How Do Covid-19 Stressors Affect Mental Health?

What you need to know

• The study found low rates of mental disorders and symptoms in Serbia during the Covid-19 pandemic
• Covid-related stressors like personal infection or infected family members were not strongly linked to poorer mental health
• Lack of protective equipment at work was associated with higher rates of anxiety disorders
• Other life stressors unrelated to Covid-19 showed stronger associations with mental health issues

Background and Purpose of the Study

The Covid-19 pandemic has raised concerns about potential negative impacts on mental health. While many studies have looked at mental health in the early stages of the pandemic, less is known about the longer-term effects as the pandemic continues. This study aimed to assess mental health in the general population of Serbia in the second year of the pandemic and examine how Covid-related stressors might be associated with mental health outcomes.

How the Study Was Conducted

The researchers conducted face-to-face interviews with a representative sample of 1,203 adults across Serbia between June and October 2021. They used standard diagnostic interviews and questionnaires to assess:

• Current mental disorders (like depression, anxiety disorders, and substance use disorders)
• Symptoms of depression and anxiety
• Experience of Covid-related stressors (personal infection, infected family members, quarantine, lack of protective equipment at work)
• Other life stressors not directly related to Covid-19

They then analyzed the relationships between these factors using statistical methods.

Key Findings on Mental Health Rates

Contrary to expectations of widespread mental health problems during the pandemic, the study found relatively low rates of mental disorders and symptoms:

• 15.2% of participants had at least one current mental disorder
• 4.6% had a mood disorder (like depression)
• 4.3% had an anxiety disorder
• 8.0% had a substance use disorder

The average scores on symptom questionnaires for depression and anxiety were also quite low, below the threshold considered clinically significant.

These rates are similar to or even lower than what has been found in general population studies before the pandemic. This suggests the pandemic may not have dramatically worsened mental health at a population level, at least in Serbia.

Covid-Related Stressors and Mental Health

The researchers looked at four main Covid-related stressors:

1. Personal infection with Covid-19
2. Having a close family member infected
3. Being required to quarantine/self-isolate
4. Lack of proper protective equipment at work

Many participants had experienced these stressors:

• 20.1% had been infected with Covid-19
• 43.2% had a close family member infected
• 27.5% had to quarantine at some point
• 28.2% reported lacking proper protective equipment at work

However, when accounting for other factors, most of these stressors did not show strong links to poorer mental health outcomes. The exception was lack of protective equipment at work, which was associated with higher rates of anxiety disorders.

Other Life Stressors May Have Bigger Impact

Interestingly, other stressful life events not directly related to Covid-19 showed stronger and more consistent associations with mental health problems. These included things like:

• Financial difficulties
• Relationship problems
• Loss of a loved one (not from Covid)
• Personal health problems

This suggests that while the pandemic created new stressors, traditional life challenges may still have a bigger influence on mental health for many people.

Factors Associated with Mental Health Issues

The study identified several factors linked to higher rates of mental disorders or symptoms:

• Being female (higher rates of anxiety, but lower substance use)
• Younger age (18-29 had highest rates of disorders)
• Being divorced
• Living in a larger city
• Having a physical health condition
• Prior history of mental health problems

These align with risk factors for mental health issues identified in pre-pandemic research.

Potential Explanations for the Findings

The researchers proposed a few reasons why mental health may not have worsened as much as feared:

• Resilience - People may have adapted and found ways to cope with pandemic-related stress over time
• Vaccination - About half the sample was vaccinated, which may have reduced anxiety about the virus
• Less restrictive measures - Serbia had relatively limited restrictions at the time of the study compared to earlier in the pandemic

It’s also possible that any mental health impacts peaked earlier in the pandemic and had started to improve by the time of this study.

Limitations to Consider

While this was a well-designed study, there are some limitations to keep in mind:

• It only provides a snapshot at one point in time - mental health may have been worse earlier in the pandemic
• The results may not generalize to other countries with different pandemic experiences or cultural factors
• People with the most severe mental health issues may have been less likely to participate

Conclusions

• The Covid-19 pandemic does not appear to have dramatically worsened mental health at a population level in Serbia, based on this study
• Most Covid-related stressors were not strongly linked to mental health problems
• Lack of proper protective equipment at work may increase risk of anxiety disorders
• Traditional life stressors unrelated to Covid-19 showed stronger associations with mental health issues
• More research is needed to understand the long-term mental health impacts as the pandemic continues

This study provides a more optimistic picture of population mental health during the pandemic than some earlier research. However, it also highlights the ongoing importance of addressing workplace safety and supporting those facing other life challenges that can impact mental wellbeing.