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Home COVID-19

A comparison of two US national surveys points to an increase in serious psychological distress during the COVID-19 pandemic

by Beth Ellwood
July 30, 2020 - Updated on September 27, 2020
in COVID-19, Mental Health
(Photo credit: andranik123)

(Photo credit: andranik123)


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While a US national survey from 2018 showed a 3.9% prevalence of serious psychological distress, national data from 2020 revealed a prevalence more than three times as large at 13.6%. This finding was recently published in the Journal of the American Medical Association.

Numerous studies have reported on the mental health consequences of the COVID-19 pandemic, suggesting an increased prevalence of loneliness and depression. As researchers Emma E. McGinty and her team express, the novel coronavirus brought with it numerous psychological stressors, including, “loneliness stemming from social isolation, fear of contracting the disease, economic strain, and uncertainty about the future.”

McGinty and associates compared national data from two surveys taken two years apart to examine how the mental health of US citizens may have changed as a result of the pandemic.

Between April 7 and April 13, 2020, a total of 1,468 US adults completed the Kessler 6 Psychological Distress scale to assess the prevalence of symptoms of serious psychological distress. This data was part of the Johns Hopkins COVID-19 Civic Life and Public Health Survey which was designed to be representative of the US population.

Researchers then compared this data to the 2018 National Health Interview Survey which was also nationally representative and included 25,417 adults. Participants had completed an identical measure of distress — the Kessler 6 scale.

While in 2018, only 3.9% of respondents showed symptoms of severe psychological distress (a score of 13 or higher on the Kessler 6 scale), in April 2020, this number was 13.6%. As the authors suggest, this jump in distress symptoms is concerning when it comes to the future mental health of Americans. “The measure of serious psychological distress derived from the Kessler 6 scale has been shown to accurately predict serious mental illness, suggesting acute distress during COVID-19 may transfer to longer-term psychiatric disorders,” the researchers say.

The 2020 survey showed that young adults aged 18-29, Hispanic adults, and those with a household income below $35,000 a year were most likely to experience distress. Those who were the least likely to report serious distress were adults over 55 years old.

Interestingly, while 13.8% of 2020 respondents indicated that they felt lonely either often or always, a national survey on loneliness conducted in April and May 2018 reported a prevalence that was only slightly higher, with 11% feeling lonely often or always. McGinty and colleagues, therefore, propose that “other factors may be driving psychological distress during the COVID-19 pandemic.”

The authors address the limitation that sampling and recruitment methods differed between the two surveys and, therefore, selection bias may have occurred. Still, both surveys were designed to be nationally representative of US adults.

The study, “Psychological Distress and Loneliness Reported by US Adults in 2018 and April 2020”, was authored by Emma E. McGinty, Rachel Presskreischer, Hahrie Han, and Colleen L. Barry.

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