Mental ill-health in this country has become more prevalent and severe during the COVID-19 pandemic. This trend, despite infection control measures being less restrictive in Sweden than in most other countries, is revealed by a study by Uppsala University researchers recently published in European Psychiatry.
Psychology. Photo: Mikael Wallerstedt
“We found clinically significant levels of depression (30%), anxiety (24%) and insomnia (38%). These figures are comparable to the mental ill-health rates reported in similar studies during the pandemic in China and Italy,” says Professor Karin Brocki of the Department of Psychology.
“True, the studies vary in terms of certain methodological aspects, pandemic phases and recruitment strategies. But in spite of these inter-study variations, a negative impact on mental health can be seen in a substantial proportion of people in all the study countries.”
Brocki and her research colleagues Lance McCracken, Farzaneh Badinlou and Monica Buhrman started investigating mental health in Sweden during the pandemic at an early stage. More than 1500 people aged 18–88 took part in the web-based questionnaire survey.
Higher prevalence than before pandemic
Mental ill-health proved to be markedly worse than in a study of the Swedish population’s mental health, using the same measures of depression and anxiety, conducted before the pandemic. This study (Johansson et al., 2013) reported that some 10.8% of the population suffered from depression, while about 14.7% had clinically significant problems with anxiety.
The research group also investigated which groups are most severely affected with respect to various factors: demographic variables, risk and vulnerability factors, exposure to COVID-19 and worry related to COVID-19.
Those with previous mental ill-health hardest hit
Another finding was that it was individuals with a history of mental ill-health were those most afflicted by elevated levels of depression, anxiety and insomnia during the pandemic. The results indicate that the young adults who took part in the study were more susceptible to mental ill-health than the older participants.
“We speculate that this may be due to young people’s situation in life being more unstable, both financially and socially. As we were already aware, mental ill-health is found on a larger scale among younger than in older groups,” Brocki says.
Psychological flexibility – an ability to adapt to various circumstances – is an interesting factor.
“Our results show that this is a protective factor, while low psychological flexibility can also be a factor making people vulnerable to mental ill-health. This trait of flexibility can be improved by training, and responds to cognitive behavioural therapy.”
Greater support for the most susceptible
The study is subject to certain limitations. Although the group was fairly large, its gender composition was uneven (73% were women) and most respondents were aged 18–40 and employed full-time or studying. The majority had no underlying disease that exacerbated the risk of COVID-19 infection. On the other hand, the researchers succeeded in recruiting participants from every county in Sweden.
What practical recommendations can be made, then, based on the study results?
“To give greater support to those who are most at risk for negative effects on mental health and well-being. They include people with previous or current health problems or those who regard themselves as being in relatively poor general health,” Brocki thinks.
Lance M McCracken, Farzaneh Badinlou, Monica Buhrman, Karin C Brocki: Psychological impact of COVID-19 in the Swedish Population: Depression, Anxiety, and Insomnia and their Associations to Risk and Vulnerability factors