Few studies assessing the effects of COVID-19 on mental health include prospective markers of risk and resilience necessary to understand and mitigate the combined impacts of the pandemic, lockdowns, and other societal responses. This population-based study of young adults includes individuals from the Neuroscience in Psychiatry Network (n = 2403) recruited from English primary care services and schools in 2012-2013 when aged 14-24. Participants were followed up three times thereafter, most recently during the initial outbreak of the COVID-19 outbreak when they were aged between 19 and 34. Repeated measures of psychological distress (K6) and mental wellbeing (SWEMWBS) were supplemented at the latest assessment by clinical measures of depression (PHQ-9) and anxiety (GAD-7). A total of 1000 participants, 42% of the original cohort, returned to take part in the COVID-19 follow-up; 737 completed all four assessments [mean age (SD), 25.6 (3.2) years; 65.4% female; 79.1% White]. Our findings show that the pandemic led to pronounced deviations from existing mental health-related trajectories compared to expected levels over approximately seven years. About three-in-ten young adults reported clinically significant depression (28.8%) or anxiety (27.6%) under current NHS guidelines; two-in-ten met clinical cut-offs for both. About 9% reported levels of psychological distress likely to be associated with serious functional impairments that substantially interfere with major life activities; an increase by 3% compared to pre-pandemic levels. Deviations from personal trajectories were not necessarily restricted to conventional risk factors; however, individuals with pre-existing health conditions suffered disproportionately during the initial outbreak of the COVID-19 pandemic. Resilience factors known to support mental health, particularly in response to adverse events, were at best mildly protective of individual psychological responses to the pandemic. Our findings underline the importance of monitoring the long-term effects of the ongoing pandemic on young adults' mental health, an age group at particular risk for the emergence of psychopathologies. Our findings further suggest that maintaining access to mental health care services during future waves, or potential new pandemics, is particularly crucial for those with pre-existing health conditions. Even though resilience factors known to support mental health were only mildly protective during the initial outbreak of the COVID-19 pandemic, it remains to be seen whether these factors facilitate mental health in the long term.

Cambridgeshire and Peterborough NHS Foundation Trust Cambridge UK

Department of Clinical Psychology Philipps University of Marburg Marburg Germany

Department of Kinanthropology and Humanities Charles University Prague Czechia

Department of Medicine Institute of Biomedical Research University of Salamanca Salamanca Spain

Department of Psychiatry Faculty of Medicine University of Southampton Southampton UK

Department of Psychiatry University of Cambridge Douglas House 18B Trumpington Road Cambridge CB2 8AH UK

Max Planck UCL Centre for Computational Psychiatry and Ageing Research London UK

National Institute for Health Research Applied Research Collaboration East of England Cambridge UK

Norwich Medical School University of East Anglia Norwich UK

Research Department of Clinical Educational and Health Psychology University College London London UK

Southern Health NHS Foundation Trust Southampton UK

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Sci Rep. 2025 Mar 24;15(1):10119. doi: 10.1038/s41598-025-93618-w. PubMed

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Tsamakis, K. et al. COVID-19 and its consequences on mental health (review). Exp. Ther. Med.21, 1–7 (2021). PubMed PMC

Torjesen, I. Covid-19: Mental health services must be boosted to deal with ‘tsunami’ of cases after lockdown. BMJ369, m1994 (2020). PubMed

Pierce, M. et al. Says who? The significance of sampling in mental health surveys during COVID-19. Lancet Psychiatry7, 567–568 (2020). PubMed PMC

Breslau, J. et al. A longitudinal study of psychological distress in the United States before and during the COVID-19 pandemic. Prevent. Med. (Baltim.)143, 106362 (2021). PubMed PMC

Peters, A., Rospleszcz, S., Dallavalle, M. & Berger, K. The impact of the COVID-19 pandemic on self-reported health. Dtsch. Arztebl. Int.117, 861–867 (2020). PubMed PMC

Pierce, M. et al. Mental health before and during the COVID-19 pandemic: A longitudinal probability sample survey of the UK population. Lancet Psychiatry7, 883–892 (2020). PubMed PMC

Ramiz, L. et al. A longitudinal study of mental health before and during COVID-19 lockdown in the French population. Glob. Health17, 29 (2021). PubMed PMC

Rimfeld, K. et al. Genetic correlates of psychological responses to the COVID-19 crisis in young adult twins in Great Britain. Behav. Genet.51, 110–124 (2021). PubMed PMC

van der Velden, P. G., Contino, C., Das, M., Loon, P. V. & Bosmans, M. W. G. Anxiety and depression symptoms, and lack of emotional support among the general population before and during the COVID-19 pandemic: A prospective national study on prevalence and risk factors. J. Affect. Disord.277, 540–548 (2020). PubMed PMC

Daly, M. & Robinson, E. Longitudinal changes in psychological distress in the UK from 2019 to September 2020 during the COVID-19 pandemic: Evidence from a large nationally representative study. Psychiatry Res.300, 113920 (2021). PubMed PMC

Emery, R. L. et al. Understanding the impact of the COVID-19 pandemic on stress, mood, and substance use among young adults in the greater Minneapolis-St. Paul area: Findings from project EAT. Soc. Sci. Med.276, 113826 (2021). PubMed PMC

Essau, C. A. & de la Torre-Luque, A. Adolescent psychopathological profiles and the outcome of the COVID-19 pandemic: Longitudinal findings from the UK Millennium Cohort Study. Prog. Neuropsychopharmacol. Biol. Psychiatry110, 110330 (2021). PubMed PMC

Pan, K.-Y.Y. et al. The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: A longitudinal study of three Dutch case-control cohorts. Lancet Psychiatry8, 121–129 (2021). PubMed PMC

Warne, N. et al. Disordered eating and self-harm as risk factors for poorer mental health during the COVID-19 pandemic: A population-based cohort study. medRxiv10.1101/2021.04.30.21256377 (2021). PubMed PMC

De France, K., Hancock, G. R., Stack, D. M., Serbin, L. A. & Hollenstein, T. The mental health implications of COVID-19 for adolescents: Follow-up of a four-wave longitudinal study during the pandemic. Am. Psychol.10.1037/amp0000838 (2021). PubMed

Hussong, A. M., Midgette, A. J., Thomas, T. E., Coffman, J. L. & Cho, S. Coping and mental health in early adolescence during COVID-19. Res. Child Adolesc. Psychopathol.49, 1113–1123 (2021). PubMed PMC

Porter, C. et al. Impact of the COVID-19 pandemic on anxiety and depression symptoms of young people in the global south: Evidence from a four-country cohort study. BMJ Open11, 1–14 (2021). PubMed PMC

Shanahan, L. et al. Emotional distress in young adults during the COVID-19 pandemic: Evidence of risk and resilience from a longitudinal cohort study. Psychol. Med.10.1017/S003329172000241X (2020). PubMed PMC

Von Elm, E. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Bull. World Health Organ.85, 867–872 (2007). PubMed PMC

Kiddle, B. et al. Cohort profile: The NSPN 2400 Cohort: A developmental sample supporting the Wellcome Trust Neuro Science in Psychiatry Network. Int. J. Epidemiol.47, 18–19g (2018). PubMed PMC

Kessler, R. C. et al. Screening for serious mental illness in the general population. Arch. Gen. Psychiatry60, 184–189 (2003). PubMed

Kessler, R. C. et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol. Med.32, 959–976 (2002). PubMed

Stewart-Brown, S. et al. Internal construct validity of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS): A Rasch analysis using data from the Scottish Health Education Population Survey. Health Qual. Life Outcomes7, 1–8 (2009). PubMed PMC

Mewton, L. et al. The psychometric properties of the Kessler Psychological Distress Scale (K6) in a general population sample of adolescents. Psychol. Assess.28, 1232–1242 (2016). PubMed

Bessaha, M. L. Factor structure of the Kessler Psychological Distress Scale (K6) among emerging adults. Res. Soc. Work Pract.27, 616–624 (2017).

Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M. & Kessler, R. C. Improving the K6 short scale to predict serious emotional disturbance in adolescents in the USA. Int. J. Methods Psychiatr. Res.19(Suppl 1), 23–35 (2010). PubMed PMC

Tomitaka, S. et al. Distribution of psychological distress is stable in recent decades and follows an exponential pattern in the US population. Sci. Rep.9, 1–10 (2019). PubMed PMC

U.S. Department of Health and Human Services. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. HHS Publication No. PEP21-07-01-003 2021.https://www.nimh.nih.gov/health/statistics/mental-illness (2021).

Ng Fat, L. et al. Evaluating and establishing national norms for mental wellbeing using the short Warwick—Edinburgh Mental Well-being Scale (SWEMWBS): Findings from the Health Survey for England. Qual. Life Res.26, 1129–1144 (2017). PubMed PMC

Melendez-Torres, G. J. et al. Measurement invariance properties and external construct validity of the short Warwick-Edinburgh mental wellbeing scale in a large national sample of secondary school students in Wales. Health Qual. Life Outcomes17, 1–3 (2019). PubMed PMC

Kroenke, K., Spitzer, R. L. & Williams, J. B. W. The PHQ-9: Validity of a brief depression severity measure. J. Gen. Intern. Med.16, 606–613 (2001). PubMed PMC

Spitzer, R. L., Kroenke, K., Williams, J. B. W. & Löwe, B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch. Intern. Med.166, 1092–1097 (2006). PubMed

National Collaborating Centre for Mental Health. The Improving Access to Psychological Therapies Manual. https://www.england.nhs.uk/wp-content/uploads/2018/06/the-iapt-manual.pdf (2021).

Fritz, J., de Graaff, A. M., Caisley, H., van Harmelen, A.-L. & Wilkinson, P. O. A systematic review of amenable resilience factors that moderate and/or mediate the relationship between childhood adversity and mental health in young people. Front. Psychiatry9, 230 (2018). PubMed PMC

Fritz, J. et al. A network model of resilience factors for adolescents with and without exposure to childhood adversity. Front. Psychiatry9, 1–13 (2018). PubMed PMC

Fritz, J. et al. Unravelling the complex nature of resilience factors and their changes between early and later adolescence. BMC Med.17, 1–16 (2019). PubMed PMC

Fritz, J., Stochl, J., Goodyer, I. M., van Harmelen, A. L. & Wilkinson, P. O. Embracing the positive: An examination of how well resilience factors at age 14 can predict distress at age 17. Transl. Psychiatry10, 1–14 (2020). PubMed PMC

Rosenberg, M. Self esteem and the adolescent. Science (80-)148, 804 (1965).

Goodyer, I. M. et al. Improving mood with psychoanalytic and cognitive therapies (IMPACT): A pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depr. Trials12, 175 (2011). PubMed PMC

Poythress, N. G. et al. Internal consistency reliability of the self-report antisocial process screening device. Assessment13, 107–113 (2006). PubMed

Bamber, D., Tamplin, A., Park, R. J., Kyte, Z. A. & Goodyer, I. M. Development of a short Leyton obsessional inventory for children and adolescents. J. Am. Acad. Child Adolesc. Psychiatry41, 1246–1252 (2002). PubMed

Frick, P. J., Christian, R. E. & Wootton, J. M. Age trends in the association between parenting practices and conduct problems. Behav. Modif.23, 106–128 (1999).

Epstein, N. B., Baldwin, L. M. & Bishop, D. S. The McMaster family assessment device. J. Marital Fam. Ther.9, 171–180 (1983).

Goodyer, I. M., Wright, C. & Altham, P. M. Recent friendships in anxious and depressed school age children. Psychol. Med.19, 165–174 (1989). PubMed

Holm, S. A simple sequentially rejective multiple test procedure. Scand. J. Stat.6, 65–70 (1979).

Epskamp, S. & Fried, E. I. A tutorial on regularized partial correlation networks. Psychol. Methods23, 617–634 (2018). PubMed

Harris, P. A. et al. The REDCap consortium: Building an international community of software platform partners. J. Biomed. Inform.95, 103208 (2019). PubMed PMC

Harris, P. A. et al. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J. Biomed. Inform.42, 377–381 (2009). PubMed PMC

R Core Team. R: A Language and Environment for Statistical Computing. (2021).

Muthén, L. K. & Muthén, B. O. Mplus User’s Guide. (2017).

Dion, J. et al. A prospective study of the impact of child maltreatment and friend support on psychological distress trajectory: From adolescence to emerging adulthood. J. Affect. Disord.189, 336–343 (2016). PubMed

Kwong, A. S. F. et al. Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts. Br. J. Psychiatry10.1192/bjp.2020.242 (2020). PubMed PMC

Remes, O., Brayne, C., van der Linde, R. & Lafortune, L. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain Behav.6, e00497 (2016). PubMed PMC

Mojtabai, R., Olfson, M. & Han, B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics138, 6 (2016). PubMed PMC

Niedzwiedz, C. L. et al. Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: Longitudinal analyses of the UK Household Longitudinal Study. J. Epidemiol. Commun. Health10.1136/jech-2020-215060 (2020). PubMed PMC

Fancourt, D., Steptoe, A. & Bu, F. Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: A longitudinal observational study. Lancet Psychiatry0366, 1–9 (2020). PubMed PMC

Crocker, J. The costs of seeking self-esteem. J. Soc. Issues58, 597–615 (2007).

Tetreault, E. et al. Perceived changes in mood and anxiety among male youth during the Covid-19 pandemic: Findings from a mixed-methods study. J. Adolesc. Heal.10.1016/j.jadohealth.2021.05.004 (2021). PubMed PMC

Fritz, J., Fried, E. I., Goodyer, I. M., Wilkinson, P. O. & van Harmelen, A. L. A network model of resilience factors for adolescents with and without exposure to childhood adversity. Sci. Rep.8, 1–13 (2018). PubMed PMC

Boyd, A. et al. Cohort profile: The ‘Children of the 90s’—The index offspring of the Avon Longitudinal Study of Parents and Children. Int. J. Epidemiol.42, 111–127 (2013). PubMed PMC