summary: The anxiety and depression that occurred as a result of the COVID-19 pandemic appears to be causing a second “midlife crisis” for those 50 and over. Researchers say women have experienced more psychological distress than men during the pandemic, and this may exacerbate and accelerate neurodegeneration, mental health and general health disorders.

source: King’s College London

British adults have experienced the highest levels of poor mental health ever during the COVID-19 pandemic, leading to a second ‘midlife crisis’.

The results also showed that women suffered more than men during the pandemic, which the researchers say may be because women do a greater share of unpaid care work such as housework, homeschooling and care responsibilities.

New research from the Center for Community and Mental Health and the UCL Center for Longitudinal Studies is published today in PLOS medicine.

The researchers analyzed data collected over four decades from more than 16,000 adults, born in 1946, 1958 and 1970, who take part in three British cohort studies of childbirth. Participants’ levels of mental distress were assessed repeatedly over the course of their adult lives, with a series of questions that monitored symptoms of depression and anxiety.

Participants were also surveyed at three points during the first year of the pandemic: in May 2020, September/October 2020, and February/March 2021.

It shows a middle-aged man
Psychological distress is known to peak in middle age, before improving again as people get older. The image is in the public domain

By the fall of 2020, those born between 1958 and 1970 had higher levels of psychological distress, on average, than they ever experienced in adulthood. Those born in 1946 had levels of psychological distress similar to the previous midlife peak in their early fifties.

Psychological distress is known to peak in middle age, before improving again as people get older. This is often referred to as a “midlife crisis” in mental health.

Women have struggled more than men with their mental health across all age groups, widening the already large gender disparities in mental health that existed before the pandemic.

The researchers explained that a second, unexpected midlife mental health crisis may accelerate and exacerbate the onset of chronic mental health problems and other related health difficulties, disproportionately affecting women and putting pressure on the NHS.

We know that anxiety and depression are among the leading causes of disease worldwide. On top of the suffering they cause, mental health issues are closely linked to many physical health issues – right down to increased morbidity.

“The fact that we are seeing a new, unexpected peak of mental health problems that can lead to these long-term pathways is very concerning,” said lead author Dr. Dario Moreno-Agostino of the ESRC Center for Community and Mental Health.

About this research psychology news

author: press office
source: King’s College London
communication: Press Office – King’s College London
picture: The image is in the public domain

Original search: open access.
“Tracks of long-term psychological distress and the COVID-19 epidemic in three British birth cohorts: a multi-cohort study” by Darío Moreno-Agostino et al. PLOS medicine

a summary

Trajectories of long-term psychological distress and the COVID-19 epidemic in three British birth cohorts: a multi-cohort study


Mounting evidence suggests that mental health outcomes for the population have worsened since the pandemic began. The extent to which these changes alter common age-related trends in psychological distress, with stress typically rising until midlife and then declining after midlife in both sexes, is unknown. We aimed to analyze whether pre-epidemic psychological distress pathways were disrupted during the epidemic, and whether these changes differed across cohorts and by sex.

Methods and results

We used data from three nationally representative birth cohorts comprising all persons born in Great Britain in one week of 1946 (National Survey of Health and Development, NSHD), 1958 (National Child Development Study, NCDS), or 1970 (British Cohort Study, BCS70 ). The follow-up data used spanned 39 years in NSHD (1982 to 2021), 40 years in NCDs (1981 to 2001), and 25 years in BCS70 (1996 to 2021). We used factor scores for psychological distress, as measured by self-validated questionnaires (NSHD: Examination of Current Status, Frequency of Psychiatric Symptoms, 28- and 12-item versions of the General Health Questionnaire; NCDS and BCS70: Malaise Inventory; all: 2-item versions of Generalized Anxiety Disorder Scale and Patient Health Questionnaire).

We used a multilevel growth curve modeling approach to model the trajectories of distress across cohorts and genders and obtained estimates of differences between the levels of distress observed during the pandemic and those observed in the most recent pre-pandemic assessment and at the peak in the cohort. – Pre-pandemic specific distress path, located in middle age. We also analyzed whether pre-existing differences and gender changed with the onset of the pandemic using the differences in differences (DiD) approach.

The analytical sample included 16,389 participants. By September/October 2020, severity levels had reached or exceeded peak levels in pre-pandemic life-cycle trajectories, with larger increases in younger cohorts (standardized mean differences [SMD] and 95% confidence intervals of SMDNSHD, pre-peak = −0.02 [−0.07, 0.04]smdNon-communicable diseases, before the peak = 0.05 [0.02, 0.07]and SMDBCS70, before peak = 0.09 [0.07, 0.12] for the 1946, 1958, and 1970 birth cohorts, respectively). Increases in distress were greater among women than among men, widening pre-existing gender inequalities (DiD and 95% confidence intervals of DiDNSHD, gender, pre-peak = 0.17 [0.06, 0.28]an actNon-communicable diseases, sexuality and pre-climax = 0.11 [0.07, 0.16]and he didBCS70, sex, pre-climax = 0.11 [0.05, 0.16] when comparing gender inequality at the pre-pandemic peak in midlife to that observed by September/October 2020).

As expected in group designs, our study suffered from high proportions of attrition with respect to the original samples. Although we used non-response weights to recover sample representation for the target population (those born in the UK in 1946, 1958 and 1970, alive and residing in the UK), the results may not be generalizable to other sections within the UK population ( For example, immigrants and ethnic minorities) and countries different from the UK.


Pre-existing psychological distress pathways for adults born between 1946 and 1970 were disrupted during the COVID-19 pandemic, particularly among women, which have reached the highest levels ever recorded in up to 40 years of follow-up data. This may influence future trends in morbidity, disability and mortality due to common mental health problems.

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