The situation regarding the COVID-19 pandemic has changed quickly due to changing case numbers and changing governmental restrictions indicating that mental health consequences may also have changed rapidly and differed by countries. The aim of our study was to describe and map changes in the scores of depression, anxiety, perceived and post-traumatic stress, and the use of alcohol in Estonia during the COVID-19 pandemic. The three waves of data collection were conducted (N = 202) in spring (T1), summer (T2) and fall (T3) in 2020. The survey included information about the study, a set of demographic, health and wellness questions, and a set of self-reported scales about mental health and wellbeing. At T3 there were a larger proportion of respondents whose Anxiety and Fatigue scores were above the cut-off point compared to T2. At T2 there were a larger proportion of respondents whose AUDIT-C score was above the cut-off point compared to T3. At T1 there was a larger proportion of respondents whose Agoraphobia and panic score was above the cut-off point compared to T3. This is the first Estonian longitudinal study mapping changes in mental health during the COVID-19 pandemic.
Ahmed, M. Z., O. Ahmed, Z. Aibao, S. Hanbin, L. Siyu, and A. Ahmad (2020) “Epidemic of COVID-19 in China and associated psychological problems”. Asian Psychiatry Journal 51, 102092.
https://doi.org/10.1016/j.ajp.2020.102092
Arias-de la Torre, J., G. Vilagut, A. Ronaldson, A. Serrano-Blanco, V. Martín, M. Peters, ... and J. Alonso (in press) “Prevalence and variability of current depressive disorder in 27 European countries: a population-based study”. The Lancet Public Health.
https://doi.org/10.1016/S2468-2667(21)00047-5
Bendau, A., J. Plag, S. Kunas, S. Wyka, A. Ströhle, and M. B. Petzold (2021) “Longitudinal changes in anxiety and psychological distress, and associated risk and protective factors during the first three months of the COVID-19 pandemic in Germany”. Brain and Behavior 11, 2, e01964.
https://doi.org/10.1002/brb3.1964
Cohen, S., T. Kamarck, and R. Mermelstein (1983) “A global measure of perceived stress”. Journal of Health and Social Behavior 24, 386–396.
https://doi.org/10.2307/2136404
Daly, M. and E. Robinson (2021) “Psychological distress and adaptation to the COVID-19 crisis in the United States”. Journal of Psychiatric Research 136, 603-609.
https://doi.org/10.1016/j.jpsychires.2020.10.035
Daly, M., A. R. Sutin, and E. Robinson (2020) “Longitudinal changes in mental health and the COVID-19 pandemic: evidence from the UK Household Longitudinal Study”. Psychological Medicine 13, 1–10. Doi:
https://doi.org/10.1017/S0033291720004432
DeVellis, R. F. (2003) Scale development: theory and applications. 2nd ed. California: SAGE Publications Inc.
Fancourt, D., A. Steptoe, and F. Bu (2021) “Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study”. The Lancet Psychiatry 8, 141-149.
https://doi.org/10.1016/S2215-0366(20)30482-X
González-Sanguino, C., B. Ausín, M. A. Castellanos, J. Saiz, and M. Muñoz (2021) “Mental health consequences of the Covid-19 outbreak in Spain: a longitudinal study of the alarm situation and return to the new normality”. Progress in Neuro-Psychopharmacology and Biological Psychiatry 107, 110219.
https://doi.org/10.1016/j.pnpbp.2020.110219
Hale, T., S. Webster, A. Petherick, T. Phillips, and B. Kira (2020) Oxford COVID-19 government response tracker. Blavatnik School of Government, University of Oxford. Available online at
<https://www.bsg.ox.ac.uk/research/research-projects/oxford-covid-19-government-response-tracker>. Accessed on 05.08. 2021.
Holmes, E. A., R. C. O’Connor, V. H. Perry, I. Tracey, S. Wessely, L. Arseneault, C. Ballard, H. Christensen, R. Cohen Silver, I. Everall, T. Ford, A. John, T. Kabir, K. King, I. Madan, S. Michie, A. K. Przybylski, R. Shafran, A. Sweeney, ... and E. Bullmore (2020) “Multi-disciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science”. The Lancet Psychiatry 7, P547-560.
https://doi.org/10.1016/S2215-0366(20)30168-1
Keyes, K. M., M. L. Hatzenbuehler, and D. S. Hasin (2011) “Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors”. Psychopharmacology 218, 1–17.
https://doi.org/10.1007/s00213-011-2236-1
Kilian, C., J. Rehm, P. Allebeck, F. Braddick, A. Gual, M. Barták, K. Bloomfield, A. Gil, M. Neufeld, A. O’Donnell, B. Petruželka, V. Rogalewicz, B. Schulte, J. Manthey, with the European Study Group on Alcohol Use and COVID-19 (2021) “Alcohol consumption during the COVID-19 pandemic in Europe: a large-scale cross-sectional study in 21 countries”. Addiction. Doi:
https://doi.org/10.1111/add.15530
Kousoulis, A., T. Van Bortel, P. Hernandez, and A. John (2020) “The long term mental health impact of COVID-19 must not be ignored”. BMJ Opinion. Available online at
<https://blogs.bmj.com/bmj/2020/05/05/the-long-term-mental-health-impact-of-covid-19-must-not-be-ignored/>. Accesed on 03.05.2021.
Kwong, A. S., R. M. Pearson, M. J. Adams, K. Northstone, K. Tilling, D. Smith, ... and N. J. Timpson (2020) “Mental health during the COVID-19 pandemic in two longitudinal UK population cohorts.” medRxiv.
https://doi.org/10.1101/2020.06.16.20133116
Newby, J. M., K. O’Moore, S. Tang, H. Christensen, and K. Faasse (2020) “Acute mental health responses during the COVID-19 pandemic in Australia”. PloS One 15, e0236562.
https://doi.org/10.1371/journal.pone.0236562
Norman, G. (2010) “Likert scales, levels of measurement and the ‘laws’ of statistics”. Advances in Health Sciences Education 15, 625–632.
https://doi.org/10.1007/s10459-010-9222-y
Oksanen, A., I. Savolainen, N. Savela, and R. Oksa (2020) “Psychological stressors predicting increased drinking during the COVID-19 crisis: a longitudinal national survey study of workers in Finland”. Alcohol and Alcoholism 56, 299-306.
https://doi.org/10.1093/alcalc/agaa124
Ööpik, P., A. Aluoja, R. Kalda, and H. Maaroos (2006) “Screening for depression in primary care”. Family Practice 23, 693–698.
https://doi.org/10.1093/fampra/cml052
Parm, Ü., A. Aluoja, T. Tomingas, and A.-L. Tamm (2021) “Impact of the COVID-19 pandemic on Estonian elite athletes: survey on mental health characteristics, training conditions, competition possibilities, and perception of supportiveness”. International Journal of Environmental Research and Public Health 18, 4317.
https://doi.org/10.3390/ijerph18084317
Pieh, C., S. Budimir, E. Humer, and T. Probst (2021) “Comparing mental health during the COVID-19 lockdown and 6 months after the lockdown in Austria: a longitudinal study”. Frontiers in Psychiatry 12.
https://doi.org/10.3389/fpsyt.2021.625973
Pierce, M., H. Hope, T. Ford, S. Hatch, M. Hotopf, A. John, ... and K. M. Abel (2020) “Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population”. The Lancet Psychiatry 7, 10, 883–892.
https://doi.org/10.1016/S2215-0366(20)30308-4
Robinson, E., A. R. Sutin, M. Daly, and A. Jones (2021) “A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic”. medRxiv.
https://doi.org/10.1101/2021.03.04.21252921
Savolainen, I., R. Oksa, N. Savela, M. Celuch, and A. Oksanen (2021) “COVID-19 anxiety – a longitudinal survey study of psychological and situational risks among Finnish workers”. International Journal of Environmental Research and Public Health 18, 794.
https://doi.org/10.3390/ijerph18020794
Stanton, R., Q. G. To, S. Khalesi, S. L. Williams, S. J. Alley, T. L. Thwaite, A. S. Fenning, and C. Vandelanotte (2020) “Depression, anxiety and stress during COVID-19: associations with changes in physical activity, sleep, tobacco and alcohol use in Australian adults”. International Journal of Environmental Research and Public Health 17, 4065.
https://doi.org/10.3390/ijerph17114065
Twenge, J. M., A. B. Cooper, T. E. Joiner, M. E. Duffy, and S. G. Binau (2019) “Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005-2017”. Journal of Abnormal Psychology 128, 185–199.
https://doi.org/10.1037/abn0000410
Weathers, F. W., B. T. Litz, D. S. Herman, J. A. Huska, and T. M. Keane (1993) “The PTSD checklist (PCL): reliability, validity, and diagnostic utility”. In Proceedings of the Annual Conference of the International Society for Traumatic Stress Studies. San Antonio, Texas.
Wilson, J. M., J. Lee, and N. J. Shook (2020) “COVID-19 worries and mental health: the moderating effect of age”. Aging and Mental Health.
https://doi.org/10.1080/13607863.2020.1856778
World Health Organization (2020) Coronavirus disease 2019 (COVID-19). (Situation Report, 91.) World Health Organization, Geneva. Available online at
<https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports>. Accessed on 05.08.2021.
World Health Organization (2001) AUDIT: the Alcohol Use Disorders Identification Test: guidelines for use in primary health care. Thomas F. Babor et al. 2nd ed. World Health Organization. Available online at
<https://apps.who.int/iris/handle/10665/67205>. Accessed on 05.08.2021.
