, that prescribed social distancing measures may serve to amplify the psychological response because one of our key resources against stress (social support) is diminished.

The study will document the psychological impact of the Covid-19 pandemic in a community cohort within the first few weeks of social distancing measures being introduced and up to 9 months later. In addition, the team will:

1. Examine which social groups (e.g., age, gender, ethnicity) are at greatest risk of psychological morbidity.
2. Explore the modifiable psychological and social constructs associated with mental health outcomes, with a view to informing future interventions.
3. Determine whether and how the psychological impact of the pandemic might affect physical health via alterations in the stress biomarker cortisol

Making a difference

The research will result in one of two outcomes:

• Identify which social groups are at greatest risk of adverse mental health outcomes during this pandemic and inform the development of interventions to mitigate these effects.
• Examine whether and how the mental health impact of COVID-19 might affect physical well-being through dysregulation of the hormone cortisol

Website

University of Nottingham: https://www.covidstressstudy.com/

Outputs

BMJ Open - Mental health in the UK during the Covid-19 pandemic: Cross sectional analyses from a community cohort study

Funded by

NIHR School for Primary Care Research, NIHR Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry at King’s College London.