A Global Meta-Analysis of Depression, Anxiety, and Stress Before and During COVID-19

Abstract

Objective: This meta-analysis compared negative emotions (NEs) as depression, anxiety, and stress, from before the pandemic to during the pandemic. Method: A total of 59 studies (19 before, 37 during-pandemic, and 3 that included both) using the Depression, Anxiety and Stress Scale (DASS) were included. A random effects model estimated the means of NEs before and during the pandemic. Results: Studies from 47 countries involving 193,337 participants were included. Globally, NEs increased during the pandemic, and depression had the largest elevation. In Asia, depression and stress were elevated, whereas in Europe, only depression increased, and in America, no differences in NEs between before and during the pandemic were observed. The later time phase of the pandemic was associated with lower stress globally, and lower stress and anxiety in Europe. Being younger was associated with more stress globally, and being older was associated with higher anxiety in Asia. Students had higher anxiety globally, and higher NEs in all three aspects in Europe compared to the general population. The COVID-19 infection rate was associated with more stress globally, and stress and anxiety in Europe. During the pandemic, females reported higher levels of depression, anxiety, and stress compared to males, most pronounced in Europe. Conclusion: NEs increased during the pandemic, with younger and student populations, females and Asians having the highest elevations. (PsycInfo Database Record (c) 2024 APA, all rights reserved)