key: cord-0951128-pbcd8f3x
authors: Salanti, Georgia; Cipriani, Andrea; Furukawa, Toshi A; Peter, Natalie; Tonia, Thomy; Papakonstantinou, Theodoros; Holloway, Alexander; Leucht, Stefan
title: An efficient way to assess the effect of COVID-19 on mental health in the general population
date: 2021-03-16
journal: Lancet Psychiatry
DOI: 10.1016/s2215-0366(21)00067-5
sha: bb6439a3bba354aa2414b4deea8d8e188f2f859f
doc_id: 951128
cord_uid: pbcd8f3x

nan

A meta-ecological study to assess the effect of the COVID-19 pandemic on mental health Schematic presentation of a meta-ecological study to associate time and location specific COVID-19 pandemic characteristics and stringency of containment policies with changes in population mental health while adjusting for population and setting characteristics. Cylinders represent data sources that will inform exposures and outcomes. The answers to these questions cannot be provided by a single study because the exposures of interest (ie, local characteristics of the pandemic and stringency of containment measures) would apply to all participants. Longitudinal studies can play a part in examining the associations of interest but they are limited in population representation. A meta-ecological study is needed to explore the effect of geographically and temporally different pandemic characteristics on populations' mental health. Despite their potential shortcomings due to confounding and aggregation bias, meta-ecological study designs have successfully answered similar global questions, such as the role of air pollution on morbidity. 2 In a meta-ecological study, a systematic review of prevalence before and during the pandemic in various locations with different responses to the pandemic should shed light on changes in mental health problems (figure). Since February, 2020, many COVID-19 studies have been published, and creative approaches, such as crowdsourcing, are needed to undertake parts of the systematic review. 3 Lay volunteers can be trained to screen and evaluate identified studies in a rapid, yet reproducible way. Then, publicly available information can be used to quantify the intensity of the pandemic and the stringency of containment measures locally and associate them with the changes in prevalence of mental health problems. As the COVID-19 pandemic is likely to continue, the whole process needs to be repeated as a living systematic review. 4 In our Mental Health in COVID-19 meta-epidemiological study, 75 trained crowd volunteers with experience in systematic reviews have screened more than 25 000 references. Such a study presents many challenges. Confounding and moderating factors need to be explored via metaregression techniques. Studies are expected to be heterogeneous in the way they measure symptoms and diagnoses, and potentially large uncertainty in model input should be accounted for.

Because the study uses published and regularly updated information, it does not require expensive or time-consuming data collection. The crowdsourcing approach will speed up the process and could be the way forward to do large-scale research in times of social isolation. Investment in methods for harnessing information in a reliable and rapid way will enable decision makers worldwide to integrate a mental health science perspective into their response to the pandemic.

Centers for Disease Control and Prevention. COVID-19: coping with stress

Publichealth impact of outdoor and traffic-related air pollution: a European assessment

Crowd research: open and scalable university laboratories

Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap

AC reports grants and personal fees from the Italian Network for Paediatric Trials and Angelini Pharma; and personal fees from the Cariplo Foundation, outside the submitted work.