Cynnwys
- Main points
- Introduction
- Symptoms of depression before and during the coronavirus pandemic
- Characteristics of adults with depressive symptoms before and during the coronavirus pandemic
- Well-being and loneliness of adults during the coronavirus pandemic
- Factors associated with adults experiencing some form of depression during the coronavirus pandemic
- Glossary
- Measuring the data
- Strengths and limitations
- Related links
1. Main points
Almost one in five adults (19.2%) were likely to be experiencing some form of depression during the coronavirus (COVID-19) pandemic in June 2020; this had almost doubled from around 1 in 10 (9.7%) before the pandemic (July 2019 to March 2020).
One in eight adults (12.9%) developed moderate to severe depressive symptoms during the pandemic, while a further 6.2% of the population continued to experience this level of depressive symptoms; around 1 in 25 adults (3.5%) saw an improvement over this period.
Adults who were aged 16 to 39 years old, female, unable to afford an unexpected expense, or disabled were the most likely to experience some form of depression during the pandemic.
Feeling stressed or anxious was the most common way adults experiencing some form of depression felt their well-being was being affected, with 84.9% stating this.
Over two in five (42.2%) adults experiencing some form of depression during the pandemic said their relationships were being affected, compared with one in five (20.7%) adults with no or mild depressive symptoms.
Statistician's comment
“Today’s research provides an insight into the mental health of adults during the coronavirus pandemic. Revisiting this same group of adults before and during the pandemic provides a unique insight into how their symptoms of depression have changed over time.
Almost 1 in 5 adults were experiencing some form of depression during the pandemic, almost doubling from around one in 10 before the pandemic. Adults who were young, female, unable to afford an unexpected expense or disabled were the most likely to experience some form of depression during the pandemic.”
Tim Vizard, Principal Research Officer, Office for National Statistics
Nôl i'r tabl cynnwys2. Introduction
This article looks at depressive symptoms in adults in Great Britain before the coronavirus (COVID-19) pandemic (July 2019 to March 2020) and during the pandemic (June 2020). It looks at the same group of adults over a 12-month period, providing a unique perspective of how depression has changed over time.
Depression is among the most common types of mental disorders experienced by adults in Great Britain. It can affect people in different ways and can cause a wide variety of symptoms. These symptoms range from lasting feelings of unhappiness and hopelessness, to losing interest in the things they used to enjoy and feeling very tearful.
This article builds on research that suggests there has been an increase in levels of mental distress in adults during the coronavirus pandemic, compared with before the pandemic. Our analysis is based on data from the Opinions and Lifestyle Survey (OPN), a nationally representative survey of adults in Great Britain.
Adults taking part in the OPN were asked a series of questions to produce a score of depressive symptoms, using the eight-item Patient Health Questionnaire (PHQ-8) depression screener. This provides a self-reported measure of depression that gives an indication of the degree of an individual's depressive symptoms over the previous two weeks. These questions were asked of adults at two points in time over a 12-month period: before the coronavirus pandemic (July 2019 to March 2020) and during the coronavirus pandemic (June 2020). This means we can take a longitudinal look at whether their depressive symptoms had changed over time.
This article looks specifically at the characteristics of adults who were likely to be experiencing some form of depression before and during the pandemic. This is based on adults who reported having moderate to severe depressive symptoms, based on their response to the PHQ-8. Further information on how this has been calculated can be found in Section 8: Measuring the data.
In addition, this article looks at those adults who have experienced a change in depression before and during the pandemic. This includes adults who:
were likely to have developed moderate to severe depressive symptoms: having no or mild depressive symptoms before the pandemic and moderate to severe depressive symptoms during the pandemic
continued to have moderate to severe depressive symptoms: having moderate to severe symptoms both before and during the pandemic
have seen an improvement in depressive symptoms: having moderate to severe depressive symptoms before the pandemic and no to mild depressive symptoms during the pandemic
Finally, a logistic regression analysis has been conducted to look at the characteristics of adults likely to have some form of depression during the pandemic. This allows us to take a more detailed look at the characteristics of adults with depression while considering multiple characteristics at the same time.
Interpreting the findings in this report
When interpreting the findings in this release, it is important to note that the associations between characteristics and the presence of depression cannot explain causality. While the presence of a given characteristic may contribute to the development of depressive symptoms in adults, the presence of depression in adults may affect the characteristic in question. It is also important to note that there could be a variety of reasons for change in depressive symptoms before and during the pandemic, rather than this solely being a result of the coronavirus pandemic.
Further information on the PHQ-8, definitions of depression and regression analysis can be found in Section 8: Measuring the data.
Where to go for help
If you are affected by the topics covered in this article, the NHS provides useful information on the symptoms of depression and support available. Every Mind Matters also provides helpful advice on looking after your mental health during the coronavirus pandemic.
More about coronavirus
7. Glossary
Depression
Depression is among the most common types of mental disorders experienced by adults in Great Britain. It can affect people in different ways and can cause a wide variety of symptoms. These symptoms range from lasting feelings of unhappiness and hopelessness to losing interest in the things they used to enjoy and feeling very tearful. Further information can be found on the NHS website.
Disability
The definition of disability used is consistent with the core definition of disability in the Equality Act 2010. A person is considered to have a disability if they have a long-standing illness, disability or impairment that causes difficulty with day-to-day activities.
This was based on information collected in wave 2 of data collection in June 2020. This was because the information was not available at wave 1 of data collection. This should be considered when assessing change over time.
Ability to afford an unexpected expense
Adults were asked if their household could afford an unexpected but necessary expense of £850. This gives us an indication of adults who may be struggling financially.
This was based on information collected in wave 2 of data collection in June 2020. This was because the information was not available at wave 1 of data collection. This should be considered when assessing change over time.
Underlying health condition
An underlying health condition is a chronic or long-term illness that can cause the individual to be more at risk of the coronavirus (COVID-19) infection. This was based on information collected in wave 2 of data collection in June 2020. This was because the information was not available at wave 1 of data collection. This should be considered when assessing change over time.
Working status
For this article, a person is said to be a "working adult" if:
they had a paid job, either as an employee or self-employed
they did any casual work for payment
they did any unpaid or voluntary work in the previous week
Working adults were split into self-reported key worker and non-key worker status, provided during information collected in June 2020.
Adults who were not working were split into those who were aged 16 to 64 years old and those aged 65 years and older.
This was based on information collected in wave 2 of data collection in June 2020. This was because the information was not available at wave 1 of data collection. This should be considered when assessing change over time.
Rural Urban Classification
The Rural Urban Classification is an official statistic used to distinguish rural and urban areas. The Classification defines areas as rural if they are outside settlements with more than 10,000 resident population. Further information can be found in Rural Urban Classification.
Household size
Household size is a binary measure to indicate those who were living alone or living with others when they completed the survey. This measure was captured before (between July 2019 and March 2020) and during (June 2020) the coronavirus pandemic.
Parental status
Parental status is a binary measure to indicate those who had no children under the age of 16 years or at least one child under the age of 16 years.
This was based on information collected in June 2020. This was because the information was not available during data collection in July 2019 to March 2020. This should be considered when assessing change over time.
Nôl i'r tabl cynnwys8. Measuring the data
Opinions and Lifestyle Survey
Analysis in this report was based on the Opinions and Lifestyle Survey (OPN). Interviews initially took place between July 2019 and March 2020, with data collection taking place via telephone interview. Additional interviews took place between 4 and 14 June 2020, which was an online survey with an option for telephone interviewing for those unable to take part online. An achieved sample of 3,527 adults took place with data weighted to be a nationally representative sample for Great Britain.
More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in the OPN QMI.
Defining depression in adults
Adults taking part in the OPN were asked a series of questions to produce a score of depressive symptoms, using the eight item Patient Health Questionnaire (PHQ-8) depression screener. This is an established measure of depression that assesses the degree of an individual's depressive symptoms over the previous two weeks. These questions were asked of adults at two points in time over a 12-month period: before the coronavirus pandemic (July 2019 to March 2020) and during the coronavirus pandemic (June 2020).
The depression score is derived using eight questions from the PHQ-8. Respondents were asked the following eight questions, with four response options ranging from zero to three:
Over the last two weeks, how often have you been bothered by having little interest or pleasure in doing things?
Over the last two weeks, how often have you been bothered by feeling down, depressed or hopeless?
Over the last two weeks, how often have you been bothered by having trouble falling or staying asleep, or sleeping too much?
Over the last two weeks, how often have you been bothered by feeling tired or having little energy?
Over the last two weeks, how often have you been bothered by having a poor appetite or overeating?
Over the last two weeks, how often have you been bothered by feeling negative about yourself or that you are a failure or have let yourself or your family down?
Over the last two weeks, how often have you been bothered by having trouble concentrating on things, such as reading the newspaper or watching television?
Over the last two weeks, how often have you been bothered by moving or speaking so slowly that other people could have noticed; or being so fidgety or restless that you have been moving around a lot more than usual?
The score is then derived by summing all responses chosen, resulting in a score ranging from 0 to 24, which could be interpreted as follows:
0 to 4 - no depression
5 to 9 - mild depression
10 to 14 - moderate depression
15 to 19 - moderately severe depression
20 or more - severe depression
According to the NHS, adults with a PHQ-8 score of 10 or more are likely to be experiencing some form of depression. Therefore, adults have been grouped into those receiving a score of 10 or more (referred to as moderate to severe depressive symptoms in this article) and those experiencing a score of zero to nine (referred to as no or mild depressive symptoms in this article).
In addition, this article looks at those adults who have experienced a change in depression before and during the pandemic (July 2019 to June 2020). This includes adults who:
were likely to have developed moderate to severe depressive symptoms, indicated by a score of 0 to 9 before the pandemic and 10 or more during the pandemic
continued to have moderate to severe depressive symptoms, indicated by a score of 10 or more before and during the pandemic
have seen an improvement in depressive symptoms, indicated by a score of 10 or more before the pandemic and a score of zero to nine during the pandemic
Regression model
Two binomial logistic regression models were produced to explain the relationships between the presence and development of moderate to severe depressive symptoms and a range of factors. The logistic regression models allow us to explore which factors remain associated with moderate to severe depressive symptoms, while controlling for multiple factors at the same time, and how the likelihood of having some form of depression differs for each level within a factor (indicated by odds ratios).
Each model was produced based on nine factors of interest and a further two factors to control for mode of data collection and time of year of interview. These nine factors can be found in the accompanying dataset. Prior to selection of these factors, a test for multicollinearity was conducted to ensure factors in the model were not highly correlated with each other (potentially leading to biased outcomes in the model). All factors were included in the final model, to identify which factors were associated with moderate to severe depressive symptoms in adults. Data were also weighted prior to entering the logistic regression model to account for non-response bias and to sum to population totals.
Statistical significance
This article presents a summary of results, with further data including confidence intervals for the estimates contained in the associated datasets. Where comparisons between groups are presented, 95% confidence intervals should be used to assess the statistical significance of the change.
For the regression analysis, factors were found to be significant based on the p-value associated (Wald Chi-Squared Test) with each factor. The odds ratios were then assessed alongside a confidence interval around each category of interest.
Causality
It is important to note that the associations between characteristics in this article and the presence of depressive symptoms cannot explain causality. While the presence of a given characteristic may contribute to the development of depressive symptoms in adults, the presence of depressive symptoms in adults may affect the characteristic in question.
Nôl i'r tabl cynnwys9. Strengths and limitations
The main strengths of this analysis include:
collecting data from the same group of adults before and during the pandemic has enabled longitudinal analysis of the likelihood of some form of depression in adults before the pandemic and during the pandemic
the use of the Patient Health Questionnaire (PHQ-8) provides a robust measure of the presence of some form of depression in the population
robust methods are adopted for the survey's sampling and weighting strategies to limit the impact of bias
quality assurance procedures are undertaken throughout the analysis stages to minimise the risk of error
The main limitations of this analysis include:
the sample sizes for some groups of the population are relatively small, particularly for younger adults, which means that confidence intervals around some estimates are larger, providing less certainty around the estimate; consequently, detailed analyses for subnational geographies and some sub-groups are not possible
data collected before the pandemic (July 2019 to March 2020) were achieved via a telephone interview, while data collected during the pandemic (June 2020) were predominantly online, with an option for telephone interview where online data collection was not possible; this means mode of data collection may have had an effect on the response given by adults to the survey questions
some characteristics of adults were based on outcomes of adults during data collection in June 2020 because the information was not available at their first interview in July 2019 to March 2020; it is possible that their characteristics may have been different between these two periods, these characteristics are mentioned in the glossary section of this article
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